Cognitive-behavioral stress management intervention decreases the prevalence of depression and enhances benefit finding among women under treatment for early-stage breast cancer.

The authors tested effects of a 10-week group cognitive-behavioral stress management intervention among 100 women newly treated for Stage 0-II breast cancer. The intervention reduced prevalence of moderate depression (which remained relatively stable in the control condition) but did not affect other measures of emotional distress. The intervention also increased participants' reports that having breast cancer had made positive contributions to their lives, and it increased generalized optimism. Both remained significantly elevated at a 3-month follow-up of the intervention. Further analysis revealed that the intervention had its greatest impact on these 2 variables among women who were lowest in optimism at baseline. Discussion centers on the importance of examining positive responses to traumatic events--growth, appreciation of life, shift in priorities, and positive affect-as well as negative responses.

Factors predicting the use of complementary therapies in a multi-ethnic sample of early-stage breast cancer patients.

OBJECTIVES: to examine predictors of use of complementary therapies reported by women who had also received standard medical treatment for early-stage breast cancer. METHODS: A volunteer sample of 231 black, Hispanic, and non-Hispanic white patients with early-stage breast cancer (diagnosed within the preceding year) reported their use of complementary therapies. We examined predictors of the use of each therapy from among a set of demographic and quality of life measures. RESULTS: Most women reported using 1 complementary therapy or more, most commonly psychotherapy, support groups, meditation, and spiritual healing. Use of psychotherapy related to age, education, and elevated distress. Use of other complementary therapies was not related to distress. More black than Hispanic or non-Hispanic white patients used herbal therapies and spiritual healing. Use of complementary therapies did not relate to expectation of recurrence, dissatisfaction with medical care, or (among relevant patients) concerns about the consequences of chemotherapy. CONCLUSIONS: Use of healing therapies that do not replace medical treatment should be viewed as attempts to increase potential benefit and not as signs of distress or dissatisfaction. Use of complementary therapies also varies across racial and ethnic groups.

Cognitive-behavioral stress management reduces serum cortisol by enhancing benefit finding among women being treated for early stage breast cancer.

OBJECTIVE: This study examined the effects of a cognitive-behavioral stress management (CBSM) group intervention on serum cortisol levels in women being treated for stage I or II breast cancer. METHODS: Participants were randomly assigned to undergo a 10-week intervention (N = 24) within 8 weeks after surgery or were placed on a waiting list (N = 10). Cortisol was assessed by means of a radioimmunoassay of blood samples collected at the same time of day just before the start of the intervention and immediately after its completion. The women also reported the degree to which breast cancer had made positive contributions to their lives. RESULTS: Intervention participants showed increased benefit finding and reduced serum cortisol levels, whereas control subjects experienced neither change. Path analysis suggested that the effect of CBSM on cortisol was mediated by increases in benefit finding. CONCLUSIONS: These findings suggest that positive growth enhanced during a time-limited intervention can influence physiological parameters such as cortisol among women with early stage breast cancer.