Long-term psychological benefits of cognitive-behavioral stress management for women with breast cancer: 11-year follow-up of a randomized controlled trial

Jamie M. Stagl, Laura C. Bouchard, Suzanne C Lechner, Bonnie B Blomberg, Lisa M. Gudenkauf, Devika R. Jutagir, Stefan Glück, Robert P. Derhagopian, Charles S Carver, Michael H Antoni

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

BACKGROUND Breast cancer survivors experience long-term physical and psychological sequelae after their primary treatment that negatively influence their quality of life (QOL) and increase depressive symptoms. Group-based cognitive-behavioral stress management (CBSM) delivered after surgery for early-stage breast cancer was previously associated with better QOL over a 12-month follow-up and with fewer depressive symptoms up to 5 years after study enrollment. This 8- to 15-year follow-up (median, 11 years) of a previously conducted trial (NCT01422551) evaluated whether women in this cohort receiving CBSM had fewer depressive symptoms and better QOL than controls at an 8- to 15-year follow-up. METHODS Women with stage 0 to IIIb breast cancer were initially recruited 2 to 10 weeks after surgery and randomized to a 10-week CBSM intervention or a 1-day psychoeducational control group. One hundred women (51 CBSM patients and 49 controls) were recontacted 8 to 15 years after study enrollment to participate in a follow-up assessment. The Center for Epidemiologic Studies-Depression (CES-D) scale and the Functional Assessment of Cancer Therapy-Breast (FACT-B) were self-administered. Multiple regression was employed to evaluate group differences on the CES-D scale and FACT-B over and above effects of confounding variables. RESULTS Participants assigned to CBSM reported significantly lower depressive symptoms (d, 0.63; 95% confidence interval [CI], 0.56-0.70) and better QOL (d, 0.58; 95% CI, 0.52-0.65) above the effects of the covariates. CONCLUSIONS Women who received CBSM after surgery for early-stage breast cancer reported lower depressive symptoms and better QOL than the control group up to 15 years later. Early implementation of cognitive-behavioral interventions may influence long-term psychosocial functioning in breast cancer survivors.

Original languageEnglish (US)
Pages (from-to)1873-1881
Number of pages9
JournalCancer
Volume121
Issue number11
DOIs
StatePublished - Jun 1 2015

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Randomized Controlled Trials
Depression
Breast Neoplasms
Psychology
Quality of Life
Quality Control
Survivors
Epidemiologic Studies
Confidence Intervals
Control Groups
Confounding Factors (Epidemiology)
Therapeutics

Keywords

  • breast neoplasms
  • cognitive therapy
  • depression
  • follow-up studies
  • psychological stress
  • quality of life
  • relaxation therapy
  • survivors

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Long-term psychological benefits of cognitive-behavioral stress management for women with breast cancer : 11-year follow-up of a randomized controlled trial. / Stagl, Jamie M.; Bouchard, Laura C.; Lechner, Suzanne C; Blomberg, Bonnie B; Gudenkauf, Lisa M.; Jutagir, Devika R.; Glück, Stefan; Derhagopian, Robert P.; Carver, Charles S; Antoni, Michael H.

In: Cancer, Vol. 121, No. 11, 01.06.2015, p. 1873-1881.

Research output: Contribution to journalArticle

Stagl, Jamie M. ; Bouchard, Laura C. ; Lechner, Suzanne C ; Blomberg, Bonnie B ; Gudenkauf, Lisa M. ; Jutagir, Devika R. ; Glück, Stefan ; Derhagopian, Robert P. ; Carver, Charles S ; Antoni, Michael H. / Long-term psychological benefits of cognitive-behavioral stress management for women with breast cancer : 11-year follow-up of a randomized controlled trial. In: Cancer. 2015 ; Vol. 121, No. 11. pp. 1873-1881.
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title = "Long-term psychological benefits of cognitive-behavioral stress management for women with breast cancer: 11-year follow-up of a randomized controlled trial",
abstract = "BACKGROUND Breast cancer survivors experience long-term physical and psychological sequelae after their primary treatment that negatively influence their quality of life (QOL) and increase depressive symptoms. Group-based cognitive-behavioral stress management (CBSM) delivered after surgery for early-stage breast cancer was previously associated with better QOL over a 12-month follow-up and with fewer depressive symptoms up to 5 years after study enrollment. This 8- to 15-year follow-up (median, 11 years) of a previously conducted trial (NCT01422551) evaluated whether women in this cohort receiving CBSM had fewer depressive symptoms and better QOL than controls at an 8- to 15-year follow-up. METHODS Women with stage 0 to IIIb breast cancer were initially recruited 2 to 10 weeks after surgery and randomized to a 10-week CBSM intervention or a 1-day psychoeducational control group. One hundred women (51 CBSM patients and 49 controls) were recontacted 8 to 15 years after study enrollment to participate in a follow-up assessment. The Center for Epidemiologic Studies-Depression (CES-D) scale and the Functional Assessment of Cancer Therapy-Breast (FACT-B) were self-administered. Multiple regression was employed to evaluate group differences on the CES-D scale and FACT-B over and above effects of confounding variables. RESULTS Participants assigned to CBSM reported significantly lower depressive symptoms (d, 0.63; 95{\%} confidence interval [CI], 0.56-0.70) and better QOL (d, 0.58; 95{\%} CI, 0.52-0.65) above the effects of the covariates. CONCLUSIONS Women who received CBSM after surgery for early-stage breast cancer reported lower depressive symptoms and better QOL than the control group up to 15 years later. Early implementation of cognitive-behavioral interventions may influence long-term psychosocial functioning in breast cancer survivors.",
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author = "Stagl, {Jamie M.} and Bouchard, {Laura C.} and Lechner, {Suzanne C} and Blomberg, {Bonnie B} and Gudenkauf, {Lisa M.} and Jutagir, {Devika R.} and Stefan Gl{\"u}ck and Derhagopian, {Robert P.} and Carver, {Charles S} and Antoni, {Michael H}",
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T2 - 11-year follow-up of a randomized controlled trial

