Stress management intervention reduces serum cortisol and increases relaxation during treatment for nonmetastatic breast cancer.
OBJECTIVE
To examine the effects of a cognitive-behavioral stress management (CBSM) intervention, which was composed of relaxation, cognitive restructuring, and coping skills training on late afternoon serum cortisol and relaxation indicators in women who were undergoing treatment for nonmetastatic breast cancer.


METHODS
Participants (N = 128) were randomly assigned to receive a 10-week CBSM group intervention or a 1-day psychoeducation seminar. Serum cortisol was collected and ability to relax was assessed at study entry and again at 6- and 12-month follow-up visits. Data were analyzed using latent growth curve modeling.


RESULTS
There was a significant effect of study condition on change across time for both cortisol and perceived ability to relax. Women receiving CBSM had significantly greater reductions in cortisol levels across the 12 months compared with those in the control group, who had no appreciable decline. Women receiving CBSM reported greater increases in ability to relax than controls across time. Perceived ability to relax did not mediate CBSM-related reductions in cortisol.


CONCLUSIONS
Women who participate in a 10-week CBSM intervention during treatment for breast cancer show decreases in physiological stress in parallel with increases in perceived relaxation skills. This is the first study demonstrating well-maintained reductions in cortisol after a CBSM intervention in cancer patients during and just after treatment.
Department of Psychology, University of Miami, Coral Gables, Florida 33124, USA.
Kristin M
KM
Phillips
Michael H
MH
Antoni
Suzanne C
SC
Lechner
Bonnie B
BB
Blomberg
Maria M
MM
Llabre
Eli
E
Avisar
Stefan
S
Glück
Robert
R
DerHagopian
Charles S
CS
Carver
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000097:blood / Q000523:psychology* / Q000628:therapy; D017024:Chemotherapy, Adjuvant / Q000523:psychology; D002940:Circadian Rhythm; D015928:Cognitive Behavioral Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008408:Mastectomy / Q000379:methods / Q000523:psychology; D008875:Middle Aged; D010353:Patient Education as Topic; D018714:Radiotherapy, Adjuvant / Q000523:psychology; D012063:Relaxation; D012064:Relaxation Therapy; D012649:Self Concept; D013312:Stress, Physiological; D013315:Stress, Psychological / Q000097:blood / Q000209:etiology / Q000628:therapy*
D006854:Hydrocortisone