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Aizpurua-Perez I, Arregi A, Gonzalez D, Urruticoechea A, Labaka A, Minguez-Alcaide X, Ugartemendia G, Pascual-Sagastizabal E, Echeverria R, Perez-Tejada J. A randomized controlled trial of the effectiveness of a one-to-one peer support intervention on resilience, social support, and salivary cortisol in recently diagnosed women with breast cancer. Eur J Oncol Nurs 2024; 71:102616. [PMID: 38885598 DOI: 10.1016/j.ejon.2024.102616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 05/11/2024] [Accepted: 05/18/2024] [Indexed: 06/20/2024]
Abstract
PURPOSE Peer support has been suggested as a way to help women diagnosed with breast cancer to better cope with their situation, but studies on its effectiveness have conflicting results. This randomized controlled trial aimed to study the effectiveness of a one-to-one peer support intervention on psychological resilience, social support, and salivary cortisol among breast cancer patients. METHODS The sample consisted of 121 newly diagnosed women at Onkologikoa Hospital. Patients who were prescribed chemotherapy were randomly assigned to Intervention Group 1 (IG1) or Control Group 1 (CG1). Similarly, those prescribed adjuvant radiotherapy were assigned to IG2 or CG2. Women in IG1 received 8 biweekly social support sessions from volunteer survivors who had successfully overcome breast cancer, while IG2 received 6 biweekly sessions. CG1 and CG2 only received standard care. Resilience, social support, and salivary cortisol were assessed at baseline (T1) and at the end of the intervention (T2). RESULTS We found a non-significant, yet a small to moderate size increase in resilience from T1 to T2 in IG1 (p = 0.246; dDc = 0.47). Upon regression analysis, we observed that this increase was determined by changes in cortisol (β = -0.658, p = 00.010), affective support (β = -0.997, p = 00.014), and emotional support (β = 0.935, p = 00.008). We also found a significant decrease in resilience levels in CG2 from T1 to T2 (p = 0.003; dDc = 0.88). CONCLUSION The present study suggests that peer support can exert a protective psychological influence on women diagnosed with breast cancer, and further indicates an exciting avenue for future intervention development in the breast cancer care continuum. TRIAL REGISTRATION ClinicalTrials.gov NCT05077371.
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Affiliation(s)
- Ibane Aizpurua-Perez
- Department of Basic Psychological Processes and Their Development, University of the Basque Country, San Sebastian, Spain.
| | - Amaia Arregi
- Department of Basic Psychological Processes and Their Development, University of the Basque Country, San Sebastian, Spain.
| | | | | | - Ainitze Labaka
- Department of Nursing II, University of the Basque Country, San Sebastian, Spain.
| | - Xavier Minguez-Alcaide
- Department of Social Psychology, University of the Basque Country, San Sebastian, Spain.
| | | | - Eider Pascual-Sagastizabal
- Department of Basic Psychological Processes and Their Development, University of the Basque Country, San Sebastian, Spain.
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Aizpurua-Perez I, Arregi A, Gonzalez D, Macia P, Ugartemendia G, Labaka A, Zabalza N, Perez-Tejada J. Resilience in Newly Diagnosed Breast Cancer Women: The Predictive Role of Diurnal Cortisol and Social Support. Biol Res Nurs 2024; 26:68-77. [PMID: 37477294 DOI: 10.1177/10998004231190074] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
BACKGROUND Breast cancer is currently the most prevalent malignancy among women. Psychological resilience is an important factor that diminishes the stress-related emotional and psychosocial disturbances triggered when receiving the diagnosis. Furthermore, resilience appears to be associated with cortisol, the hormonal end-product of the hypothalamic-pituitary-adrenal axis; however, further studies are needed due to the mixed results reported. Thus, we aim to examine the predictive role of social support and cortisol in resilience among breast cancer patients. METHODS A total of 132 women with primary breast cancer completed the Medical Outcomes Study-Social Support Survey (MOS-SSS) and the Resilience Scale (RS-14) and provided four salivary samples for the estimation of participants' total daily cortisol production, for which the formula of the area under the curve with respect to the ground (AUCg) was applied. Moderation analyses were performed to study the influence of social support and AUCg on psychological resilience levels. RESULTS The regression analyses showed a direct significant effect for the emotional support subscale of MOS-SSS on resilience and the interaction between emotional support and AUCg was also found to be statistically significant. Specifically, the conditional effect of emotional support on resilience was found to be significant at middle (M = 3.08; p < .05) and low levels (M = .59; p < .001) of AUCg. CONCLUSIONS Our results suggest that newly diagnosed breast cancer women with middle and low diurnal cortisol profiles may benefit more from emotional support based-interventions while women with high diurnal cortisol may need more individualized therapies.
