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Shrout MR, Renna ME, Leonard MJ, Friedman EM, Miller KD. Couples in breast cancer survivorship: Daily associations in relationship satisfaction, stress, and health. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2024; 20:100261. [PMID: 39281968 PMCID: PMC11393601 DOI: 10.1016/j.cpnec.2024.100261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 08/05/2024] [Accepted: 08/16/2024] [Indexed: 09/18/2024] Open
Abstract
Romantic relationships are a key health determinant underlying both morbidity and mortality. Dr. Janice Kiecolt-Glaser's prolific research revealed cardiovascular, metabolic, endocrine, and immune pathways connecting marriage to health and longevity. In addition to her empirical work, she developed conceptual models on marriage, the gut microbiome, stress reactivity, and spousal health concordance; these models guide and inspire mechanistic research, serve as essential readings for graduate students and mentees, and provide inspiration for researchers across career stages. This paper highlights Dr. Kiecolt-Glaser's influential work, includes personal reflections and professional growth as past mentees, and provides Dr. Kiecolt-Glaser-inspired evidence linking relationships to health among couples in breast cancer survivorship. Using baseline questionnaires and daily dairies, breast cancer survivors (stage I-IIIB) and their cohabiting partners (60 individuals, 30 couples) rated their relationship satisfaction, stress, and physical health symptoms every day for 7 days. Results suggest that breast cancer survivors and their partners who felt more satisfied with their relationships also felt less stressed, both typically and on a daily basis. Survivors' and partners' lower stress was also associated with fewer physical health problems on average and in daily life. These findings demonstrate the daily stress and health advantages of satisfying relationships for both breast cancer survivors and their partners. We discuss the study's implications and several avenues for Dr. Kiecolt-Glaser-inspired research addressing a relationship's long-term health impact among couples in survivorship.
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Affiliation(s)
- M Rosie Shrout
- Human Development and Family Science, Purdue University, West Lafayette, IN, USA
- Center on Aging and the Life Course, Purdue University, West Lafayette, IN, USA
| | - Megan E Renna
- School of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | - MiKaila J Leonard
- Human Development and Family Science, Purdue University, West Lafayette, IN, USA
- Center on Aging and the Life Course, Purdue University, West Lafayette, IN, USA
| | - Elliot M Friedman
- Human Development and Family Science, Purdue University, West Lafayette, IN, USA
- Center on Aging and the Life Course, Purdue University, West Lafayette, IN, USA
| | - Kathy D Miller
- Division of Hematology and Oncology, Indiana University School of Medicine, Indianapolis, IN, USA
- Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, IN, USA
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Bennett JM. The post-Cartesian dilemma: Reuniting the mind and body through psychoneuroimmunology. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2024; 20:100265. [PMID: 39391061 PMCID: PMC11465197 DOI: 10.1016/j.cpnec.2024.100265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 09/22/2024] [Accepted: 09/24/2024] [Indexed: 10/12/2024] Open
Abstract
While today, it might seem absurd to hear anyone claim that stress does not alter all aspects of the human experience, including behavioral, cognitive, affective, and physiological processes. Dr. Janice Kiecolt-Glaser started her career at a time when stress was primarily considered a neuroendocrine response with cardiovascular repercussions. She was part of a small group of innovative scientists who began to push the boundaries of stress research - many contemporary immunologists and virologist disputed their early results in 1980s and 90s - and, yet, they persevered by connecting psychological stress to altered immune function via stress-related neuroendocrine changes. As a clinical psychologist, she focused mainly on human research studies to advance the field of psychoneuroimmunology throughout her career. Her research demonstrates how adversity and psychosocial aspects of human experience alter physiological functioning, primarily immune, and health or, in other words, the embodiment of our lived experiences. This short review is a contextualized synthesis of Dr. Kiecolt-Glaser's key contributions to the fields of psychoneuroimmunology and health psychology and her influence on my present day thinking and research approaches, as well as potential steps forward in our post-pandemic world.
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Affiliation(s)
- Jeanette M. Bennett
- Department of Psychological Science, Health Psychology PhD Program, University of North Caroline at Charlotte, USA
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Christian LM. Turning stress into success: A festschrift in honor of Janice Kiecolt-Glaser. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2024; 19:100251. [PMID: 39170082 PMCID: PMC11338126 DOI: 10.1016/j.cpnec.2024.100251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 07/12/2024] [Accepted: 07/17/2024] [Indexed: 08/23/2024] Open
Affiliation(s)
- Lisa M. Christian
- Department of Psychiatry & Behavioral Health and the Institute for Behavioral Medicine Research and The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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Renna ME, Shrout MR. You can't spell distress without stress: Expanding our perspective of the intersection between mental and physical health in cancer survivors. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2024; 19:100240. [PMID: 38774516 PMCID: PMC11107216 DOI: 10.1016/j.cpnec.2024.100240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 04/23/2024] [Accepted: 05/07/2024] [Indexed: 05/24/2024] Open
Abstract
Although many breast cancer survivors adjust to cancer treatment and survivorship, a sizable subgroup of women do not do so, resulting in psychological distress. Over time, this psychological distress can contribute to immune dysfunction and accompanying worsened physical symptoms as women navigate survivorship. Dr. Kiecolt-Glaser's work and mentorship has been integral to our understanding of breast cancer survivors' immune risks, and how behavioral factors may enhance these risks. As a postdoctoral fellow in the Stress and Health Lab, under Dr. Kiecolt-Glaser's mentorship, my research focused on understanding how distress is associated with immune functioning and physical health in breast cancer survivors. In this paper, we highlight Dr. Kiecolt-Glaser's influence on our careers as a strong female research and mentor, the work completed under her mentorship, and how the field of psychoneuroimmunology can continue to expand her research to better understand how distress in the cancer context confers long-term health risks.
