2007 Final Program - Society of Behavioral Medicine

2007 SBM Annual Meeting & Scientific Sessions March 21-24, 2007 FINAL PROGRAM
Rapid Communications Posters Friday, March 23, 2007 • 6:30 PM-8:00 PM • Poster Session C
status (Karnofsky Performance Status, KPS), signs/symptoms of
treatment toxicities (Sym/S), patient ratings of fatigue (Fatigue
Severity Index) and quality of life disruption due to physical
symptoms (PCS; MOS SF-36). In addition to baseline physical
status, predictors were hopelessness (Beck Hopelessness Scale)
and social support (Perceived Social Support-Family & Friends).
RESULTS: Using hierarchical multiple regression, hopelessness
predicted poorer physical status at both 4- (β = -.34, p < .01)
and 10-months (β = -.30, p < .05), whereas social support did
not. Follow-up regressions clarified that hopelessness predicted
fatigue at 4- (β = .28) and 10-months (β = .48, ps < .05), KPS
(β = -.40) and Sym/S (β =.36, ps < .01) at 4-months, and PCS at
10-months (β = -.29, p < .05). CONCLUSIONS: These results
show that hopelessness in response to recurrence can be especially
burdensome. In this example, it related to poorer physical status
months later, which included ratings of performance status and
signs and symptoms of treatment toxicities as assessed by a nurse,
and not the participant. This effect was not lessened by concurrent
social support from family and friends.
CORRESPONDING AUTHOR: Namrata Ahuja, BS in progress,
Department of Psychology, The Ohio State University, Columbus,
OH, 43202; ahuja.16@osu.edu
3463
PERCEIVED ABILITY TO RELAX MEDIATES
INTERVENTION-RELATED CHANGE IN EVENING
CORTISOL AMONG BREAST CANCER PATIENTS
Kristin M. Phillips, MS, Suzanne C. Lechner, PhD, Charles S.
Carver, PhD, Bonnie Blomberg, PhD and Michael H. Antoni, PhD
University of Miami, Coral Gables, FL.
Previous work demonstrated that a Cognitive-Behavioral Stress
Management (CBSM) intervention reduced evening serum cortisol
over 10-weeks among breast cancer (BRCA) patients. The present
study used sophisticated analyses to examine change over a longer
period of time in evening serum cortisol levels in a larger sample.
We hypothesized CBSM would decrease cortisol levels at 6 & 12
month follow-up and self-perceived ability to relax might mediate
intervention effects on cortisol reduction. One hundred eighteen
women (age M= 49.4,SD=7.68) were recruited 4-8 weeks postsurgery
for non-metastatic breast cancer (Stage 0=21, I=49 II=44,
III=4) and had not begun chemotherapy at entry. They were
randomized to a 10-week CBSM group intervention (n=58) or oneday
seminar (n=60) and were assessed at study entry (T1) & 6 (T2)
& 12 (T3) month follow-up. Perceived ability to relax was measured
using the Measure of Current Status (MOCSrelax).
Using latent growth-curve modeling (intent-to-treat) and
controlling for chemotherapy, we tested whether CBSM was related
to ability to relax. The model fit the data (χ2(1)=0.034,p=0.8544).
Condition related significantly to slope of MOCSrelax (z=2.400),
indicating differential change over time; there were significant
differences between groups at T2 (z=1.974) & T3 (z=2.522): those
receiving CBSM had greater perceived ability to relax than controls.
Next we tested whether the intervention predicted decreases in
cortisol. The model fit the data (χ2(2)=0.773,p=0.6779). Condition
related significantly to slope of cortisol change (z=-2.133): women
receiving CBSM showed reduced evening cortisol levels over time,
whereas those in the control group had no appreciable decline
~ 119 ~
in cortisol. When the MOCSrelax path was added to the model
(χ2(11)= 14.051, p=0.3702), the direct effect of condition on
cortisol was no longer significant, indicating successful mediation.
Thus, perceived ability to relax was one explanation for the CBSMrelated
reductions in evening cortisol among women being treated
for breast cancer.
CORRESPONDING AUTHOR: Kristin M. Phillips, MS,
University of Miami, Coral Gables, FL, 33146; kphillips@miami.edu
3464
RELATIONSHIPS OF EXERCISE AND SURVIVAL TIME
TO MENTAL HEALTH AND BODY ESTEEM OF CANCER
SURVIVORS
Christina Wagner, PhD 1 and Silvia Bigatti, PhD 2
1
Behavioral Sciences, Rush University Medical Center, Chicago, IL
and 2 Psychology, IUPUI, Indianapolis, IN.
Mood and body image may be disturbed following breast
cancer treatment and exercise may ameliorate these symptoms.
Unfortunately, long-term survivors have received less research
attention than women soon after diagnosis, and the long-term
consequences of treatment on body image, mental health and health
behavior remain unclear. The present study assessed anxiety and
depression (POMS-SF-36), satisfaction with body appearance and
function (Body Esteem Scale) and exercise (Godin Leisure Time
Index) of 95 breast cancer survivors who completed mail-based
surveys to elucidate the impact of exercise, survival time, and their
interaction on mental health. Survival time ranged from 1 to 37
years with a median of 5 years and mean of 6.5 years (SD = 5.5).
An ANCOVA and MANCOVA, controlling age and hormone
therapy, revealed short-term survivors exercised significantly more,
but long-term survivors reported greater satisfaction with body
appearance and function. Regressions for each dependent variable
examined exercise and survival time in the first step followed by
their interaction in the second. The models for body function,
body appearance, and tension-anxiety were significant explaining
13%, 8%, and 9% of variance. Exercise entered the equation for
body function and tension-anxiety, while survival entered the
regression equation for tension-anxiety only. While the model for
body appearance was significant, individual predictors did not
reach significance. The interaction of exercise and survival time did
not account for additional variance. These findings indicate breast
cancer survivors who exercise more report higher satisfaction with
their body function and less tension-anxiety, and increased survival
time is associated with decreased tension-anxiety. Importantly,
exercise seems to impact survivor’s body image and mood regardless
of time since diagnosis.
CORRESPONDING AUTHOR: Christina Wagner, PhD,
Behavioral Sciences, Rush Medical Center, Chicago, IL,
Chrisitna_D_Wagner@rush.edu