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Affiliation(s)
- Ibane Aizpurua-Perez
- Department of Basic Psychological Processes and Their Development, University of the Basque Country, San Sebastian, Spain
| | - Amaia Arregi
- Department of Basic Psychological Processes and Their Development, University of the Basque Country, San Sebastian, Spain
| | | | - Patricia Macia
- Department of Basic Psychological Processes and Their Development, University of the Basque Country, San Sebastian, Spain
| | | | - Ainitze Labaka
- Department of Nursing II, University of the Basque Country, San Sebastian, Spain
| | - Nerea Zabalza
- Oncologic Center (Onkologikoa), San Sebastian, Spain
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3
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Aizpurua-Perez I, Arregi A, Labaka A, Martinez-Villar A, Perez-Tejada J. Psychological resilience and cortisol levels in adults: A systematic review. Am J Hum Biol 2023; 35:e23954. [PMID: 37395446 DOI: 10.1002/ajhb.23954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 07/04/2023] Open
Abstract
Resilience or the capacity to "bend but not break" refers to the ability to maintain or regain psychobiological equilibrium during or after exposure to stressful life events. Specifically, resilience has been proposed as a potential resource for staving off pathological states that often emerge after exposure to repeated stress and that are related to alterations in circulating cortisol. The aim of this systematic review of the literature was to gather evidence related to the relationship between psychological resilience and cortisol levels in adult humans. An extensive systematic search was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method in the PubMed and Web of Science databases. In total, 1256 articles were identified and, of these, 35 peer-reviewed articles were included in the systematic review. We categorized findings according to (1) the short and long-term secretion period covered by the cortisol matrices selected by studies and also according to (2) the differentiated diurnal, phasic (acute), and tonic (basal) components of the HPA output to which they refer and their relationships with resilience. Reported relationships between psychological resilience and distinct cortisol output parameters varied widely across studies, finding positive, negative, and null associations between the two variables. Notably, several of the studies that found no relationship between resilience and cortisol used a single morning saliva or plasma sample as their assessment of HPA axis activity. Despite limitations such as the great variability of the instruments and methods used by the studies to measure both resilience and cortisol, together with their high heterogeneity and small sample sizes, the evidence found in this systematic review points to the potential of resilience as a modifiable key factor to modulate the physiological response to stress. Therefore, further exploration of the interaction between the two variables is necessary for the eventual development of future interventions aimed at promoting resilience as an essential component of health prevention.
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Affiliation(s)
- Ibane Aizpurua-Perez
- Department of Basic Psychological Processes and their Development, University of the Basque Country, San Sebastian, Spain
| | - Amaia Arregi
- Department of Basic Psychological Processes and their Development, University of the Basque Country, San Sebastian, Spain
| | - Ainitze Labaka
- Department of Nursing II, University of the Basque Country, San Sebastian, Spain
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Sharpley CF, Evans ID, Bitsika V, Arnold WM, Jesulola E, Agnew LL. Frontal Alpha Asymmetry Argues for the Heterogeneity of Psychological Resilience. Brain Sci 2023; 13:1354. [PMID: 37759955 PMCID: PMC10526132 DOI: 10.3390/brainsci13091354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 09/29/2023] Open
Abstract
Depression is associated with frontal alpha asymmetry (FAA) and Psychological Resilience (PR), although in different ways. Only cursory attention has been given to how these three constructs interact despite the possible clinical and research implications of those associations. One limitation of recent research into these associations has been conceptualising PR as a unitary construct, whereas it has been shown to be multi-component. This study investigated the underlying components of PR, their correlations with FAA, and the effect that participants' depressive status had upon those correlations in a community sample of 54 males and 46 females aged between 18 yr and 75 years. Results confirmed the overall inverse association between total PR and depression for four of the original five PR components and for one of the two components found in this sample. Similarly, there were differences between the ways that FAA and PR components were associated, depending upon the depressive status of participants. Source localisation data indicated that the PR components were not uniformly correlated with alpha activity in the same brain regions. These findings of content, efficacy, and neurophysiological differences between the five components of PR and their associations with FAA argue against consideration of PR as a unitary construct.
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Affiliation(s)
- Christopher F. Sharpley
- Brain-Behavior Research Group, University of New England, Armidale, NSW 2350, Australia; (I.D.E.); (V.B.); (W.M.A.); (E.J.)
