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Hardardottir H, Aspelund T, Fall K, Broström E, Sigurdsson BB, Cook E, Valdimarsdottir H, Fang F, Sloan EK, Lutgendorf SK, Jansson C, Valdimarsdottir UA. Psychobiological stress response to a lung cancer diagnosis: a prospective study of patients in Iceland and Sweden. Acta Oncol 2023; 62:1338-1347. [PMID: 37747345 DOI: 10.1080/0284186x.2023.2258445] [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: 06/20/2023] [Accepted: 09/08/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND A diagnostic work-up leading to a lung cancer diagnosis is a severely stressful experience that may impact tumor progression. Yet, prospective data are scarce on psychological and biological components of stress at the time of lung cancer diagnosis. The aim of this study was to assess pre-to-post diagnosis change in psychological distress and urinary excretion of catecholamines in patients with suspected lung cancer. METHODS Participants were 167 patients within the LUCASS study, recruited at referral for suspected lung cancer to University Hospitals in Iceland and Sweden. Patients completed questionnaires on perceived distress (Hospital Anxiety and Depression Scale, HADS) before and after diagnosis of lung cancer or a non-malignant origin. A subpopulation of 85 patients also provided overnight urine for catecholamine analysis before and at a median of 24 days after diagnosis but before treatment. RESULTS A lung cancer diagnosis was confirmed in 123 (73.7%) patients, with a mean age of 70.1 years. Patients diagnosed with lung cancer experienced a post-diagnosis increase in psychological distress (p = 0.010), while patients with non-malignant lung pathology showed a reduction in distress (p = 0.070). Both urinary epinephrine (p = 0.001) and norepinephrine (p = 0.032) levels were higher before the diagnosis among patients eventually diagnosed with lung cancer compared to those with non-malignant lung pathology. We observed indications of associations between pre-to-post diagnosis changes in perceived distress and changes in urinary catecholamine levels. CONCLUSION Receiving a lung cancer diagnosis is associated with an increase in psychological distress, while elevated catecholamine levels are evident already before lung cancer diagnosis.
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Affiliation(s)
- Hronn Hardardottir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Department of Respiratory Medicine, Landspitali University Hospital, Reykjavik, Iceland
| | - Thor Aspelund
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Katja Fall
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Erika Broström
- Department of Immunology, Genetics and Pathology, Clinical and Experimental Pathology, Uppsala University, Uppsala, Sweden
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Baldur B Sigurdsson
- Department of Clinical Chemistry, Landspitali University Hospital, Reykjavik, Iceland
| | - Elizabeth Cook
- Department of Clinical Chemistry, Landspitali University Hospital, Reykjavik, Iceland
| | - Heiddis Valdimarsdottir
- Department of Psychology, Reykjavik University, Reykjavik, Iceland
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Fang Fang
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Erica K Sloan
- Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Susan K Lutgendorf
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, Iowa, USA
| | - Christer Jansson
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Unnur A Valdimarsdottir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Kumar S, Kumar K, Singh B, Mehrotra D, Mahdi A. Association of salivary cortisol and psychological burden in patients with oral cancer and oral potentially malignant disorders: A prospective study. J Cancer Res Ther 2023; 19:S0. [PMID: 37147974 DOI: 10.4103/jcrt.jcrt_530_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Introduction This study aimed to find an association between psychological burden (in terms of depression, anxiety, and stress) and salivary cortisol among oral cancer (OC) and oral potentially malignant disorder (OPMD) patients at various time frames. Methods In total, 50 patients with OC and OPMD were studied after their informed consent along with 30 healthy controls. Depression, anxiety, and stress scale-21 (DASS-21) was administered and saliva was collected (non-invasively) at different stages including the time of diagnosis, one and three months after intervention (medical or surgical). To avoid diurnal variation, saliva was collected twice (morning and evening). To assess the linear relationship between depression, anxiety, and stress with salivary cortisol, a partial correlation was calculated. Results Comparison of salivary cortisol levels among control, OC, and OPMD groups showed a statistically significant difference in both morning and evening values at different point of time intervals. Higher values of salivary cortisol were observed in OC patients (both morning and evening) in comparison to the OPMD or control group. A positive correlation was discerned between stress and salivary cortisol in both OPMD and OC patients, while no association was found for depression and anxiety domains. Conclusion The measurement of salivary cortisol effectively demonstrates raised stress levels in OPMD as well as OC patients. Therefore, it is recommended to institute stress management interventions in the patients as part of the treatment of OPMD and OC.