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Andreoli G, Rafanelli C, Gremigni P, Hofmann SG, Casu G. Positive sexuality, relationship satisfaction, and health: a network analysis. Front Psychol 2024; 15:1420148. [PMID: 38903470 PMCID: PMC11189356 DOI: 10.3389/fpsyg.2024.1420148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 05/24/2024] [Indexed: 06/22/2024] Open
Abstract
Introduction Positive sexuality, defined as the happiness and fulfillment individuals derive from their sexual experiences, expressions, and behaviors, has been linked to relationship satisfaction and health. However, the intricate associations between positive sexuality and relationship functioning and health indicators have rarely been explored from a network perspective. This approach, by analyzing the interconnections among these factors within a broader system, can offer insights into complex dynamics and identify key variables for targeted interventions. Methods The present study applied network analysis to uncover interconnections between positive sexuality, relationship satisfaction, and health indicators, highlight the most relevant variables and explore potential gender-based differences in a sample of 992 partnered individuals (51% women, aged 18-71 years). Networks were estimated via Gaussian Graphical Models, and network comparison test was used to compare men and women. Results Results indicated that variables related to positive sexuality were more highly interconnected than the rest of the network. There were small-to-negligible connections between positive sexuality and relationship satisfaction variables, both of which had negligible or no connections with health. The network was globally invariant across gender, though a few connections were gender-specific. The most important variables, regardless of gender, related to pleasurable feelings during sexual intercourse. Discussion The findings underscore the importance of enhancing positive sexual experiences within intimate relationships and have implications for research and clinical practice in positive sexuality.
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Affiliation(s)
- Giovanbattista Andreoli
- Department of Psychology, University of Bologna, Bologna, Italy
- Department of Psychology, Philipps-Universität Marburg, Marburg, Germany
| | | | - Paola Gremigni
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Stefan G. Hofmann
- Department of Psychology, Philipps-Universität Marburg, Marburg, Germany
| | - Giulia Casu
- Department of Psychology, University of Bologna, Bologna, Italy
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Jolink TA, West TN, Alvarez GM, Cardenas MN, Feldman MJ, Algoe SB, Muscatell KA. Higher interleukin-6 is associated with greater momentary social connection in close relationships in daily life. Psychoneuroendocrinology 2024; 164:107020. [PMID: 38520887 DOI: 10.1016/j.psyneuen.2024.107020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 03/04/2024] [Accepted: 03/07/2024] [Indexed: 03/25/2024]
Abstract
Recent evidence has documented associations between higher levels of inflammation and social approach behaviors toward close others in laboratory-based tasks. Yet it is unknown if this translates to interactions with close others in daily life. Given that momentary experiences of social connection have both relational and health consequences, this is a critical gap in our knowledge. To address the association between inflammation and momentary social connection experiences in close relationships, 55 participants provided blood samples on two consecutive days, which were assayed for circulating levels of the inflammatory marker interleukin-6 (IL-6). After providing the first blood sample, participants received the annual influenza vaccine as a mild inflammatory challenge. Participants also reported on cognitive, affective, and behavioral indicators of social connection with a specific close other multiple times across the two study days. Results indicated that levels of IL-6 were positively associated with temporally-proximal indicators of momentary social connection with a close other. Specifically, higher levels of IL-6 were associated with greater feelings of comfort from the close other, greater desire to be near them, and higher reported relationship quality. Greater IL-6 reactivity to the vaccine was only associated with increased reported relationship quality. These data add to the existing literature suggesting that higher levels of IL-6 may motivate social approach toward a close other, extending evidence to now include momentary social connection experiences in daily life.