- School of Science & Technology, University of New England, Queen Elizabeth Drive, Armidale, NSW 2351, Australia
| | - Ian D. Evans
- Brain-Behavior Research Group, University of New England, Armidale, NSW 2350, Australia; (I.D.E.); (V.B.); (W.M.A.); (E.J.)
| | - Vicki Bitsika
- Brain-Behavior Research Group, University of New England, Armidale, NSW 2350, Australia; (I.D.E.); (V.B.); (W.M.A.); (E.J.)
| | - Wayne M. Arnold
- Brain-Behavior Research Group, University of New England, Armidale, NSW 2350, Australia; (I.D.E.); (V.B.); (W.M.A.); (E.J.)
| | - Emmanuel Jesulola
- Brain-Behavior Research Group, University of New England, Armidale, NSW 2350, Australia; (I.D.E.); (V.B.); (W.M.A.); (E.J.)
- Department of Neurosurgery, The Alfred Hospital, Melbourne, VIC 4222, Australia
| | - Linda L. Agnew
- Brain-Behavior Research Group, University of New England, Armidale, NSW 2350, Australia; (I.D.E.); (V.B.); (W.M.A.); (E.J.)
- Griffith University, Nathan, QLD 4222, Australia
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Zhu Y, Chen J, Li J, Zhou C, Huang X, Chen B. Ginsenoside Rg1 as a promising adjuvant agent for enhancing the anti-cancer functions of granulocytes inhibited by noradrenaline. Front Immunol 2023; 14:1070679. [PMID: 36817446 PMCID: PMC9929943 DOI: 10.3389/fimmu.2023.1070679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 01/16/2023] [Indexed: 02/04/2023] Open
Abstract
Introduction In recent years, numerous studies have confirmed that chronic stress is closely related to the development of cancer. Our previous research showed that high levels of stress hormones secreted in the body during chronic stress could inhibit the cancer-killing activity of granulocytes, which could further promote the development of cancer. Therefore, reversing the immunosuppressive effect of stress hormones on granulocytes is an urgent problem in clinical cancer treatment. Here, we selected noradrenaline (NA) as a representative stress hormone. Methods and results After screening many traditional Chinese herbal medicine active ingredients, a promising compound, ginsenoside Rg1, attracted our attention. We verified the immunoprotective effect of ginsenoside Rg1 on granulocytes in vitro and ex vivo, and attempted to understand its potential immunoprotective mechanism. We confirmed the immunoprotective effect of ginsenoside Rg1 on granulocytes using cell and animal experiments. Cell counting kit-8 (CCK-8) and ex vivo experiments were performed to investigate the immunoprotective effects of ginsenoside Rg1 on the anti-cancer function of granulocytes inhibited by NA. Transcriptome sequencing analysis and qRT-PCR showed that NA elevated the mRNA expression of ARG2, MMP1, S100A4, and RAPSN in granulocytes, thereby reducing the anti-cancer function of granulocytes. In contrast, ginsenoside Rg1 downregulated the mRNA expression of ARG2, MMP1, S100A4, and RAPSN, and upregulated the mRNA expression of LAMC2, DSC2, KRT6A, and FOSB, thereby enhancing the anti-cancer function of granulocytes inhibited by NA. Transwell cell migration experiments were performed to verify that ginsenoside Rg1 significantly enhanced the migration capability of granulocytes inhibited by NA. Tumor-bearing model mice were used to verify the significant immunoprotective effects in vivo. Finally, CCK-8 and hematoxylin and eosin staining experiments indicated that ginsenoside Rg1 exhibited high biosafety in vitro and in vivo. Discussion In future clinical treatments, ginsenoside Rg1 may be used as an adjuvant agent for cancer treatment to alleviate chronic stress-induced adverse events in cancer patients.