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Kulik G. ADRB2-Targeting Therapies for Prostate Cancer. Cancers (Basel) 2019; 11:E358. [PMID: 30871232 PMCID: PMC6468358 DOI: 10.3390/cancers11030358] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 03/07/2019] [Accepted: 03/08/2019] [Indexed: 01/01/2023] Open
Abstract
There is accumulating evidence that β-2 adrenergic receptor (ADRB2) signaling contributes to the progression and therapy resistance of prostate cancer, whereas availability of clinically tested β-blocker propranolol makes this pathway especially attractive as potential therapeutic target. Yet even in tumors with active ADRB2 signaling propranolol may be ineffective. Inhibition of apoptosis is one of the major mechanisms by which activation of ADRB2 contributes to prostate cancer pathophysiology. The signaling network that controls apoptosis in prostate tumors is highly redundant, with several signaling pathways targeting a few critical apoptosis regulatory molecules. Therefore, a comprehensive analysis of ADRB2 signaling in the context of other signaling mechanisms is necessary to identify patients who will benefit from propranolol therapy. This review discusses how information on the antiapoptotic mechanisms activated by ADRB2 can guide clinical trials of ADRB2 antagonist propranolol as potential life-extending therapy for prostate cancer. To select patients for clinical trials of propranolol three classes of biomarkers are proposed. First, biomarkers of ADRB2/cAMP-dependent protein kinase (PKA) pathway activation; second, biomarkers that inform about activation of other signaling pathways unrelated to ADRB2; third, apoptosis regulatory molecules controlled by ADRB2 signaling and other survival signaling pathways.
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Affiliation(s)
- George Kulik
- Department of Cancer Biology, Wake Forest University Health Sciences, Medical Center Blvd, Winston-Salem, NC 27157, USA.
- Department of Life Sciences, Alfaisal University, Riyadh 11533, Saudi Arabia.
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Bastos DB, Sarafim-Silva BAM, Sundefeld MLMM, Ribeiro AA, Brandão JDP, Biasoli ÉR, Miyahara GI, Casarini DE, Bernabé DG. Circulating catecholamines are associated with biobehavioral factors and anxiety symptoms in head and neck cancer patients. PLoS One 2018; 13:e0202515. [PMID: 30125310 PMCID: PMC6101398 DOI: 10.1371/journal.pone.0202515] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 08/03/2018] [Indexed: 02/06/2023] Open
Abstract
Studies have shown that stress-related catecholamines may affect cancer progression. However, little is known about catecholamine secretion profiles in head and neck cancer patients. The present study investigated plasma norepinephrine and epinephrine levels in head and neck squamous cell carcinoma (HNSCC) patients and patients with oral leukoplakia, as well as their association with clinicopathological and biobehavioral variables and anxiety symptoms. A total of 93 patients with HNSCC and 32 patients with oral leukoplakia were included. Plasma norepinephrine and epinephrine levels were measured by high performance liquid chromatography with electrochemical detection (HPLC-ED), and psychological anxiety levels were measured by the Beck Anxiety Inventory (BAI). Plasma norepinephrine and epinephrine concentrations were significantly higher in patients with oral and oropharyngeal squamous cell carcinoma (SCC) compared to non-cancer patients. Oral SCC patients displayed plasma norepinephrine levels about six times higher than oropharyngeal SCC patients, and nine times higher than oral leukoplakia patients (p < .001). Plasma epinephrine levels in oral SCC patients were higher compared to the oropharyngeal SCC (p = .0097) and leukoplakia (p < .0001) patients. Oropharyngeal SCC patients had higher plasma norepinephrine (p = .0382) and epinephrine levels (p = .045) than patients with oral leukoplakia. Multiple regression analyses showed that a history of high alcohol consumption was predictive for reduced plasma norepinephrine levels in the oral SCC group (p < .001). Anxiety symptom of “hand tremor” measured by the BAI was an independent predictor for higher plasma norepinephrine levels in HNSCC patients (β = 157.5, p = .0377), while the “heart pounding/racing” symptom was independently associated with higher plasma epinephrine levels in the oropharyngeal SCC group (β = 15.8, p = .0441). In oral leukoplakia patients, sleep deprivation and worse sleep quality were independent predictors for higher plasma norepinephrine levels, while severe tobacco consumption and higher anxiety levels were factors for higher plasma epinephrine levels. These findings suggest that head and neck cancer patients display sympathetic nervous system hyperactivity, and that changes in circulating catecholamines may be associated with alcohol consumption, as well as withdrawal-related anxiety symptoms.
