Graduate

Coping with Cancer

Along with Michael Antoni and several other collaborators and graduate students, I am involved in research studying the adaptation of newly diagnosed early-stage breast cancer patients (for an overview see Carver, 2005, below). This project, which has now been funded for three cycles by the National Cancer Institute, completed its first intervention study about 6 years ago. Women in this study experienced either a 10-week cognitive-behavioral stress management therapy group, or a single-day seminar (focusing on the same topics as the longer intervention). We examined the impact of the intervention over the subsequent year on the women's quality of life in several distinct domains (Antoni et al., 2001, below).

There are many other variables in the study as well, including vulnerability and resilience factors such as optimism adult attachment patters, and mediating factors such as coping responses. We have recently examined the role of partner reactions to the woman's surgery as an influence on her psychosocial well-being apart from the intervention (Wimberly et al., 2005, below).  We expect other papers to emerge from that data set over the next couple of years.

We have also recently concluded a second intervention trial, in part to examine the impact of the intervention on immune functioning during the subsequent year.  We are now (as of December 2006) part-way through analyzing outcomes from this project (physiological outomes still under way). We have found that the intervention decreases distress and intrusive thoughts (Antoni et al., 2006a, below), and that it enhances positive responses of several types (Antoni et al., 2006b, below).  Using a new measure to probe for mediational effects, we have also obtained evidence that these beneficial effects of the intervention depend on a particular aspect of the intervention's impact:  giving women confidence that they can use techniques to relax whenever they wish to (in that same manuscript under review).

Another project I am  involved in looks at quality of life among adult long-term survivors of cancer (5 years or longer after treatment).  This project has several facets. One of them was the development of a new measure of quality of life designed specifically for long-term survivors (Avis et al., 2005, below). This project has also involved follow-up contacts with persons who participated in our earlier studies many years ago, to predict their quality of life at long-term follow-up on the basis of variables assessed many years earlier.  We have found very large effects of personality on well-being across that period (Carver et al., 2005, below); this finding will not surprise personality psychologists, but it is in rather sharp contrast to the general view of most people in oncology circles, who expect medical variables to be of primary importance. On the other hand, we have also found that different types of quality-of-life outcomes are predicted by different antecedents (Carver et al., 2006, below).

Another interesting aspect of all of this research concerns the fact that some cancer patients also report experiencing substantial benefits from having had cancer. This benefit finding has been shown to predict better psychological well-being several years later in one of our samples (Carver & Antoni, 2005, below). More recently, our group has found that the association of benefit finding to other indicators of well-being is actually curvilinear, both in the short term and in the long term (Lechner et al., 2006, below).  That is, some women with breast cancer who reported good psychosocial well-being report high benefit finding, some reported low benefit finding.  Women with intermediate levels of benefit finding were the ones who reported less well-being.

Relevant articles (reverse chronology):

Lechner, S. C., Carver, C. S., Antoni, M. H., Weaver, K. E., & Phillips, K. M. (2006).  Curvilinear associations between benefit finding and psychosocial adjustment to breast cancer. Journal of Consulting and Clinical Psychology, 74, 828-840.   [abstract]

Antoni, M. H., Lechner, S. C., Kazi, A., Wimberly, S. R., Sifre, T., Urcuyo, K. R., Phillips, K., Gluck, S., & Carver, C. S. (2006). How stress management improves quality of life after treatment for breast cancer. Journal of Consulting and Clinical Psychology, 74, 1143-1152.   [abstract]

Antoni, M. H.,  Wimberly, S. R., Lechner, S. C., Kazi, A., Sifre, T., Urcuyo, K. R., Phillips, K., Smith, R. G., Petronis, V. M., Guellati, S., Wells, K. A., Blomberg, B., & Carver, C. S. (2006). Stress management intervention reduces cancer-specific thought intrusions and anxiety symptoms among women undergoing treatment for breast cancer. American Journal of Psychiatry, 163, 1791-1797.    [abstract]

Carver, C. S., Smith, R. G., Petronis, V. M., & Antoni, M. H. (2006). Quality of life among long-term survivors of breast cancer: Different types of antecedents predict different classes of outcomes. Psycho-Oncology, 15, 749-758.    [abstract]

Carver, C. S., Smith, R. G., Antoni, M. H., Petronis, V. M., Weiss, S., & Derhagopian, R. P. (2005). Optimistic personality and psychosocial well-being during treatment predict psychosocial well-being among long-term survivors of breast cancer. Health Psychology, 24, 508-516.    [abstract]

Avis, N. E., Smith, K. W., McGraw, S., Smith, R. G., Petronis, V. M., & Carver, C. S. (2005). Assessing quality of life in adult cancer survivors (QLACS). Quality of Life Research, 14, 1007-1023.    [abstract]

Carver, C. S. (2005). Enhancing adaptation during treatment, and the role of individual differences. Cancer, 104, 2602-2607.   [abstract]

Urcuyo, K. R., Boyers, A. E., Carver, C. S., & Antoni, M. H. (2005). Finding benefit in breast cancer: Relations with personality, coping, and concurrent well-being. Psychology & Health, 20, 175-192.    [abstract]