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Affiliation(s)
| | | | | | | | - Xin Huang
- Shanghai East Hospital, The Institute for Biomedical Engineering & Nano Science, Tongji University School of Medicine, Shanghai, China
| | - Bingdi Chen
- Shanghai East Hospital, The Institute for Biomedical Engineering & Nano Science, Tongji University School of Medicine, Shanghai, China
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Li G, Qian Y, Chen Y, Cao M, Yang X, Kong D, Wang G, An H, Yang N, Huang W, Liu Y. Wip1 contributes to the adaptation of HepG2 human liver cancer cells to stress hormone-induced DNA damage. Oncol Lett 2022; 25:31. [PMID: 36589663 PMCID: PMC9773319 DOI: 10.3892/ol.2022.13617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 10/19/2022] [Indexed: 12/03/2022] Open
Abstract
Numerous studies have shown that the release of stress hormones resulting from repeated exposure to chronic psychological stress increases DNA damage and promotes tumorigenesis. However, the mechanisms that enable cancerous cells adapt to stress hormone-induced DNA damage and survive remain unclear. The present study aimed to investigate the impact of stress hormones on the survival of liver cancer cells and the underlying mechanism. HepG2 human liver cancer cells were treated with dexamethasone (DEX), epinephrine (EPI) and norepinephrine (NE) and subjected to the testing of DNA damage, cell survival and cell apoptosis by alkaline comet assay, CCK-8 viability assay and flow cytometry, respectively. The protein expression levels of DNA damage response factors were determined by western blotting analysis. The results revealed that treatment of HepG2 cells with DEX, EPI and NE induced DNA damage without affecting cell survival or inducing apoptosis. The protein levels of wild-type p53-induced phosphatase 1 (Wip1), a type 2C family serine/threonine phosphatase, were increased, and the dephosphorylation of DNA damage response factors, including phosphorylated (p-)ataxia-telangiectasia mutated and p-checkpoint kinase 2, occurred following treatment with DEX, EPI and NE. In addition, a cycloheximide chase assay was performed to explore the protein stability under treatment with stress hormones. Compared with vehicle-treated cells, Wip1 exhibited increased protein stability in stress hormone-treated HepG2 cells. Eventually, the depletion of Wip1 using small interfering RNA verified the role of Wip1 in the modulation of stress hormone-induced DNA damage. These findings suggest that cancerous cells likely adapt to stress hormone-induced DNA damage via Wip1 upregulation. The present study provides an insight into the underlying mechanism that links chronic psychological stress with tumor growth and progression.
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Affiliation(s)
- Gaoxiang Li
- Department of Pharmacology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing 100005, P.R. China,Medical College, Tibet University, Lhasa, Tibet Autonomous Region 850000, P.R. China
| | - Yazhi Qian
- Department of Pharmacology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing 100005, P.R. China
| | - Yuzhu Chen
- Department of Pharmacology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing 100005, P.R. China
| | - Mingyue Cao
- Department of Pharmacology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing 100005, P.R. China
| | - Xiaozhou Yang
- Department of Pharmacology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing 100005, P.R. China
| | - Dexin Kong
- Department of Pharmacology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing 100005, P.R. China
| | - Guiping Wang
- Department of Pharmacology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing 100005, P.R. China,Medical College, Tibet University, Lhasa, Tibet Autonomous Region 850000, P.R. China
| | - Haiyan An
- Department of Anesthesiology, Peking University People's Hospital, Beijing 100044, P.R. China
| | - Nan Yang
- Department of Pharmacology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing 100005, P.R. China
| | - Wei Huang
- Department of Pharmacology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing 100005, P.R. China,Correspondence to: Dr Yanyong Liu or Dr Wei Huang, Department of Pharmacology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, 5 Dong Dan San Tiao, Dong-Cheng, Beijing 100005, P.R. China, E-mail: , E-mail:
| | - Yanyong Liu
- Department of Pharmacology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, Beijing 100005, P.R. China,Medical College, Tibet University, Lhasa, Tibet Autonomous Region 850000, P.R. China,Correspondence to: Dr Yanyong Liu or Dr Wei Huang, Department of Pharmacology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and School of Basic Medicine, Peking Union Medical College, 5 Dong Dan San Tiao, Dong-Cheng, Beijing 100005, P.R. China, E-mail: , E-mail:
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Chien CH, Pang ST, Chuang CK, Liu KL, Wu CT, Yu KJ, Huang XY, Lin PH. Exploring psychological resilience and demoralisation in prostate cancer survivors. Eur J Cancer Care (Engl) 2022; 31:e13759. [PMID: 36271629 DOI: 10.1111/ecc.13759] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/28/2022] [Accepted: 10/09/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study aimed to investigate psychological resilience and demoralisation and their predictors and mediators in prostate cancer survivors (PCSs). METHODS A cross-sectional research design was used. PCSs (N = 122; mean time since diagnosis = 54.79 months, range in 13 years and 2 months) were recruited using convenience sampling at the outpatient department of a hospital in Taiwan. Data collection was conducted using self-report structured questionnaires, including one for demographic and disease characteristics, the Expanded Prostate Cancer Index Composite, Cancer Survivors' Self-Efficacy Scale, Connor-Davidson Resilience Scale and the Demoralisation Scale. RESULTS In PCSs, a lower most-recent level of prostate-specific antigen and higher cancer-specific self-efficacy were associated with better psychological resilience. Further, fewer hormonal, bowel and urinary symptoms and bother; higher cancer-specific self-efficacy; and better psychological resilience were associated with less demoralisation. Cancer-specific self-efficacy was a mediator for the relationship between urinary symptoms and bother and demoralisation, while psychological resilience mediated the relationship between cancer-specific self-efficacy and demoralisation. CONCLUSIONS The results reveal that cancer-specific self-efficacy is a protective factor against demoralisation and increases psychological resilience in PCSs. Better psychological resilience and fewer physical symptoms and bother are associated with less demoralisation in PCSs.