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Affiliation(s)
- Daniela B. Bastos
- Psychosomatic Research Center and Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Bruna A. M. Sarafim-Silva
- Psychosomatic Research Center and Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Maria Lúcia M. M. Sundefeld
- Psychosomatic Research Center and Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Amanda A. Ribeiro
- Department of Medicine, Nephrology Division, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Juliana D. P. Brandão
- Department of Medicine, Nephrology Division, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Éder R. Biasoli
- Psychosomatic Research Center and Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Glauco I. Miyahara
- Psychosomatic Research Center and Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Dulce E. Casarini
- Department of Medicine, Nephrology Division, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Daniel G. Bernabé
- Psychosomatic Research Center and Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
- * E-mail:
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Perceived stress moderates the effects of a randomized trial of dance movement therapy on diurnal cortisol slopes in breast cancer patients. Psychoneuroendocrinology 2018; 87:119-126. [PMID: 29059542 DOI: 10.1016/j.psyneuen.2017.10.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 10/12/2017] [Accepted: 10/12/2017] [Indexed: 12/22/2022]
Abstract
Women with breast cancer are at risk of psychosocial distress and may suffer from aberrant diurnal cortisol rhythms. Dance movement therapy (DMT), a movement-based psychotherapy that incorporates exercise and artistic components, has demonstrated stress reduction effects. This study examined the effects of DMT on the diurnal cortisol rhythms of breast cancer patients undergoing radiotherapy treatment and the role of perceived stress in producing such effects. The study sample comprised 121 Chinese breast cancer patients randomized to the DMT (n=63) and control (n=58) groups. The intervention consisted of six 1.5-h group sessions held twice weekly over the course of radiotherapy. Participants completed validated self-report measures of perceived stress, fatigue, pain, and sleep disturbance and provided five salivary cortisol samples at baseline (Time 1) and post-intervention (Time 2). Moderated mediation analysis was used to evaluate the intervention effect on Time 2 diurnal cortisol slopes. Despite the absence of a significant DMT effect on diurnal cortisol slopes (B=-0.55, 95% CI=-1.20 to 0.08, β=-0.14), baseline perceived stress significantly moderated the intervention effect (B=-0.18, 95% CI=-0.32 to -0.05, β=-0.30). At high levels of baseline perceived stress (1 SD above the mean), the DMT group showed a steeper cortisol slope (M=-7.14) than the control group (M=-5.80) at Time 2. The present findings suggest that DMT might have a beneficial effect on diurnal cortisol slopes in breast cancer patients with high levels of distress.