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Affiliation(s)
- Tatum A Jolink
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Taylor N West
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Gabriella M Alvarez
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Megan N Cardenas
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Mallory J Feldman
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sara B Algoe
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Keely A Muscatell
- Department of Psychology & Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Zhang M, Zhang L, Zhi X, Cheng F, Yao Y, Deng R, Liu C, Wang Y. Demand analysis of health care services for community-dwelling breast cancer survivors based on the Kano model: A cross-sectional study. Int J Nurs Sci 2024; 11:171-178. [PMID: 38707692 PMCID: PMC11064550 DOI: 10.1016/j.ijnss.2024.03.015] [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: 09/19/2023] [Revised: 02/19/2024] [Accepted: 03/10/2024] [Indexed: 05/07/2024] Open
Abstract
Objectives Providing satisfactory healthcare services for breast cancer survivors can effectively reduce their burden and the pressure on medical resources. The aim of this study was to explore health care service demands for community-dwelling breast cancer survivors using the Kano model. Methods A cross-sectional survey was conducted from January to March 2023 among breast cancer survivors discharged from a tertiary cancer hospital. Participants were asked to fill out a self-designed questionnaire involving the Kano model, which helped to categorize and prioritize the attributes of healthcare services. The questionnaire included 30 health care services. Additionally, their social demographic characteristics were collected during the survey. Results A total of 296 valid questionnaires were collected, and demand attributes of the 30 health care services were evaluated. The findings revealed that one of 30 services was classified as "must-be attributes" (body image management), 13 as "one-dimensional attributes" (focused on medical security support, health management, and health counseling), 3 as "attractive attributes" (focused on communication needs and telehealth services), and 11 as "indifferent attributes" (mainly in the area of psycho-social services). Conclusions Breast cancer survivors in the community have different levels of need for various health care services. It's crucial for healthcare providers to identify these needs and devise effective strategies to deliver the appropriate services. Services with must-be and one-dimensional attributes should be given priority, and efforts should be made to provide services with attractive attributes, hence improving the quality of life of breast cancer survivors.
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Affiliation(s)
- Maomao Zhang
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China
| | - Liuliu Zhang
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China
| | - Xiaoxu Zhi
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China
| | - Fang Cheng
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China
| | - Yufeng Yao
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China
| | - Rong Deng
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China
| | - Chunli Liu
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China
| | - Yan Wang
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China
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Badenes-Sastre M, Beltrán-Morillas AM, Expósito F. Absence Versus Presence of Intimate Partner Violence in a Sample of Spanish Women: Conflict Resolution Strategies and Associated Variables. Violence Against Women 2024; 30:832-853. [PMID: 36628445 DOI: 10.1177/10778012221147907] [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] [Indexed: 01/12/2023]
Abstract
Through two studies (N = 544 women), the role of types of relational problems (absence vs. presence of intimate partner violence [IPV]) in the use of conflict resolution strategies (exit and loyalty) was analyzed, considering the serial mediating effect of dependency and commitment and the moderating effect of benevolent sexism. The main results showed that higher scores in dependency and commitment predicted less use of exit strategies among women who reported IPV. No significant results were found regarding loyalty strategy and benevolent sexism. Ultimately, implications for women's perceived risk of future violence were discussed.
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Affiliation(s)
- Marta Badenes-Sastre
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
- Department of Social Psychology, University of Granada, Granada, Spain
| | - Ana M Beltrán-Morillas
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
- Department of Personality, Evaluation and Psychological Treatment, University of Granada, Granada, Spain
| | - Francisca Expósito
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
- Department of Social Psychology, University of Granada, Granada, Spain
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Kang D, Park S, Kim HJ, Kim SW, Lee JE, Yu J, Lee SK, Kim JY, Nam SJ, Cho J, Park YH. Impact of Social Support during Diagnosis and Treatment on Disease Progression in Young Patients with Breast Cancer: A Prospective Cohort Study. Cancer Res Treat 2024; 56:125-133. [PMID: 37669709 PMCID: PMC10789941 DOI: 10.4143/crt.2023.673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 09/03/2023] [Indexed: 09/07/2023] Open
Abstract
PURPOSE We evaluated the association between changes in social support after cancer treatment and recurrence-free survival (RFS) in such patients using a prospective cohort study. MATERIALS AND METHODS Data were obtained from a prospective cohort study (NCT03131089) conducted at Samsung Medical Center (2013-2021). The primary outcome measure was RFS. Social support was measured using the social and family well-being (SFWB) domain of the Functional Assessment of Cancer Therapy-General. We calculated the changes in SFWB scores before and during treatment and the hazard ratio for RFS by comparing such changes. RESULTS The mean±standard deviation (SD) age of the patients was 35±3.9 years, and 71.5% and 64.8% of the patients were married and had children, respectively. The mean±SD SFWB score at baseline was 20.5±5.0 out of 26. After cancer treatment, 35.9%, 10.3%, and 53.8% of the participants had increasing, unchanged, and decreasing SFWB scores, respectively. The decreasing SFWB score group had a higher risk of mortality or recurrence than the increasing group. Risk factors for the decreasing score were the presence of children during diagnosis. CONCLUSION In this cohort, changes in social support after treatment were associated with RFS in young patients with breast cancer. Health professionals should develop family interventions to help them receive proper social support.