AU - Stagl, Jamie M.

AU - Bouchard, Laura C.

AU - Lechner, Suzanne C

AU - Blomberg, Bonnie B

AU - Gudenkauf, Lisa M.

AU - Jutagir, Devika R.

AU - Glück, Stefan

AU - Derhagopian, Robert P.

AU - Carver, Charles S

AU - Antoni, Michael H

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N2 - BACKGROUND Breast cancer survivors experience long-term physical and psychological sequelae after their primary treatment that negatively influence their quality of life (QOL) and increase depressive symptoms. Group-based cognitive-behavioral stress management (CBSM) delivered after surgery for early-stage breast cancer was previously associated with better QOL over a 12-month follow-up and with fewer depressive symptoms up to 5 years after study enrollment. This 8- to 15-year follow-up (median, 11 years) of a previously conducted trial (NCT01422551) evaluated whether women in this cohort receiving CBSM had fewer depressive symptoms and better QOL than controls at an 8- to 15-year follow-up. METHODS Women with stage 0 to IIIb breast cancer were initially recruited 2 to 10 weeks after surgery and randomized to a 10-week CBSM intervention or a 1-day psychoeducational control group. One hundred women (51 CBSM patients and 49 controls) were recontacted 8 to 15 years after study enrollment to participate in a follow-up assessment. The Center for Epidemiologic Studies-Depression (CES-D) scale and the Functional Assessment of Cancer Therapy-Breast (FACT-B) were self-administered. Multiple regression was employed to evaluate group differences on the CES-D scale and FACT-B over and above effects of confounding variables. RESULTS Participants assigned to CBSM reported significantly lower depressive symptoms (d, 0.63; 95% confidence interval [CI], 0.56-0.70) and better QOL (d, 0.58; 95% CI, 0.52-0.65) above the effects of the covariates. CONCLUSIONS Women who received CBSM after surgery for early-stage breast cancer reported lower depressive symptoms and better QOL than the control group up to 15 years later. Early implementation of cognitive-behavioral interventions may influence long-term psychosocial functioning in breast cancer survivors.

AB - BACKGROUND Breast cancer survivors experience long-term physical and psychological sequelae after their primary treatment that negatively influence their quality of life (QOL) and increase depressive symptoms. Group-based cognitive-behavioral stress management (CBSM) delivered after surgery for early-stage breast cancer was previously associated with better QOL over a 12-month follow-up and with fewer depressive symptoms up to 5 years after study enrollment. This 8- to 15-year follow-up (median, 11 years) of a previously conducted trial (NCT01422551) evaluated whether women in this cohort receiving CBSM had fewer depressive symptoms and better QOL than controls at an 8- to 15-year follow-up. METHODS Women with stage 0 to IIIb breast cancer were initially recruited 2 to 10 weeks after surgery and randomized to a 10-week CBSM intervention or a 1-day psychoeducational control group. One hundred women (51 CBSM patients and 49 controls) were recontacted 8 to 15 years after study enrollment to participate in a follow-up assessment. The Center for Epidemiologic Studies-Depression (CES-D) scale and the Functional Assessment of Cancer Therapy-Breast (FACT-B) were self-administered. Multiple regression was employed to evaluate group differences on the CES-D scale and FACT-B over and above effects of confounding variables. RESULTS Participants assigned to CBSM reported significantly lower depressive symptoms (d, 0.63; 95% confidence interval [CI], 0.56-0.70) and better QOL (d, 0.58; 95% CI, 0.52-0.65) above the effects of the covariates. CONCLUSIONS Women who received CBSM after surgery for early-stage breast cancer reported lower depressive symptoms and better QOL than the control group up to 15 years later. Early implementation of cognitive-behavioral interventions may influence long-term psychosocial functioning in breast cancer survivors.

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