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Nolte S, van der Mei SH, Strehl-Schwarz K, Köster J, Bender A, Rose M, Kruse J, Peters EMJ. Comparison of patient-reported need of psycho-oncologic support and the doctor's perspective: how do they relate to disease severity in melanoma patients? Psychooncology 2015; 25:1271-1277. [DOI: 10.1002/pon.4050] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 10/19/2015] [Accepted: 11/12/2015] [Indexed: 12/30/2022]
Affiliation(s)
- Sandra Nolte
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology; Charité - Universitätsmedizin Berlin; Berlin Germany
- Population Health Strategic Research Centre, School of Health and Social Development; Deakin University; Burwood VIC 3125 Australia
| | - Sicco H. van der Mei
- Department of Psychosomatic Medicine; Justus Liebig University (JLU); Giessen Germany
| | - Kerstin Strehl-Schwarz
- Department of Psychosomatic Medicine; Philipps University Marburg; Marburg Germany
- Psychoneuroimmunology Laboratory, Department of Psychosomatic Medicine; Justus Liebig University (JLU); Giessen Germany
| | - Johanna Köster
- Psychoneuroimmunology Laboratory, Department of Psychosomatic Medicine; Justus Liebig University (JLU); Giessen Germany
| | - Armin Bender
- Department of Dermatology; Philipps University Marburg; Marburg Germany
| | - Matthias Rose
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology; Charité - Universitätsmedizin Berlin; Berlin Germany
- Quantitative Health Sciences, Outcomes Measurement Science; University of Massachusetts Medical School; Worcester MA USA
| | - Johannes Kruse
- Department of Psychosomatic Medicine; Justus Liebig University (JLU); Giessen Germany
- Department of Psychosomatic Medicine; Philipps University Marburg; Marburg Germany
| | - Eva M. J. Peters
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology; Charité - Universitätsmedizin Berlin; Berlin Germany
- Psychoneuroimmunology Laboratory, Department of Psychosomatic Medicine; Justus Liebig University (JLU); Giessen Germany
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Chen CJ, Sung HC, Lee MS, Chang CY. The effects of Chinese five-element music therapy on nursing students with depressed mood. Int J Nurs Pract 2014; 21:192-9. [PMID: 24593291 DOI: 10.1111/ijn.12236] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study aimed to evaluate the effects of Chinese five-element music therapy on nursing students with depressed mood. We randomly assigned 71 nursing students from Taiwan with depressed mood to the music and control groups. The music group (n = 31) received Chinese five-element music therapy, whereas the participants in the control group (n = 40) maintained their routine lifestyles with no music therapy. All of the participants were assessed using the Depression Mood Self-Report Inventory for Adolescence, and their salivary cortisol levels were measured. The study found that there was a significant reduction in depression between the pre- and posttherapy test scores and in salivary cortisol levels over time in the music group. After receiving the music therapy, the nursing students' depression levels were significantly reduced (P = 0.038) compared with the control group (P < 0.001). These results indicate that the Chinese five-element music therapy has the potential to reduce the level of depression in nursing students with depressed mood.