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Affiliation(s)
- Danbee Kang
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seri Park
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea
| | - Hyo Jung Kim
- Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Korea
- Research Institution for Future Medicine, Samsung Medical Center, Seoul, Korea
| | - Seok Won Kim
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeong Eon Lee
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jonghan Yu
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Se Kyung Lee
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji-Yeon Kim
- Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seok Jin Nam
- Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Juhee Cho
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yeon Hee Park
- Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea
- Division of Hematology-Oncology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Mera-Mamián AY, Moreno-Montoya J, Rodríguez-Villamizar LA, Muñoz DI, Segura ÁM, García HI. Construction of multilevel statistical models in health research: Foundations and generalities. BIOMEDICA : REVISTA DEL INSTITUTO NACIONAL DE SALUD 2023; 43:520-533. [PMID: 38109143 PMCID: PMC10826466 DOI: 10.7705/biomedica.6946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 09/27/2023] [Indexed: 12/19/2023]
Abstract
This topic review aims to present a global vision of multilevel analysis models’ applicability to health research, explaining its theoretical, methodological, and statistical foundations. We describe the basic steps to build these models and examples of their application according to the data hierarchical structure. It ir worth noticing that before using these models, researchers must have a rationale for needing them, and a statistical evaluation accounting for the variance percentage explained by the observations grouping effect. The requirements to conduct this type of analysis depends on special conditions such as the type of variables, the number of units per level, or the type of hierarchical structure. We conclude that multilevel analysis models are a useful tool to integrate information, considering the complexity of the relationships and interactions involved in most health conditions, including the loss of independence between observation units.
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Affiliation(s)
| | - José Moreno-Montoya
- División de Estudios Clínicos y Epidemiología Clínica, Hospital Universitario de la Fundación Santa Fe de Bogotá, Bogotá, D.C., Colombia.
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Shi Y, Gu L, Zhang X, Chen M. Traditional Chinese medicine mediated tumor suppression via regulating psychological factors. MEDICINE IN NOVEL TECHNOLOGY AND DEVICES 2022. [DOI: 10.1016/j.medntd.2022.100162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Saita E, Ferraris G, Acquati C, Molgora S, Sorge A, Valenti F, Grassi MM, Vagnini D. Dyadic Profiles of Couples Coping With Body Image Concerns After Breast Cancer: Preliminary Results of a Cluster Analysis. Front Psychol 2022; 13:869905. [PMID: 35401315 PMCID: PMC8983958 DOI: 10.3389/fpsyg.2022.869905] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 02/28/2022] [Indexed: 11/16/2022] Open
Abstract
Breast cancer treatments have multiple adverse effects, including concerns about body appearance and function that are experienced by most patients. Altered body image negatively affects mental health, social, and relationship functioning. While the relationship with a partner is critical for patients’ psychological wellbeing and partners can promote positive body image, limited research has investigated individual and relational factors affecting the experience of both. This cross-sectional study aimed at (1) exploring rates of body image concerns among breast cancer patients, and (2) identifying dyadic profiles among participating dyads. Couples composed by patients who had undergone surgery and their romantic partners (n = 32) were recruited from the Breast Unit of a hospital in northern Italy. Both partners completed measures of personality characteristics (BFQ-2), psychological distress (HADS), coping flexibility (PACT), dyadic coping (DCQ), and closeness (IOS). Body image (BIS) and adjustment to cancer (Mini-MAC) measures were completed by patients only. K-mean cluster analyses identified 2-cluster solution among patients and partners, respectively. “Active patients” (cluster-1) reported low rates of body image concerns (p < 0.001), anxious preoccupation, negative dyadic coping, and self-oriented stress communication (p < 0.05), compared to “worried patients” (cluster-2). “Comfortable partners” (cluster-1) reported lower anxiety and depression (p < 0.001), self-oriented negative dyadic coping and closeness (p < 0.05) than “uncomfortable partners” (cluster-2). Three different dyadic profiles emerged: functional, dysfunctional, and ambivalent. Significant variations (p < 0.05) by anxiety, depression, and delegating dyadic coping existed. Results indicate there are groups of couples at greater risk for impaired psychological distress and body image concerns, which should be addressed in the context of dyadic psychosocial interventions.
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Affiliation(s)
- Emanuela Saita
- Department of Psychology, Catholic University of Sacred Heart, Milan, Italy
| | - Giulia Ferraris
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Chiara Acquati
- Graduate College of Social Work, University of Houston, Houston, TX, United States.,Department of Clinical Sciences, College of Medicine, University of Houston, Houston, TX, United States.,Department of Health Disparities Research, The UT MD Anderson Cancer Center, Houston, TX, United States
| | - Sara Molgora
- Department of Psychology, Catholic University of Sacred Heart, Milan, Italy
| | - Antonia Sorge
- Department of Psychology, Catholic University of Sacred Heart, Milan, Italy
| | | | | | - Denise Vagnini
- Department of Psychology, Catholic University of Sacred Heart, Milan, Italy
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Levkovich I, Hamama-Raz Y, Shinan-Altman S. "A kaleidoscope of relationships" - cervical cancer survivors' perspectives on their intimate relationships: A qualitative study. Palliat Support Care 2022; 21:1-10. [PMID: 35130992 DOI: 10.1017/s147895152100198x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Cervical cancer is known to affect survivors' intimate relationships, as well as their communication and coping. Yet little is known about the perspectives of these survivors on their intimate relationships in the context of their needs during and after medical treatment. Additionally, only a few studies have focused on survivors' perceived needs or on existing psychosexual support. Understanding these perceptions can help provide a tailored response and improve dyadic interventions. The aim of this study was to examine cervical cancer survivors' perspectives on their intimate relationships during and after their treatment. METHOD The present study adopted a qualitative-phenomenological approach. In-depth, semi-structured interviews were conducted with 15 survivors of cervical cancer between the ages of 38 and 44 who were diagnosed at stages I-II and were treated with radiotherapy or chemo-radiotherapy and surgery. Data collection continued until saturation of concepts was reached. The results underwent thematic analysis. RESULTS Analysis of the findings revealed two key themes: (1) Together and apart in the shadow of cervical cancer. This theme focuses on the recovery period as a potential opportunity for changing and improving the couple relationship, such that men no longer withdraw but rather provide their partners with needed support and encouragement. (2) Changes in sexual life and couple intimacy. This theme focuses on changes in sexual relations, which have become a burden, painful, and something to avoid. SIGNIFICANCE OF RESULTS The study provides a comprehensive picture of intimate relationships during and after cervical cancer treatment and highlights the women's needs and desires for support from their intimate partners. The discussion notes that oncology providers can better facilitate supportiveness on the part of cervical cancer partners by offering better couple-oriented education and interventions to promote couple communication.
