title: Sisters in hereditary breast and ovarian cancer families: communal coping, social integration, and psychological well-being.
abstract: OBJECTIVE
  We investigated the association between psychological distress and indices of social integration and communal coping among sisters from hereditary breast and ovarian cancer (HBOC) families.
  
  
  METHODS
  Sixty-five sisters from 31 HBOC families completed the Brief Symptom Inventory-18 and the Colored Eco-Genetic Relationship Map, which identified members of participants' social support networks. Hierarchical linear models were used for all analyses to account for the clustering of sisters within families.
  
  
  RESULTS
  Intra-family correlation coefficients suggested that sisters shared perceptions of breast cancer risk and worry, but not ovarian cancer risk and worry. Further, sisters demonstrated shared levels of anxiety and somatization, but not depressive symptoms. Communal coping indices quantifying shared support resources were negatively related to anxiety and somatization. The number of persons with whom cancer risk information was shared exhibited a positive trend with somatization. Social integration, as measured by the size of participants' emotional support network, was negatively associated with anxiety. Lower depression scores were observed among participants with more persons playing multiple support roles and fewer persons providing tangible assistance.
  
  
  CONCLUSIONS
  Understanding how support relationships impact well-being among persons adjusting to HBOC risk, and the particular role of family in that process, will facilitate developing appropriate management approaches to help cancer-prone families adjust to their cancer risk.
authors.affiliation: Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA. koehlyl@mail.nih.gov
authors.forename: Laura M
authors.initials: LM
authors.lastname: Koehly
authors.forename: June A
authors.initials: JA
authors.lastname: Peters
authors.forename: Natalia
authors.initials: N
authors.lastname: Kuhn
authors.forename: Lindsey
authors.initials: L
authors.lastname: Hoskins
authors.forename: Anne
authors.initials: A
authors.lastname: Letocha
authors.forename: Regina
authors.initials: R
authors.lastname: Kenen
authors.forename: Jennifer
authors.initials: J
authors.lastname: Loud
authors.forename: Mark H
authors.initials: MH
authors.lastname: Greene
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000235:genetics* / Q000523:psychology; D003299:Cooperative Behavior; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000453:epidemiology* / Q000235:genetics* / Q000523:psychology; D017354:Point Mutation / Q000235:genetics; D011788:Quality of Life / Q000523:psychology*; D012801:Sibling Relations; D035781:Siblings / Q000523:psychology*; D012944:Social Support; D011795:Surveys and Questionnaires; D055815:Young Adult