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Affiliation(s)
- Chen-Jung Chen
- Department of Nursing, Jen-Teh Junior of Medicine Nursing and Management, Miaoli County, Taiwan
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Cohen L, Cole SW, Sood AK, Prinsloo S, Kirschbaum C, Arevalo JMG, Jennings NB, Scott S, Vence L, Wei Q, Kentor D, Radvanyi L, Tannir N, Jonasch E, Tamboli P, Pisters L. Depressive symptoms and cortisol rhythmicity predict survival in patients with renal cell carcinoma: role of inflammatory signaling. PLoS One 2012; 7:e42324. [PMID: 22870317 PMCID: PMC3409855 DOI: 10.1371/journal.pone.0042324] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Accepted: 07/05/2012] [Indexed: 01/06/2023] Open
Abstract
Purpose Evidence has supported the association between psychological factors and cancer biology; however, findings are equivocal on the role of psychosocial factors in cancer progression. This study generates a hypothesis of mechanistic variables by examining the clinical effects of psychosocial factors and cortisol dysregulation in patients with metastatic renal cell carcinoma (RCC) and examines associated activation of transcription control pathways. Methods Patients with metastatic RCC (n = 217) were prospectively enrolled in this study. Patients completed questionnaires (Centers for Epidemiologic Studies – Depression; SF-36 Health Status Survey; Duke Social Support Index; Coping Operations Preference Enquiry; organized and non-organized religious activity; and intrinsic religiosity), and provided blood and saliva samples. Cortisol levels and whole genome transcriptional profiling were assessed to identify potential alterations in circadian rhythms and genomic pathways. Results Separate Cox regression models, controlling for disease risk category, revealed that CES-D scores (p = 0.05, HR = 1.5, 95% CI for HR: 1.00–2.23) and cortisol slope (p = 0.002; HR = 1.9; 95%CI for HR: 1.27–2.97) were significantly associated with decreased survival. Only cortisol slope and risk category remained significant in the complete model. Functional genomic analyses linked depressive symptoms to increased expression of pro-inflammatory and pro-metastatic genes in circulating leukocytes. 116 transcripts were found to be upregulated by an average of 50% or more in high CES-D patients, and 57 transcripts downregulated by at least 50%. These changes were also found in the tumor in a subset of patients. Conclusion These findings identify depressive symptoms as a key predictor of survival in renal cell carcinoma patients with potential links to dysregulation of cortisol and inflammatory biology.
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Affiliation(s)
- Lorenzo Cohen
- Department of General Oncology and the Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America.
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Gross AF, Smith FA, Stern TA. Is depression an appropriate response to having cancer? A discussion of diagnostic criteria and treatment decisions. PRIMARY CARE COMPANION TO THE JOURNAL OF CLINICAL PSYCHIATRY 2011; 9:382-7. [PMID: 17998958 DOI: 10.4088/pcc.v09n0508] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Levi B, Benish M, Goldfarb Y, Sorski L, Melamed R, Rosenne E, Ben-Eliyahu S. Continuous stress disrupts immunostimulatory effects of IL-12. Brain Behav Immun 2011; 25:727-35. [PMID: 21277367 PMCID: PMC3081380 DOI: 10.1016/j.bbi.2011.01.014] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2010] [Revised: 01/05/2011] [Accepted: 01/23/2011] [Indexed: 11/28/2022] Open
Abstract
Immune stimulation by biological response modifiers is a common approach in tumor immunotherapy. IL-12 was found effective in various animal studies, but clinical trials showed limited success. However, among other differences, animal models do not simulate psychological or physiological stress while employing IL-12, whereas cancer patients often experience distress while treated with immunostimulants. Thus, in the current study we assessed the impact of continuous stress on the efficacy of IL-12 immunostimulation. F344 rats were subjected to a pharmacological stress paradigm (continuous administration of a β-adrenergic agonist) or to a 20 h behavioral stress paradigm (wet cage exposure) commencing 2h before IL-12 administration. Twenty-six hours after stress initiation, we studied indices known to reflect IL-12 immunostimulatory impacts, including NK cell numbers and activity in different immune compartments, and in vivo resistance to MADB106 lung tumor colonization. The results indicated that both the pharmacological and behavioral stress paradigms significantly reduced the increase in the number and activity of marginating-pulmonary NK cells evident in non-stressed IL-12 treated animals. Additionally, stressed animals exhibited a lower IL-12-induced improvement of MADB106 lung clearance, an in vivo index that markedly depends on total marginating-pulmonary NK activity. These deleterious effects of stress were more prominent in males than in females. Overall, the findings demonstrate that prolonged stress exposure can disrupt the efficacy of simultaneous immunostimulatory treatments, irrespective of stress effects on baseline immune measures. Neuroendocrine and cellular mediating mechanisms are yet unknown, but the potential clinical ramifications of these findings warrant consideration in clinical trials employing immunostimulatory agents.