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Affiliation(s)
- Inbar Levkovich
- Faculty of Graduate Studies, Oranim Academic College of Education, Kiryat Tivon, Israel
| | - Yaira Hamama-Raz
- School of Social Work, Ariel University, Ariel Science Park, Ariel, 40700, Israel
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Shrout MR, Madison AA, Renna ME, Alfano CM, Povoski SP, Lipari AM, Agnese DM, Carson WE, Malarkey WB, Bailey MT, Kiecolt-Glaser JK. The gut connection: Intestinal permeability as a pathway from breast cancer survivors' relationship satisfaction to inflammation across treatment. Brain Behav Immun 2022; 100:145-154. [PMID: 34808291 PMCID: PMC8769505 DOI: 10.1016/j.bbi.2021.11.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 11/07/2021] [Accepted: 11/13/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Breast cancer survivors are prone to weakened gut barriers, allowing bacteria to migrate into the blood stream. Gut permeability fuels inflammation, which, among survivors, can elevate risk for comorbid disease development, cancer recurrence, and a poor quality of life; however, survivors' satisfying relationships can provide health benefits. This longitudinal study used a conceptual model addressing how intimate relationships is associated with health through changes in gut permeability and inflammation. METHOD Breast cancer survivors (n = 139, stages 0-IIIC) completed a baseline visit before treatment and two follow-up visits 6 and 18 months after treatment ended. Women who had an abnormal breast cancer test followed by a benign diagnosis completed visits within a comparable timeframe (noncancer patient controls; n = 69). All women completed questionnaires assessing their relationship satisfaction and provided blood samples to assess two bacterial endotoxin biomarkers, lipopolysaccharide-binding protein (LBP) and soluble CD14 (sCD14), as well as C-reactive protein (CRP) and interleukin 6 (IL-6). RESULTS Within-person multilevel mediation analyses showed that when a survivor's relationship satisfaction was higher than usual, her own LBP and LBP/sCD14 were lower, which was associated with lower than her own average CRP and IL-6 (95% CIs [-0.0104, -0.0002]). IL-6 was also higher when older survivors, but not younger survivors, experienced higher than usual intestinal permeability (p = .001). These effects of satisfying relationships held after accounting for cancer-related and behavioral factors. Post-hoc analyses showed LBP, sCD14, and LBP/sCD14 were associated with CRP for the cancer survivors, but only LBP and LBP/sCD14 were linked to CRP among the noncancer control patients. CONCLUSION The gut environment is a new promising candidate for understanding a relationship's long-term health impact, particularly among those with elevated health risks. Survivors may reap multiple physiological benefits from satisfying relationships.
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Affiliation(s)
- M Rosie Shrout
- Department of Human Development and Family Studies, Purdue University, West Lafayette, IN, USA; Center on Aging and the Life Course, Purdue University, West Lafayette, IN, USA.
| | - Annelise A Madison
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, USA; Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Megan E Renna
- School of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | | | - Stephen P Povoski
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, USA; Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Adele M Lipari
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, USA; Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Doreen M Agnese
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, USA; Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA
| | - William E Carson
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, USA; Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA
| | - William B Malarkey
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, USA; Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Michael T Bailey
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, USA; Department of Pediatrics, The Ohio State College of Medicine, Columbus, OH, USA; Center for Microbial Pathogenesis, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA; Oral and Gastrointestinal Microbiology Research Affinity Group, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Janice K Kiecolt-Glaser
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, USA; Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, Columbus, OH, USA
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15
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Li M, Chan CW, Choi KC, Zhang H, Ng SN, Huang L, Zhang M, Zhao W. The Chinese version of the Revised Dyadic Adjustment Scale for gynaecological cancer patients and their partners: Translation and psychometric evaluation. Asia Pac J Oncol Nurs 2021; 9:48-54. [PMID: 35528790 PMCID: PMC9072179 DOI: 10.1016/j.apjon.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/23/2021] [Indexed: 11/15/2022] Open
Abstract
Objective The objective of the study was to translate the revised dyadic adjustment scale into Chinese and evaluate its psychometric properties in gynaecological cancer patients and their male partners. Methods A cross-sectional design with a random subsample re-tested at the one-week interval was adopted. Gynaecological cancer patients and their partners were asked to complete the Chinese version of the revised dyadic adjustment and quality of marriage index. Internal consistency, test-retest reliability, convergent validity, structural validity and known-group validity was assessed. Results A total of 252 participants (i.e., 126 female patients and 126 male partners) were recruited. The Chinese version of the Revised Dyadic Adjustment showed good internal consistency (Cronbach's α = 0.85), test–retest reliability (r = 0.88), known group validity and adequate convergent validity with a significant positive correlation (r = 0.60) with the Quality of Marriage Index. Confirmatory factor analysis indicated an acceptable model fit to a second-order three-factor structure (GFI = 0.913, RMR = 0.046, CFI = 0.932). Conclusions The Chinese version of revised dyadic adjustment demonstrated good reliability and acceptable validity in gynaecological cancer patients and male partners. The scale can be used to assess the effectiveness of clinical nursing services for couples on their relationship and to compare marital satisfaction and adjustment between China and other parts of the world.
