Do cancer curvivors and metavivors have distinct needs for stress management intervention? Retrospective analysis of a mind-body survivorship program.

PURPOSE: Cancer "curvivors" (completed initial curative intent treatment with surgery, radiation, chemotherapy, and/or other novel therapies) and "metavivors" (living with metastatic or chronic, incurable cancer) experience unique stressors, but it remains unknown whether these differences impact benefits from mind-body interventions. This study explored differences between curvivors and metavivors in distress (depression, anxiety, worry) and resiliency changes over the course of an 8-week group program, based in mind-body stress reduction, cognitive-behavioral therapy (CBT), and positive psychology. METHODS: From 2017-2021, 192 cancer survivors (83% curvivors; 17% metavivors) completed optional online surveys of resiliency (CES) and distress (PHQ-8, GAD-7, PSWQ-3) pre- and post- participation in an established clinical program. Mixed effect regression models explored curvivor-metavivor differences at baseline and in pre-post change. RESULTS: Compared to curvivors, metavivors began the program with significantly more resilient health behaviors (B = 0.99, 95% CI[0.12, 1.86], p = .03) and less depression (B = -2.42, 95%CI[-4.73, -0.12], p = .04), with no other significant differences. Curvivors experienced significantly greater reductions in depression (curvivor-metavivor difference in strength of change = 2.12, 95% CI [0.39, 3.83], p = .02) over the course of the program, with no other significant differences. Neither virtual delivery modality nor proportion of sessions attended significantly moderated strength of resiliency or distress change. CONCLUSION: Metavivors entering this mind-body program had relatively higher well-being than did curvivors, and both groups experienced statistically comparable change in all domains other than depression. Resiliency programming may thus benefit a variety of cancer survivors, including those living with incurable cancer.

Testing psychosocial mediators of a mind-body resiliency intervention for cancer survivors.

PURPOSE: Group-based mind-body interventions such as the Stress Management and Resiliency Training-Relaxation Response Resiliency Program (SMART-3RP) hold promise for enhancing resiliency among cancer survivors. Mechanisms underlying improvements in psychological outcomes are theoretically established but remain unexamined empirically. METHODS: Adult cancer survivors (n = 105) participating in the SMART-3RP completed surveys of resiliency and five hypothesized mediators: coping (ability to relax physical tension and assertive social support-seeking), mindfulness, positive affect, and worry. Pre-post intervention changes were assessed using repeated-measures t-tests. Bivariate correlations between change scores and a more conservative within-person parallel mediation model tested covariance between resiliency and mediators. RESULTS: Participants experienced moderate to large improvements in all patient-reported outcomes (ds = 1.01-0.46). Increased resiliency was significantly associated with increases in mindfulness, positive affect, and assertive social support-seeking (rs = 0.36-0.50); smaller associations with increased relaxation and decreased worry were not significant. Mindfulness and positive affect explained the largest proportion of variance in resiliency increase in the full multivariate model. CONCLUSIONS: Cancer survivors completing the SMART-3RP had increased resiliency, which was associated with improvements in mindfulness, positive affect, and the ability to assertively seek social support. Enhancing mindfulness and positive affect were critical components for enhancing resiliency. Implications for resiliency interventions with cancer survivors are discussed.

The Role of the Mirror System in Influencing Musicians' Evaluation of Musical Creativity: A tDCS Study.

Evidence reported in the literature suggests that the mirror system not only plays a role in recognizing motor action but also fosters a better understanding of other people because it helps an individual assume another's perspective. This led to the idea, supported by research findings, that people with higher empathy scores should show higher activation of the mirror system. Recently, it has been hypothesized that a purely auditory mirror system exists. In this study, we aimed to explore the possibility that this system might play a particular role for musicians. Specifically, this system would impact their response to a new piece of music by using non-invasive brain stimulation to modulate the activation of the mirror system. A sample of 40 young musicians was involved in this study. Half of the participants were randomly assigned to a cathodal stimulation condition, while the other half was used as a control. After listening to a new piece of music, participants were asked to rate the creativity of the piece (by focusing on how interesting, innovative, and exciting the piece was) as well as their general emotional response to it. Their empathy levels were also assessed using the Interpersonal Reactivity Index (IRI). Results showed that the cathodal stimulation of the mirror system negatively affected both the perception of creativity (level of innovation) and the emotional response to the music. There was no significant difference in the ratings of how interesting the piece was perceived. The effect was mediated by the individuals' level of empathy. Specifically, empathic concern and fantasy dimensions increased the evaluation of creativity. Results also showed that participants reported less emotion with a negative valence in the cathodal stimulation condition.