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Affiliation(s)
- Ching Hui Chien
- College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
| | - See Tong Pang
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan.,School of Medicine, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Cheng Keng Chuang
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan.,School of Medicine, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Kuan Lin Liu
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Keelung, Keelung City, Taiwan
| | - Chun Te Wu
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan.,School of Medicine, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Kai Jie Yu
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan.,School of Medicine, College of Medicine, Chang Gung University, Taoyuan City, Taiwan.,Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei City, Taiwan
| | - Xuan Yi Huang
- College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan
| | - Po Hung Lin
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan.,School of Medicine, College of Medicine, Chang Gung University, Taoyuan City, Taiwan.,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
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8
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Sharpley CF, Christie DRH, Bitsika V. Which Aspects of Psychological Resilience Moderate the Association between Deterioration in Sleep and Depression in Patients with Prostate Cancer? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148505. [PMID: 35886356 PMCID: PMC9320600 DOI: 10.3390/ijerph19148505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/08/2022] [Accepted: 07/09/2022] [Indexed: 12/04/2022]
Abstract
This study aimed to investigate the moderating effect of psychological resilience on sleep-deterioration-related depression among patients with prostate cancer, in terms of the total score and individual symptoms. From a survey of 96 patients with prostate cancer, 55 who reported a deterioration in their sleep quality since diagnosis and treatment completed the Zung Self-Rating Depression Scale, Connor–Davidson Resilience Scale, and the Insomnia Severity Index. Moderation analysis was conducted for the scale total scores and for the ‘core’ symptoms of each scale within this sample, based on data analysis. Interaction analysis was used to identify key associations. The moderation analysis suggested that psychological resilience moderated the depressive effect of sleep deterioration that patients reported occurred after their diagnosis and treatment and did so at the total and ‘core’ symptom levels of being able to see the humorous side of things and to think clearly when under pressure, but there was an interaction between this moderating effect, the strength of psychological resilience, and severity of sleep deterioration. Although it appears to be a successful moderator of depression arising from sleep deterioration that was reported by patients with prostate cancer, the effectiveness of psychological resilience is conditional upon the severity of patients’ sleep difficulties and the strength of their psychological resilience. Implications for the application of resilience training and concomitant therapies for patients with prostate cancer with sleep difficulties and depression are discussed.
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Affiliation(s)
- Christopher F. Sharpley
- Brain-Behaviour Research Group, School of Science & Technology, University of New England, Armidale, NSW 2351, Australia; (D.R.H.C.); (V.B.)
- Correspondence:
| | - David R. H. Christie
- Brain-Behaviour Research Group, School of Science & Technology, University of New England, Armidale, NSW 2351, Australia; (D.R.H.C.); (V.B.)
- Genesiscare, John Flynn Private Hospital, Tugun, QLD 4224, Australia
| | - Vicki Bitsika
- Brain-Behaviour Research Group, School of Science & Technology, University of New England, Armidale, NSW 2351, Australia; (D.R.H.C.); (V.B.)
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Allostatic Load as an Insight into the Psychological Burden after Primary Treatment in Women with Breast Cancer: Influence of Physical Side Effects and Pain Perception. J Clin Med 2022; 11:jcm11082144. [PMID: 35456237 PMCID: PMC9031666 DOI: 10.3390/jcm11082144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/04/2022] [Accepted: 04/11/2022] [Indexed: 12/12/2022] Open
Abstract
Breast cancer (BC) diagnosis and treatment have become a cumulative long-standing chronic disease impairment, causing stress and turning into an allostatic load (AL) framework. This study aimed to investigate the relationship between physical issues and mental health in patients with BC after medical treatment. We conducted an observational study of 61 female patients with BC, and clinical and psychological markers have been detected. We conducted descriptive statistics, ANOVA analyses, correlations, and mediation analyses to verify the effect of the comorbidity index on psychological dimensions. The findings showed high levels of distress and moderate pain, and 32.8% of the patients showed moderate physical impairment. Significant effects of “age” and “physical issues” were found. The adult group reported a higher incidence of physical issues, and the group of patients reporting moderate physical impairment seemed more depressed than patients with mild physical issues. Finally, the comorbidity condition mediated the presence of signs of depression. Patients with BC seemed to experience negative emotions related to comorbidities associated with compromised activities of daily living. Our findings highlighted allostatic overload as a predictive framework to better understand the mental health of women with BC diagnoses to tailor effective psychological treatments for enhanced recovery.