Wimberly, S. R., Carver, C. S., Laurenceau, J-P., Harris, S. D., & Antoni, M. H. (2005). Perceived partner reactions to diagnosis and treatment of breast cancer: Impact on psychosocial and psychosexual adjustment. Journal of Consulting and Clinical Psychology, 73, 300-311.    [abstract]

Carver, C. S., & Antoni, M. H. (2004). Finding benefit in breast cancer during the year after diagnosis predicts better adjustment 5 to 8 years after diagnosis. Health Psychology, 26, 595-598.    [abstract]

Culver, J. L., Arena, P. L., Wimberly, S. R., Antoni, M. H., & Carver, C. S. (2004). Coping among African American, Hispanic, and non-Hispanic white women recently treated for early stage breast cancer. Psychology & Health, 19, 157-166.  [abstract]

Penedo, F. J., Dahn, J. R., Molton, I., Gonzalez, J. S., Kinsinger, D., Roos, B. A., Carver, C. S., Schneiderman, N., & Antoni, M. H. (2004). Cognitive behavioral stress management improves stress management skills and quality of life in men recovering from prostate cancer treatment. Cancer, 100, 192-200.

Carver, C. S., Lehman, J. M., & Antoni, M. H. (2003). Dispositional pessimism predicts illness-related disruption of social and recreational activities among breast cancer patients. Journal of Personality and Social Psychology, 84, 813-821.   [abstract]

Petronis, V. M., Carver, C. S., Antoni, M. H., & Weiss, S. (2003). Investment in body image and psychosocial well-being among women treated for early stage breast cancer: Partial replication and extension. Psychology & Health, 18, 1-13.  

Penedo, F. J., Dahn, J. R., Gonzalez, J. S., Molton, I., Carver, C. S., Antoni, M. H., Roos, B., & Schneiderman, N. (2003). Perceived stress management skill mediates the relationship between optimism and positive mood following radical prostatectomy. Health Psychology, 22, 220-222.

Culver, J. L., Arena, P. L., Antoni, M. H., & Carver, C. S. (2002). Coping and distress among women under treatment for early stage breast cancer: Comparing African Americans, Hispanics, and non-Hispanic Whites. Psycho-Oncology, 11, 495-504.   [ abstract ]

Antoni, M. H., Lehman, J. M., Kilbourn, K. M., Boyers, A. E., Culver, J. L., Alferi, S. M., Yount, S. E., McGregor, B. A., Arena, P. L., Harris, S. D., Price, A. A., & Carver, C. S.  (2001).  Cognitive-behavioral stress management intervention decreases the prevalence of depression and enhances benefit finding among women under treatment for early-stage breast cancer.  Health Psychology, 20, 20-32.  [ abstract ]

Alferi, S. M., Carver, C. S., Antoni. M. H., Weiss, S., & Durán, R. E.  (2001).  An exploratory study of social support, distress, and life disruption among low-income Hispanic women under treatment for early stage breast cancer.   Health Psychology, 20, 41-46.   [abstract ]

Carver, C. S., Meyer, B., & Antoni, M. H.  (2000). Responsiveness to threats and incentives, expectancy of recurrence, and distress and disengagement:  Moderator effects in early-stage breast cancer patients.  Journal of Consulting and Clinical Psychology, 68, 965-975.     [ abstract ]

Cruess, D. G., Antoni, M. H., McGregor, B. A., Kilbourn, K. M., Boyers, A. E., Alferi, S. M., Carver, C. S., & Kumar, M.  (2000).  Cognitive behavioral stress management reduces serum cortisol by enhancing benefit finding among women being treated for early-stage breast cancer. Psychosomatic Medicine, 62, 304-308.   [abstract]

Carver, C. S., Harris, S. D., Lehman, J. M., Durel, L. A., Antoni, M. H., Spencer, S. M., & Pozo-Kaderman, C.  (2000).  How important is the perception of personal control?  Studies of early stage breast cancer patients.  Personality and Social Psychology Bulletin, 26, 139-150.  [abstract ]

Spencer, S. M., Lehman, J. M., Wynings, C., Arena, P., Carver, C. S., Antoni, M. H., Derhagopian, R. P., Ironson, G., & Love, N.  (1999).  Concerns about breast cancer and relations to psychosocial well-being in a multiethnic sample of early stage patients.  Health Psychology, 18 , 159-168. [abstract ]

Carver, C. S., Pozo-Kaderman, C., Price, A. A., Noriega, V., Harris, S. D., Derhagopian, R. P., Robinson, D. S., & Moffatt, F. L., Jr. (1998). Concern about aspects of body image and adjustment to early stage breast cancer. Psychosomatic Medicine, 60, 168-174.   [abstract ]

Carver, C. S., Pozo-Kaderman, C., Harris, S. D., Noriega, V., Scheier, M. F., Robinson, D. S., Ketcham, A. S., Moffat, F. L., Jr., & Clark, K. C. (1994). Optimism vs pessimism predicts the quality of women's adjustment to early stage breast cancer. Cancer, 73, 1213-1220.   [ abstract ]

Carver, C. S., Pozo, C., Harris, S. D., Noriega, V., Scheier, M. F., Robinson, D. S., Ketcham, A. S., Moffat, F. L., Jr., & Clark, K. C. (1993). How coping mediates the effect of optimism on distress: A study of women with early stage breast cancer. Journal of Personality and Social Psychology , 65, 375-390.       [abstract ]

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