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MESH Headings
- Adenocarcinoma/complications
- Adenocarcinoma/immunology
- Adjuvants, Immunologic/administration & dosage
- Adrenergic beta-2 Receptor Agonists
- Analysis of Variance
- Animals
- Chronic Disease
- Corticosterone/blood
- Epinephrine/blood
- Female
- Interleukin-12/administration & dosage
- Interleukin-12/immunology
- Killer Cells, Natural/cytology
- Killer Cells, Natural/immunology
- Lung Neoplasms/complications
- Lung Neoplasms/immunology
- Male
- Metaproterenol
- Neoplasms, Experimental/complications
- Neoplasms, Experimental/immunology
- Rats
- Rats, Inbred F344
- Sex Factors
- Stress, Psychological/blood
- Stress, Psychological/chemically induced
- Stress, Psychological/complications
- Stress, Psychological/immunology
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Affiliation(s)
- Ben Levi
- Neuroimmunology Research Unit, Department of Psychology, Tel-Aviv University, Tel-Aviv 69978, Israel
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A Meta-Analysis of Coefficient Alpha for the Impact of Event Scales: A Reliability Generalization Study. SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2011. [DOI: 10.1177/008124631104100102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We conducted a score reliability meta-analysis across studies using the Impact of Event Scales. Five hundred and ninety-four studies using the measure were located through electronic database searches and then separated to identify studies that had calculated and reported reliability coefficients from their own data. The 66 articles that remained were then coded to identify potential study characteristics that might influence the variation in reliability estimates. Results indicate adequate internal consistency estimates for all subscales across both scale versions. Furthermore, coefficient alpha was positively correlated with studies involving war and abuse victims for the IES Avoidance subscale. The alpha coefficient was also positively correlated with the percentage of female participants for the Intrusion subscale and negatively correlated to journal type for the composite reliability estimate. Results from this study provide useful information, in terms of scale performance, for researchers interested in using the scale for future academic pursuits and for school psychologists. In particular, implications for school psychologists are considered.
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Thornton LM, Andersen BL, Blakely WP. The pain, depression, and fatigue symptom cluster in advanced breast cancer: covariation with the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system. Health Psychol 2010; 29:333-7. [PMID: 20496988 DOI: 10.1037/a0018836] [Citation(s) in RCA: 135] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Neuroendocrine-immune models have been proposed to account for the frequent co-occurrence of pain, depression, and fatigue (PDF) among cancer patients. DESIGN In a cross-sectional observational study of advanced cancer patients (N = 104), we tested the hypothesis that the PDF cluster covaries with proposed biological mediators: hormones of the sympathetic nervous system (SNS) and the hypothalamic-pituitary-adrenal (HPA) axis. MAIN OUTCOME MEASURES PDF symptoms were measured using the Brief Pain Inventory, Fatigue Symptom Inventory, and the Center for Epidemiological Studies Depression scales. HPA activation was indicated by plasma levels of cortisol and adrenocorticotropic hormone, and SNS activation was indicated by plasma epinephrine and norepinephrine. RESULTS Preliminary analyses supported the use of covariance structure modeling to test whether shared variance among hormone levels predicted shared variance among PDF symptoms. Latent variable analysis indicated that neuroendocrine levels predicted PDF (standardized beta = .23, p = .039), while controlling for important disease and demographic variables. CONCLUSION Previous studies have linked individual symptoms to individual biomarkers. The observed significant paring of the 4 hormones to the PDF cluster provides the first evidence suggestive of stress hormones as a common mechanism for the co-occurrence of pain, depression, and fatigue symptoms.
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Affiliation(s)
- Lisa M Thornton
- Department of Psychology & Comprehensive Cancer Center, Ohio State University, 1835 Neil Avenue, Columbus, OH 43210, USA.