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Psychological intervention to treat distress: An emerging frontier in cancer prevention and therapy. Biochim Biophys Acta Rev Cancer 2021; 1877:188665. [PMID: 34896258 DOI: 10.1016/j.bbcan.2021.188665] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/27/2021] [Accepted: 12/01/2021] [Indexed: 02/05/2023]
Abstract
Psychological distress, such as chronic depression and anxiety, is a topical problem. In the context of cancer patients, prevalence rates of psychological distress are four-times higher than in the general population and often confer worse outcomes. In addition to evidence from epidemiological studies confirming the links between psychological distress and cancer progression, a growing body of cellular and molecular studies have also revealed the complex signaling networks which are modulated by psychological distress-derived chronic stress during cancer progression. In this review, aiming to uncover the intertwined networks of chronic stress-driven oncogenesis and progression, we summarize physiological stress response pathways, like the HPA, SNS, and MGB axes, that modulate the release of stress hormones with potential carcinogenic properties. Furthermore, we discuss in detail the mechanisms behind these chronic stimulations contributing to the initiation and progression of cancer through direct regulation of cancer hallmarks-related signaling or indirect promotion of cancer risk factors (including obesity, disordered circadian rhythms, and premature senescence), suggesting a novel research direction into cancer prevention and therapy on the basis of psychological interventions.
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Chair SY, Law BM, Chan JY, So WK, Waye MM. Association of Genetic Polymorphisms with Psychological Symptoms in Cancer: A Systematic Review. Asia Pac J Oncol Nurs 2021; 9:12-20. [PMID: 35528795 PMCID: PMC9072184 DOI: 10.1016/j.apjon.2021.11.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 11/28/2021] [Indexed: 11/28/2022] Open
Abstract
Cancer patients suffer from a repertoire of symptoms, including such psychological and psychiatric symptoms as anxiety, depression, and posttraumatic stress. Exploration of genetic factors that modify the risk and severity of these symptoms may facilitate the development of personalised care plans for managing these symptoms. This review aims to provide an overview on the variations in genes that may contribute to the occurrence and severity of anxiety, depression, and posttraumatic stress disorder (PTSD) among cancer patients. Literature search was performed in nine English and Chinese electronic databases, and extracted data are presented narratively. The reporting quality of the included studies was assessed using selected items of The STrengthening the REporting of Genetic Association (STREGA) checklist. Twenty-nine studies were included in the review. Most studies involved breast cancer patients, while patients of other cancer types appeared to be understudied. A number of studies reported the association between genes involved in inflammatory pathways and depression and anxiety. Other genes found to show associations with anxiety, depression, and PTSD among cancer patients are those involved in neurotrophic signalling, serotonergic signalling, regulation of stress response, antioxidation, dopamine catabolism and cellular apoptosis, despite some inconsistencies in findings between studies. Our review highlighted a need for further research for enhancing our knowledge on the association between genetic variations and anxiety, depression, and PTSD of patients of various cancer types. Future studies examining such associations in patients of various cancers should utilise standardised instruments for outcome assessments and stratify the patients based on their age for analysis.
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Cui B, Peng F, Lu J, He B, Su Q, Luo H, Deng Z, Jiang T, Su K, Huang Y, Ud Din Z, Lam EWF, Kelley KW, Liu Q. Cancer and stress: NextGen strategies. Brain Behav Immun 2021; 93:368-383. [PMID: 33160090 DOI: 10.1016/j.bbi.2020.11.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/17/2020] [Accepted: 11/01/2020] [Indexed: 12/12/2022] Open
Abstract
Chronic stress is well-known to cause physiological distress that leads to body balance perturbations by altering signaling pathways in the neuroendocrine and sympathetic nervous systems. This increases allostatic load, which is the cost of physiological fluctuations that are required to cope with psychological challenges as well as changes in the physical environment. Recent studies have enriched our knowledge about the role of chronic stress in disease development, especially carcinogenesis. Stress stimulates the hypothalamic-pituitaryadrenal (HPA) axis and the sympathetic nervous system (SNS), resulting in an abnormal release of hormones. These activate signaling pathways that elevate expression of downstream oncogenes. This occurs by activation of specific receptors that promote numerous cancer biological processes, including proliferation, genomic instability, angiogenesis, metastasis, immune evasion and metabolic disorders. Moreover, accumulating evidence has revealed that β-adrenergic receptor (ADRB) antagonists and downstream target inhibitors exhibit remarkable anti-tumor effects. Psychosomatic behavioral interventions (PBI) and traditional Chinese medicine (TCM) also effectively relieve the impact of stress in cancer patients. In this review, we discuss recent advances in the underlying mechanisms that are responsible for stress in promoting malignancies. Collectively, these data provide approaches for NextGen pharmacological therapies, PBI and TCM to reduce the burden of tumorigenesis.