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16
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Renna ME, Shrout MR, Madison AA, Jaremka LM, Alfano CM, Povoski SP, Agnese DM, Carson WE, Kiecolt-Glaser JK. Fluctuations in depression and anxiety predict dysregulated leptin among obese breast cancer survivors. J Cancer Surviv 2021; 15:847-854. [PMID: 33409856 DOI: 10.1007/s11764-020-00977-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 11/27/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Leptin influences inflammation and tumor growth and leptin signaling is often dysregulated among obese breast cancer survivors. This leads to a lack of satiety and, ultimately, risk for further weight gain. Breast cancer survivors also experience high rates of depression and anxiety, which are linked to leptin production. This study examined how a woman's anxiety and depressive symptoms, in combination with their obesity status, were associated with leptin. METHODS Breast cancer survivors (n = 200, stages 0-IIIa) completed a baseline visit before treatment and two follow-up visits, 6 and 18 months after treatment ended. Women completed anxiety and depression measures, and blood samples provided leptin data at each visit. This study related fluctuations in a survivor's own depression and anxiety (i.e., within-person effects), as well as average effects of depression and anxiety (i.e., between-person effects) to changes in leptin depending on BMI. RESULTS Obese survivors' leptin was significantly higher at visits when they had higher anxiety and depression symptoms than their own average level of symptoms. In contrast, within-person fluctuations in depression and anxiety were not related to leptin levels among non-obese survivors. No significant between-person effects of depression or anxiety on leptin emerged. CONCLUSIONS Leptin is a critical risk factor for recurrence and further health consequences. Our findings highlight how psychological health influences leptin production among breast cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS These results highlight a biological pathway that may facilitate further weight gain and health risks among distressed, obese breast cancer survivors.
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Affiliation(s)
- Megan E Renna
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, 43210, USA.
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, USA.
| | - M Rosie Shrout
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, 43210, USA
| | - Annelise A Madison
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, 43210, USA
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Lisa M Jaremka
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, USA
| | - Catherine M Alfano
- Northwell Health Cancer Institute & Center for Personalized Health, New York, NY, USA
| | - Stephen P Povoski
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, USA
- Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Doreen M Agnese
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, USA
- Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA
| | - William E Carson
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, USA
- Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Janice K Kiecolt-Glaser
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, 43210, USA
- Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, Columbus, OH, USA
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Cozzolino M, Celia G. The psychosocial genomics paradigm of hypnosis and mind-body integrated psychotherapy: Experimental evidence. AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2021; 64:123-138. [PMID: 34723776 DOI: 10.1080/00029157.2021.1947767] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The psychosocial genomics paradigm first proposed by Ernest Rossi established an epistemological shift in our application of hypnosis. We present original experimental research conducted within this paradigm that highlights the mind-gene relationship and, in particular, the positive health effects associated with hypnosis and mind-body integrated psychotherapy. We document that these approaches can stimulate epigenetic modifications and the expression of genes related to anti-inflammatory processes. These strategies strengthen the immune system and reduce oxidative stress both in normal and in oncological participants.
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18
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Shrout MR. The health consequences of stress in couples: A review and new integrated Dyadic Biobehavioral Stress Model. Brain Behav Immun Health 2021; 16:100328. [PMID: 34589814 PMCID: PMC8474672 DOI: 10.1016/j.bbih.2021.100328] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/03/2021] [Accepted: 08/09/2021] [Indexed: 11/24/2022] Open
Abstract
Despite marriage's health benefits, all couples experience stress that can increase morbidity and mortality risks. Marital stress can alter endocrine, cardiovascular, and immune function-key pathways from troubled relationships to poor health. This review discusses how partners "get under each other's skin" to influence psychological, behavioral, and biological health. Then, I offer a comprehensive Dyadic Biobehavioral Stress Model to build on this foundational work and inspire transdisciplinary research integrating psychoneuroimmunological and relational lenses. This conceptual and empirically driven model provides promising new directions to investigate mechanisms linking individuals' relationships behaviors to their own and their partners' health, with particular emphasis on biological pathways. These mechanisms may impact each partner's physical health outcomes, such as disease development, illness severity, and accelerated biological aging. Risk and protective factors across developmental stages and diverse contexts are also discussed to help explain how, and under what conditions, partners influence each other's health. Research applying this model can push the boundaries of our current understanding on dyadic stress its far-reaching health effects on self-report and biological markers across the lifespan.
