Stress-Related Growth Scale-Short Form: A Portuguese validation for cancer patients

Emotional, inflammatory, and genetic factors of resilience and vulnerability to depression in patients with premenopausal breast cancer: A longitudinal study protocol

BACKGROUND

Psychosocial stress and depressive disorder have been associated with cancer as putative contributors to worse prognosis. On the other hand, cancer diagnosis is a recognised life event that can contribute to distress and depressive states. Humoral and cellular inflammation can promote depressive disorder by means of decreased monoamine synthesis, glutamate neurotoxicity, neurogenesis and neuroplasticity, dysregulated hypothalamic-pituitary-adrenal axis, and glucocorticoid resistance. This protocol objectives are to observe the interactions between psychosocial variables and biochemical and immunological biomarkers in a longitudinal, prospective design; to identify inflammation-related depression endophenotypes in breast cancer patients and to understand if early diagnosed and treated depression in this population will translate in better inflammation status and better global prognosis.

METHODS

Prospective observational cohort, composed by 100 consecutive premenopausal patients, diagnosed with non-distant metastatic breast carcinoma and with no history of major psychopathology or other organic illness. The participants will have an in-person assessment in three different moments, along illness treatment and follow-up, with respect to cytometric, immunologic, and psychosocial parameters and will be tested for depression vulnerability and resilience inflammation-related functional genetic polymorphisms. Additionally, at years 5 and 10 post enrollment, patients`medical records will be assessed. As a control cohort, all patients excluded due to psychiatric history or past psychiatric treatments will have their clinical records assessed at years 5 and 10 after admission. All the data will be managed with the SPSS® software.

DISCUSSION AND CONCLUSION

This study is an original longitudinal cohort of breast cancer premenopausal patients, with a comprehensive approach to psychosocial, clinical, inflammatory, and genetic variables. It expects to provide evidence regarding the links between genetic, cytometric, immunologic, and psychosocial factors, their potential contribution to the pathophysiology of depressive disorder, breast cancer course, progression, and prognosis. It may further contribute with data to better efficacy of the psycho-oncological interventions.

TRIAL REGISTRATION

National Commission of Data Protection (CNPD) 13413/2017; Ethics Committee of IPOP project code CI-IPOP81/2017.

Measurement properties of the Spanish version of the brief resilient coping scale (BRCS) in cancer patients

Background/Objective

Resilience is the capacity to adaptively confront stress. The aim of this study was to evaluate the psychometric properties, convergent validity, and factorial invariance of the Spanish version of the Brief Resilient Coping Scale (BRCS).

Method

Exploratory and confirmatory factor analyses based on a cross-validation were conducted to explore the scale's dimensionality and test for strong (scalar) measurement invariance across gender, age, tumor site, and survival, by fitting multiple-group confirmatory solutions. An extended structural equation model was used to assess external validity. Prospective, multicenter cohort study of 636 patients who completed the BRCS, Satisfaction with Life Scale (SWLS), and Spiritual well-being (FACIT-sp) scales.

Results

The data supported a unidimensional structure. The BRCS is a very short, narrow bandwidth measure, with items demonstrating high discriminating power. A strong invariance solution demonstrated excellent fit across gender, age, tumor site, and survival. Scores derived from the unidimensional structure exhibited satisfactory degrees of reliability (ω = .86) and determinacy (FDI = .94). BRCS revealed substantial associations with satisfaction with life and spirituality well-being (all p < .001), factors widely related to resilience, particularly in cancer patients.

Conclusions

The Spanish version of the BRCS is a reliable, valid resilience measure in advanced cancer.