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Affiliation(s)
- Bai Cui
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province 116044, China; State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-sen University, 651 Dongfeng East Road, Guangzhou, Guangdong Province 510060, China
| | - Fei Peng
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province 116044, China
| | - Jinxin Lu
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province 116044, China
| | - Bin He
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province 116044, China
| | - Qitong Su
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province 116044, China
| | - Huandong Luo
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province 116044, China
| | - Ziqian Deng
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province 116044, China
| | - Tonghui Jiang
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province 116044, China
| | - Keyu Su
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province 116044, China
| | - Yanping Huang
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province 116044, China
| | - Zaheer Ud Din
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province 116044, China
| | - Eric W-F Lam
- Department of Surgery and Cancer, Imperial College London, London W12 0NN, UK
| | - Keith W Kelley
- Department of Pathology, College of Medicine and Department of Animal Sciences, College of ACES, University of Illinois at Urbana-Champaign, 212 Edward R. Madigan Laboratory, 1201 West Gregory Drive, Urbana, Il 61801, USA.
| | - Quentin Liu
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province 116044, China; State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-sen University, 651 Dongfeng East Road, Guangzhou, Guangdong Province 510060, China.
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Sharpley CF, Christie DRH, Bitsika V. 'Steeling' effects in the association between psychological resilience and cancer treatment in prostate cancer patients. Psychooncology 2020; 30:67-73. [PMID: 32877009 DOI: 10.1002/pon.5537] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/23/2020] [Accepted: 08/27/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To test the 'buffering' effect of psychological resilience (PR) upon depression in prostate cancer patients and to also investigate any effects that past or current treatment may have had upon patients' PR as a test of the 'steeling' hypothesis of past adversity upon future resilience. METHODS A total of 576 volunteer prostate cancer patients completed questionnaires about their demographic and treatment variables, and their psychological resilience and depression. Factor analysis was used to identify the underlying components of the resilience measure. RESULTS PR was confirmed as an inverse correlate of depression in these men. Additionally, some past and current treatments were found to be significantly associated with patients' psychological resilience in a way suggestive of 'steeling' effects. CONCLUSION These data provide support for the model of PR as being influenced by past experiences of adversity and demonstrate that association for prostate cancer patients.
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Affiliation(s)
- Christopher F Sharpley
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia.,School of Science & Technology, University of New England, Armidale, New South Wales, Australia
| | - David R H Christie
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia.,GenesisCare, John Flynn Private Hospital, Tugun, Queensland, Australia
| | - Vicki Bitsika
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia
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Sharpley CF, Christie DRH, Bitsika V. Depression and prostate cancer: implications for urologists and oncologists. Nat Rev Urol 2020; 17:571-585. [PMID: 32733038 DOI: 10.1038/s41585-020-0354-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2020] [Indexed: 02/07/2023]
Abstract
Many patients with prostate cancer experience severe levels of depression, which can negatively affect their treatment and disease course. Some prostate cancer treatments can increase the severity of a patient's depression, for example, by increasing anhedonia and erectile dysfunction. Depression is often thought of as a unitary phenomenon, but multiple subtypes can be distinguished. This variety of manifestations challenges the successful application of universal antidepressant treatment options and argues for a multi-symptom assessment process that considers a patient's disease burden and their particular form of depression. Inclusion of screening and detailed diagnosis of depression can be argued to be part of good practice, and clinicians are urged to consider when and how this might be accomplished within their urological practice.