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Affiliation(s)
- M. Rosie Shrout
- Department of Human Development and Family Studies, Purdue University, West Lafayette, IN, 47907, USA
- Center on Aging and the Life Course, Purdue University, West Lafayette, IN, 47907, USA
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19
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Shrout MR, Renna ME, Madison AA, Alfano CM, Povoski SP, Lipari AM, Agnese DM, Farrar WB, Carson WE, Kiecolt-Glaser JK. Breast cancer survivors' satisfying marriages predict better psychological and physical health: A longitudinal comparison of satisfied, dissatisfied, and unmarried women. Psychooncology 2021; 30:699-707. [PMID: 33340188 DOI: 10.1002/pon.5615] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 12/15/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Breast cancer survivors who experience psychological and physical symptoms after treatment have an increased risk for comorbid disease development, reduced quality of life, and premature mortality. Identifying factors that reduce or exacerbate their symptoms may enhance their long-term health and physical functioning. This study examined how survivors' marital status and marital satisfaction-key health determinants-impacted their psychological and physical health trajectories to understand when, and for whom, marriage offers health benefits. METHODS Breast cancer survivors (n = 209, stages 0-IIIC) completed a baseline visit before treatment and two follow-up visits 6 and 18 months after treatment ended. Women completed questionnaires assessing their marital status and satisfaction when applicable, as well as their psychological (depressive symptoms, stress) and physical (fatigue, pain) health at each visit. RESULTS Married women-both those in satisfying and dissatisfying marriages-experienced improvements in their depressive symptoms, stress, and fatigue from pretreatment to 6- and 18-month posttreatment. Unmarried (i.e., single, divorced/separated, or widowed) women's depressive symptoms, stress, fatigue, and pain did not change over time, instead remaining elevated 6 and 18 months after treatment ended. Women in satisfying marriages also had fewer psychological and physical symptoms after treatment than those who were unmarried or in dissatisfying marriages. CONCLUSIONS Although marriage was associated with improved psychological and physical health, the gains were most notable when survivors' marriages were satisfying. Thus, the quality of survivors' marriages, rather than the marriage itself, provided the most benefits to their psychological and physical health.
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Affiliation(s)
- M Rosie Shrout
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Megan E Renna
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, Ohio, USA
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Annelise A Madison
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, Ohio, USA
- Department of Psychology, The Ohio State University, Columbus, Ohio, USA
| | | | - Stephen P Povoski
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, Ohio, USA
- Department of Surgery, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Adele M Lipari
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, Ohio, USA
- Department of Surgery, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Doreen M Agnese
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, Ohio, USA
- Department of Surgery, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - William B Farrar
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, Ohio, USA
- Department of Surgery, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - William E Carson
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, Ohio, USA
- Department of Surgery, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Janice K Kiecolt-Glaser
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, Ohio, USA
- Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, Columbus, Ohio, USA
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20
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Cozzolino M, Cocco S, Piezzo M, Celia G, Costantini S, Abate V, Capone F, Barberio D, Girelli L, Cavicchiolo E, Ascierto PA, Madonna G, Budillon A, De Laurentiis M. A Psychosocial Genomics Pilot Study in Oncology for Verifying Clinical, Inflammatory and Psychological Effects of Mind-Body Transformations-Therapy (MBT-T) in Breast Cancer Patients: Preliminary Results. J Clin Med 2021; 10:E136. [PMID: 33401546 PMCID: PMC7796278 DOI: 10.3390/jcm10010136] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/26/2020] [Accepted: 12/30/2020] [Indexed: 01/12/2023] Open
Abstract
Several studies have highlighted the key role of chronic inflammation in breast cancer development, progression, metastasis, and therapeutic outcome. These processes are mediated through a variety of cytokines and hormones that exert their biological actions either locally or distantly via systemic circulation. Recent findings suggest that positive psychosocial experiences, including psychotherapeutic interventions and therapeutic mind-body protocols, can modulate the inflammatory response by reducing the expression of genes/proteins associated with inflammation and stress-related pathways. Our preliminary results indicate that a specific mind-body therapy (MBT-T) could induce a significant reduction of the release of different cytokines and chemokines, such as SCGFβ, SDF-1α, MCP3, GROα, LIF, and IL-18, in the sera of breast cancer patients compared to a control group, suggesting that MBT-T could represent a promising approach to improve the wellness and outcome of breast cancer patients.