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Campbell JD, Yoon DP, Johnstone B. Determining relationships between physical health and spiritual experience, religious practices, and congregational support in a heterogeneous medical sample. JOURNAL OF RELIGION AND HEALTH 2010; 49:3-17. [PMID: 20162451 DOI: 10.1007/s10943-008-9227-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2008] [Accepted: 11/12/2008] [Indexed: 05/11/2023]
Abstract
Previous research indicates that increased religiosity/spirituality is related to better health, but the specific nature of these relationships is unclear. The purpose of this study was to determine the relationships between physical health and spiritual belief, religious practices, and congregational support using the Brief Multidimensional Measure of Religiousness/Spirituality and the Medical Outcomes Scale Shortform-36. A total of 168 participants were surveyed with the following medical disorders: Cancer, Spinal Cord Injury, Traumatic Brain Injury, and Stroke, plus a healthy sample from a primary care setting. The results show that individuals with chronic medical conditions do not automatically turn to religious and spiritual resources following onset of their disorder. Physical health is positively related to frequency of attendance at religious services, which may be related to better health leading to increased ability to attend services. In addition, spiritual belief in a loving, higher power, and a positive worldview are associated with better health, consistent with psychoneuroimmunological models of health. Practical implications for health care providers are discussed.
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Affiliation(s)
- James D Campbell
- Department of Family and Community Medicine, University of Missouri, Columbia, MO 65212, USA.
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Pierrehumbert B, Torrisi R, Laufer D, Halfon O, Ansermet F, Beck Popovic M. Oxytocin response to an experimental psychosocial challenge in adults exposed to traumatic experiences during childhood or adolescence. Neuroscience 2009; 166:168-77. [PMID: 20018229 DOI: 10.1016/j.neuroscience.2009.12.016] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2009] [Revised: 12/03/2009] [Accepted: 12/05/2009] [Indexed: 10/20/2022]
Abstract
Long-term implications of the exposure to traumatizing experiences during childhood or adolescence, such as sexual abuse, or cancer, have been documented, namely the subjects' response to an acute stress in adulthood. Several indicators of the stress response have been considered (e.g. cortisol, heart rate). Oxytocin (OT) response to an acute stress of individuals exposed to trauma has not been documented. Eighty subjects (n=26 women who had experienced episodes of child abuse, n=25 men and women healthy survivors of cancer in childhood or adolescence, and 29 controls) have been submitted to a laboratory session involving an experimental stress challenge, the Trier social stress test. Overall, there was a clear OT response to the psychosocial challenge. Subjects having experienced a childhood/adolescence life-threatening illness had higher mean levels of OT than both abused and control subjects. There was a moderate negative relationship between OT and salivary cortisol. It is suggested that an acute stress stimulates OT secretion, and that the exposure to enduring life-threatening experiences in childhood/adolescence has long-lasting consequences regarding the stress system and connected functions, namely the activation of OT secretion. Better knowledge of such long-term implications is important so that to prevent dysregulations of the stress responses, which have been shown to be associated to the individual's mental health.
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Affiliation(s)
- B Pierrehumbert
- Service Universitaire de Psychiatrie de l'enfant et de l'adolescent, Lausanne, Switzerland.
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15
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Vadiraja HS, Raghavendra RM, Nagarathna R, Nagendra HR, Rekha M, Vanitha N, Gopinath KS, Srinath BS, Vishweshwara MS, Madhavi YS, Ajaikumar BS, Ramesh BS, Nalini R, Kumar V. Effects of a yoga program on cortisol rhythm and mood states in early breast cancer patients undergoing adjuvant radiotherapy: a randomized controlled trial. Integr Cancer Ther 2009; 8:37-46. [PMID: 19190034 DOI: 10.1177/1534735409331456] [Citation(s) in RCA: 163] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED Objectives. This study compares the effects of an integrated yoga program with brief supportive therapy in breast cancer outpatients undergoing adjuvant radiotherapy at a cancer center. METHODS Eighty-eight stage II and III breast cancer outpatients are randomly assigned to receive yoga (n = 44) or brief supportive therapy (n = 44) prior to radiotherapy treatment. Assessments include diurnal salivary cortisol levels 3 days before and after radiotherapy and self-ratings of anxiety, depression, and stress collected before and after 6 weeks of radiotherapy. RESULTS Analysis of covariance reveals significant decreases in anxiety (P < .001), depression (P = .002), perceived stress (P < .001), 6 a.m. salivary cortisol (P = .009), and pooled mean cortisol (P = .03) in the yoga group compared with controls. There is a significant positive correlation between morning salivary cortisol level and anxiety and depression. CONCLUSION Yoga might have a role in managing self-reported psychological distress and modulating circadian patterns of stress hormones in early breast cancer patients undergoing adjuvant radiotherapy.