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Affiliation(s)
- Christopher F Sharpley
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia.
| | - David R H Christie
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia.,Genesiscare, John Flynn Private Hospital, Tugun, Queensland, Australia
| | - Vicki Bitsika
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia
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Salomon RE, Tan KR, Vaughan A, Adynski H, Muscatell KA. Minimally-invasive methods for examining biological changes in response to chronic stress: A scoping review. Int J Nurs Stud 2020; 103:103419. [PMID: 31945603 DOI: 10.1016/j.ijnurstu.2019.103419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 09/05/2019] [Accepted: 09/06/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Nurse researchers are increasingly interested in incorporating biological indicators related to chronic stress, or repeated or constant exposure to psychological stressors. Minimally invasive collection methods may improve access to vulnerable populations. OBJECTIVE To map biological indicators measured through minimally invasive methods investigating biological changes in response to chronic stress. DESIGN, DATA SOURCES, AND METHODS The paper seeks to answer two questions: What are the characteristics of the minimally-invasive methods used to measure the biological correlates of chronic stress? What are the limitations regarding the use of the minimally-invasive methods and/or biological indicators identified above? Authors completed a scoping review following guidelines from the Joanna Briggs Institute Manual and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Scoping Reviews. A literature search was completed in PubMed, PsycINFO, and Scopus. 2518 articles were screened and 145 studies were included. Data were extracted using a standardized extraction tool, compiled, and coded. RESULTS Studies included minimally-invasive methods to measure the hypothalamic-adrenal-pituitary axis (N = 173), immune and inflammatory markers (N = 118), and adult neurogenesis (N = 6). Cortisol was most frequently measured (N = 136), usually in saliva (N = 86). Studies included a variety of limitations for the methods and indicators, including concerns about timing and accuracy of collection, frequency of sampling, and controlling for acute stressors. CONCLUSIONS Nurse researchers have access to many minimally-invasive methods to measure altered biological processes related to chronic stress. A gap identified by this review is the paucity of minimally-invasive methods for investigating neurogenesis; the measurement of brain derived neurotrophic factor in plasma is a distal proxy and further research is needed to test the response of peripheral levels to psychosocial stress interventions. Additionally, while this scoping review allows nurse researchers to consider possible biological indicators to include in their research, future research is still needed on some of the basic premises of stress research, including agreement on the conceptualization of chronic stress.
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Affiliation(s)
- Rebecca E Salomon
- School of Nursing, University of California San Francisco, 2 Koret Way, UCSF Box 0608, San Francisco, CA 94143-0608, USA.
| | - Kelly R Tan
- School of Nursing, University of California San Francisco, 2 Koret Way, UCSF Box 0608, San Francisco, CA 94143-0608, USA.
| | - Ashley Vaughan
- School of Nursing, University of California San Francisco, 2 Koret Way, UCSF Box 0608, San Francisco, CA 94143-0608, USA.
| | - Harry Adynski
- School of Nursing, University of California San Francisco, 2 Koret Way, UCSF Box 0608, San Francisco, CA 94143-0608, USA.
| | - Keely A Muscatell
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Campus Box #3270, 235 E. Cameron Avenue, Chapel Hill, NC 27599-3270, USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Campus Box #7295, 450 West Drive, Chapel Hill, NC 27599-7295, USA.
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de Assis GG, Gasanov EV. BDNF and Cortisol integrative system - Plasticity vs. degeneration: Implications of the Val66Met polymorphism. Front Neuroendocrinol 2019; 55:100784. [PMID: 31425696 DOI: 10.1016/j.yfrne.2019.100784] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 08/12/2019] [Accepted: 08/14/2019] [Indexed: 12/12/2022]
Abstract
UNLABELLED BDNF is the neurotrophin mediating pro-neuronal survival and plasticity. Cortisol (COR), in turn, is engaged in the coordination of several processes in the brain homeostasis. Stress-responsive, both factors show an integrative role through their receptor's dynamics in neurophysiology. Furthermore, the Val66Met BDNF polymorphism may play a role in this mechanism. AIM to investigate BDNF-COR interaction in the human neurophysiology context. METHODS We collected all papers containing BDNF and COR parameters or showing COR analyses in genotyped individuals in a PubMed search - full description available on PROSPERO - CRD42016050206. DISCUSSION BDNF and COR perform distinct roles in the physiology of the brain whose systems are integrated by glucocorticoid receptors dynamics. The BDNF polymorphism appears to have an influence on individual COR responsivity to stress. BDNF and COR play complementary roles in the nervous system where COR is a regulator of positive/negative effects. Exercise positively regulates both factors, regardless of BDNF polymorphism.
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Affiliation(s)
- Gilmara Gomes de Assis
- Department of Applied Physiology, Mossakowski Medical Research Centre Polish Academy of Sciences, Warsaw, Poland; Lab. of Behavioral Endocrinology, Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil.
| | - Eugene V Gasanov
- Laboratory of Neurodegeneration, International Institute of Molecular and Cell Biology in Warsaw, Poland
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