Emotion-Regulation, Inflammatory Processes, and Depression in Prostate Cancer Sur

描述（由申请人提供）：在大约250万确诊的美国男性中，前列腺癌的经历会造成心理和身体上的损失。根治性前列腺切除术或局部前列腺癌放射治疗后的一段时间，其特征是身体功能发生相对迅速的变化，并且可能是男性抑郁症增加和心理适应不良的关键时期。在癌症的背景下，抑郁症会损害重要的健康结果。然而，很少有研究试图检查前列腺癌治疗后抑郁症的风险和发生情况。本研究的一个主要目标是指定和测试一个理论驱动的模型，该模型是关于心理和环境脆弱性如何在前列腺癌治疗后的一年中塑造抑郁的轨迹的。本项目结合压力与应对、心理神经免疫学、情绪调节等理论与研究，探讨前列腺癌患者抑郁的原因与机制。这项研究旨在实现三个具体目标。目的1是研究心理和环境脆弱性（包括癌症相关和一般压力源）、情绪调节过程和促炎细胞因子如何在治疗后的一年内塑造前列腺癌患者抑郁的轨迹。目的2和3将分别研究情绪调节过程和促炎标志物作为心理和情境脆弱性对抑郁症影响的近端介质。我们将采用纵向研究设计，在150名不同种族的男性开始癌症治疗之前开始，在治疗后1个月和2个月进行后续评估，随后每2个月进行一次评估，直到第12个月。将进行血样采集、有效的问卷调查和访谈以及情绪表达行为的评估。这种方法将允许识别哪些特征是抑郁症患者持续存在的特征，以及针对谁进行干预。了解前列腺癌患者所经历的抑郁模式和病因学过程将对抑郁症的评估和治疗以及有效干预措施的发展产生影响

DESCRIPTION (provided by applicant): In the approximately 2.5 million American men diagnosed, the experience of prostate cancer can exact a psychological and physical toll. The period following radical prostatectomy or radiation therapy for localized prostate cancer is marked by relatively rapid changes physical functioning and can be a critical period marked by increased depression and poor psychological adjustment for men. In the context of cancer, depression can compromise important health outcomes. However, little research has sought to examine the unfolding risk and occurrence of depression following prostate cancer treatment. A primary goal of this research is to specify and test a theoretically-driven model of how psychological and contextual vulnerabilities shape trajectories of depression in the year following prostate cancer treatment. This project calls upon stress and coping, psychoneuroimmunology, and emotion regulation theories and research to investigate the causes and mechanisms of depression among prostate cancer patients. This research seeks to accomplish three specific aims. Aim 1 is to investigate how psychological and contextual vulnerabilities (including cancer-related and general stressors), emotion-regulating processes, and proinflammatory cytokines shape trajectories of depression in men with prostate cancer in the year following treatment. Aims 2 and 3 will examine emotion regulating processes and proinflammatory markers as proximal mediators of psychological and contextual vulnerabilities' effects on depression, respectively. We will accomplish these aims using a longitudinal research design set to begin prior to initiation of cancer treatment in 150 ethnically-diverse men, with subsequent assessments at 1 and 2 months post-treatment, and every 2 subsequent months through month 12. Blood sample collection, validated questionnaires and interviews, and evaluations of emotionally-expressive behaviors will be administered. This approach will allow for identification of which features characterize patients in whom depression is persistent and to whom to target intervention. Understanding the patterns and etiologic processes of depression as it is experienced by prostate cancer patients will have implications for the assessment and treatment of depression and the development of efficacious interventions