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Affiliation(s)
- H S Vadiraja
- Department of Yoga Research, Swami Vivekananda Yoga Anusandhana Samsthana, Bangalore, India [corrected]
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16
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Abstract
BACKGROUND The Brief Symptom Inventory (BSI) is a popular measure of psychopathology frequently used as an outcome measure, but clinicians and researchers have had to rely on normative data based on US samples which may not be appropriate for the British population. OBJECTIVES The aim was to develop culturally relevant outpatient norms for the BSI that would reflect hypothesized differences between US and UK population in responding to items on the BSI. METHOD BSI and demographic data were collected for 378 patients referred to clinical psychology services in the Midlands, England, during routine practice. RESULTS Significantly higher rates of psychopathology were reported by the UK sample than for the normative group reported in the US. CONCLUSION Outpatient normative data for British participants are presented. The study examines the impact of occupational status, age and gender differences on the level of reported distress.
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17
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Dettenborn L, James GD, van Berge-Landry H, Valdimarsdottir HB, Montgomery GH, Bovbjerg DH. Heightened cortisol responses to daily stress in working women at familial risk for breast cancer. Biol Psychol 2005; 69:167-79. [PMID: 15804544 DOI: 10.1016/j.biopsycho.2004.07.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2004] [Accepted: 07/16/2004] [Indexed: 11/18/2022]
Abstract
Consistent with animal models and experimental studies with humans facing other 'background' stressors, women at familial risk for breast cancer have been reported to have stronger cortisol responses to laboratory stressors. To explore the relevance of these findings to daily life, we compared work-stress cortisol responses in women with >or=1 first-degree relative with breast cancer (FH+, n = 74) to women without this risk factor (FH-, n = 141). Repeated-measures ANOVA revealed a group by time interaction (p <or= 0.05) with FH+ women having higher (p <or= 0.05) urinary cortisol levels than FH- during work, but not at home or during sleep. They also had a higher percentage increase between nadir cortisol levels and work levels. These results provide evidence that the heightened cortisol responses of FH+ women also apply to daily life stressors, and suggest the need for additional research to explore the possibility that accentuated hypothalamic-pituitary-axis responses to such stressors may increase health risk for these women.
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Affiliation(s)
- Lucia Dettenborn
- Biobehavioral Medicine Program, Department of Oncological Sciences, Mount Sinai School of Medicine, Box 1130, 1425 Madison Avenue, New York, NY 10029-6574, USA
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18
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Yehuda R. Hypothalamic-pituitary-adrenal alterations in PTSD: are they relevant to understanding cortisol alterations in cancer? Brain Behav Immun 2003; 17 Suppl 1:S73-83. [PMID: 12615190 DOI: 10.1016/s0889-1591(02)00070-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Recent studies of hypothalamic-pituitary-adrenal axis alterations in PTSD have demonstrated a specific type of hyperresponsivity of this stress hormonal system characterized by a greater negative feedback inhibition of cortisol, which may paradoxically serve to lower cortisol levels. The occurrence of cancer has been recently described by many investigators as an event that fulfills the DSM-IV criteria for a "traumatic event" that has been demonstrated in some cases to be linked with the subsequent development of PTSD. This review considers the extent to which neuroendocrine alterations observed in PTSD may be useful in understanding cortisol alterations involved in cancer.
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Affiliation(s)
- Rachel Yehuda
- Psychiatry Department and Division of Traumatic Stress Studies, Mount Sinai School of Medicine and Bronx Veterans Affairs, NY, USA.
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