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Affiliation(s)
- Mauro Cozzolino
- Department of Human, Philosophical and Educational Sciences, University of Salerno, 84084 Fisciano (SA), Italy; (M.C.); (G.C.); (L.G.); (E.C.)
| | - Stefania Cocco
- Department of Breast and Thoracic Oncology, Division of Breast Medical Oncology, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy; (S.C.); (M.P.)
| | - Michela Piezzo
- Department of Breast and Thoracic Oncology, Division of Breast Medical Oncology, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy; (S.C.); (M.P.)
| | - Giovanna Celia
- Department of Human, Philosophical and Educational Sciences, University of Salerno, 84084 Fisciano (SA), Italy; (M.C.); (G.C.); (L.G.); (E.C.)
| | - Susan Costantini
- Experimental Pharmacology Unit—Mercogliano Laboratory, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy; (S.C.); (F.C.); (A.B.)
| | - Valentina Abate
- Psychology Unit, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy; (V.A.); (D.B.)
| | - Francesca Capone
- Experimental Pharmacology Unit—Mercogliano Laboratory, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy; (S.C.); (F.C.); (A.B.)
| | - Daniela Barberio
- Psychology Unit, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy; (V.A.); (D.B.)
| | - Laura Girelli
- Department of Human, Philosophical and Educational Sciences, University of Salerno, 84084 Fisciano (SA), Italy; (M.C.); (G.C.); (L.G.); (E.C.)
| | - Elisa Cavicchiolo
- Department of Human, Philosophical and Educational Sciences, University of Salerno, 84084 Fisciano (SA), Italy; (M.C.); (G.C.); (L.G.); (E.C.)
| | - Paolo Antonio Ascierto
- Department Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy; (P.A.A.); (G.M.)
| | - Gabriele Madonna
- Department Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy; (P.A.A.); (G.M.)
| | - Alfredo Budillon
- Experimental Pharmacology Unit—Mercogliano Laboratory, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy; (S.C.); (F.C.); (A.B.)
| | - Michelino De Laurentiis
- Department of Breast and Thoracic Oncology, Division of Breast Medical Oncology, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, 80131 Naples, Italy; (S.C.); (M.P.)
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21
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Renna ME, Shrout MR, Madison AA, Alfano CM, Povoski SP, Lipari AM, Agnese DM, Carson WE, Kiecolt-Glaser JK. Within-person changes in cancer-related distress predict breast cancer survivors' inflammation across treatment. Psychoneuroendocrinology 2020; 121:104866. [PMID: 32947247 PMCID: PMC7572735 DOI: 10.1016/j.psyneuen.2020.104866] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 08/31/2020] [Accepted: 09/01/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Among breast cancer survivors, elevated inflammation has been linked to greater recurrence risk. Psychological processes, such as cancer-related distress, can pose threats to a survivor's longevity and wellbeing. Although distress can heighten inflammation, little is known about how fluctuations in distress during and after treatment impact a woman's own inflammation - the primary question of this study. METHODS Breast cancer survivors (n = 165, stages 0-III) completed a baseline visit before treatment and two follow-up visits 6 and 18 months after. At each visit, women completed the Impact of Events Scale to assess cancer-related distress, and a blood sample was collected to measure proinflammatory cytokines IL-6, TNF-α, IL-1β, and IL-8. This longitudinal study related fluctuations in survivor's own cancer-related distress (i.e., within-person effects), as well as average effects of cancer-related distress between survivors (i.e., between-person effects) to inflammatory changes across visits. RESULTS Women had elevated inflammation at visits where they expressed more cancer-related distress than what was typical. In contrast, the average cancer-related distress was not associated with inflammation. CONCLUSION Larger increases in a women's cancer-related distress was linked with higher inflammation across visits. Comparing a survivor's own cancer-related distress to her average levels may prove useful in identifying links between distress and inflammation.
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Affiliation(s)
- Megan E. Renna
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, USA,Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, USA,Corresponding author at: Institute of Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, 43210, United States. (M.E. Renna)
| | - M. Rosie Shrout
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Annelise A. Madison
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, USA,Department of Psychology, The Ohio State University, Columbus, OH, USA
| | | | - Stephen P. Povoski
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, USA,Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Adele M. Lipari
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, USA,Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Doreen M. Agnese
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, USA,Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA
| | - William E. Carson
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, USA,Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Janice K. Kiecolt-Glaser
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, USA,Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, Columbus, OH, USA
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Borgi M, Collacchi B, Ortona E, Cirulli F. Stress and coping in women with breast cancer:unravelling the mechanisms to improve resilience. Neurosci Biobehav Rev 2020; 119:406-421. [PMID: 33086128 DOI: 10.1016/j.neubiorev.2020.10.011] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 10/01/2020] [Accepted: 10/13/2020] [Indexed: 12/15/2022]
Abstract
Breast cancer diagnosis, surgery, adjuvant therapies and survivorship can all be extremely stressful. In women, concerns about body image are common as a result of the disease and can affect interpersonal relationships, possibly leading to social isolation, increasing the likelihood for mood disorders. This is particularly relevant as women are at greater risk to develop anxiety and depressive symptoms in response to highly stressful situations. Here we address the mechanisms and the pathways activated as a result of stress and contributing to changes in the pathophysiology of breast cancer, as well as the potential of stress management factors and interventions in buffering the deleterious effects of chronic stress in a gender perspective. An improved understanding of the biological mechanisms linking stress-management resources to health-relevant biological processes in breast cancer patients could reveal novel therapeutic targets and help clarifying which psychosocial interventions can improve cancer outcomes, ultimately offering a unique opportunity to improve contemporary cancer treatments.
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Affiliation(s)
- Marta Borgi
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Barbara Collacchi
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Elena Ortona
- Center for Gender Specific Medicine, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Francesca Cirulli
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
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