CBSM effects in postadjuvant breast cancer survivors

乳腺癌幸存者会遇到许多压力源，这些压力源可能导致持久的、改变生活的心理社会、行为和生理后遗症。在整个疾病过程中遇到的压力包括但不限于生活任务的中断、社交网络的变化、治疗相关的副作用、经济困难以及对疾病复发和进展的不确定性。当然，乳腺癌的不良影响已经有了很好的记录，但越来越多的文献表明，一些癌症幸存者也报告了他们的经历中的积极增长。目前，很少有人知道这些潜在的改变生活的消极和积极的变化是否或如何可以通过心理社会干预的影响。也就是说，如果有的话，心理社会干预如何缓冲乳腺癌及其治疗的负面影响？这些干预措施如何促进幸存者的积极成长？此外，介入相关处理如何影响生理变化（即，行为、免疫系统功能和神经内分泌功能），这反过来又可能增加或降低乳腺癌复发和进展的风险？这些问题是拟议项目的重点。我们建议测试我们的小组为基础的，认知行为压力管理（CBSM干预白色，西班牙裔和黑人妇女已被诊断为原发性，早期至中期乳腺癌（阶段I-III）和治疗的有效性。拟议的项目将研究CBSM对各种心理社会过程的影响（即，认知评价、自我效能、社会支持和生理唤醒）。具体而言，我们预计这些过程中与干预相关的变化将促进更快地恢复到诊断前的生活质量水平，并增强积极增长的感觉。我们还将研究这些过程中与干预相关的变化如何与健康行为，免疫系统功能和生殖激素水平的变化相关，这些变化本身可能与疾病复发和进展有关。

Breast cancer survivors encounter many stressors that may resulting in lasting, life-altering psychosocial, behavioral, and physiological sequelae. The stressors encountered throughout the course of the disease include, but are not limited to, disruption of life tasks, changes in social network, treatment-related side effects, financial hardship, and uncertainty about disease recurrence and progression. Certainly, the adverse effects of breast cancer have been well documented, but a growing body of literature reveals that some cancer survivors also report positive growth from their experience. At present, little is known about whether or how these potentially life-altering changes negative and positive can be influenced by psychosocial interventions. That is, how, if all, do psychosocial interventions buffer the negative effects of breast cancer and its treatment? How do such interventions enhance positive growth in survivors? Moreover, how do intervention-related processed influence physiological changes (i.e., in behavior, immune system functioning, and neuroendocrine functioning), which in turn, may increased or reduce the risk of breast cancer recurrence and progression? These questions are the focus of the proposed project. We propose to test the effectiveness of our group-based, cognitive behavioral stress management (CBSM intervention among White, Hispanic, and Black women who have been diagnosed with and treated for primary, early- to middle stage breast cancer (Stages I-III). The proposed project will examine the effects of CBSM on a variety of psychosocial processes (i.e., cognitive appraisals, self-efficacy, social support, and physiological arousal) immediately, 6 months, and 12 months after the intervention. Specifically, we expect intervention-related changes in these processes to foster a more rapid return to pre-diagnostic levels of quality of life, as well as enhance a sense of positive growth. We will also examine how intervention-related changes in these processes are associated with changes in health behaviors, immune system functioning, and reproductive hormone levels, which themselves may be related to disease recurrence and progression.