title: Identifying how and for whom cognitive-behavioral stress management improves emotional well-being among recent prostate cancer survivors.
abstract: OBJECTIVE
  The outcomes of a 10-week cognitive-behavioral stress management (CBSM) group intervention were evaluated in prostate cancer survivors. A model was tested in which CBSM-related improvements in emotional well-being were attained through changes in men's perceptions of their condition, as conceptualized by information processing explanations of self-regulation theory. The model also tested whether life stress and treatment-related side effects moderated intervention effects.
  
  
  METHODS
  Men treated for localized prostate cancer (n = 257) within the past 18 months were randomized to CBSM or a half-day psycho-educational seminar. At pre-intervention and 12-week follow-up, emotional well-being, illness perceptions, life stress, and sexual and urinary function were assessed using validated questionnaires.
  
  
  RESULTS
  After controlling for covariates, CBSM participants showed greater improvements in emotional well-being relative to control participants (β = 0.13, p < 0.05). For men reporting higher stress upon study entry, CBSM-related improvements were partially explained by changes in some, but not all, illness perceptions. Sexual and urinary dysfunction did not influence CBSM-related gains.
  
  
  CONCLUSIONS
  Prostate cancer perceptions may be an important target for enhancing emotional well-being, particularly for men experiencing general life stress. However, interventions that explicitly target mental representations of cancer may be needed to modify perceptions of the disease.
authors.affiliation: Behavioral Medicine Service, Massachusetts General Hospital, One Bowdoin Square, Boston, MA 02114, USA. ltraeger@partners.org
authors.forename: Lara
authors.initials: L
authors.lastname: Traeger
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Penedo
authors.forename: Catherine
authors.initials: C
authors.lastname: Benedict
authors.forename: Jason R
authors.initials: JR
authors.lastname: Dahn
authors.forename: Suzanne C
authors.initials: SC
authors.lastname: Lechner
authors.forename: Neil
authors.initials: N
authors.lastname: Schneiderman
authors.forename: Michael H
authors.initials: MH
authors.lastname: Antoni
mesh_terms: D000368:Aged; D015928:Cognitive Behavioral Therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010465:Perception; D011468:Prostatectomy / Q000009:adverse effects / Q000523:psychology; D011471:Prostatic Neoplasms / Q000523:psychology* / Q000628:therapy; D011788:Quality of Life; D012735:Sexual Dysfunction, Physiological / Q000209:etiology / Q000523:psychology; D013315:Stress, Psychological / Q000628:therapy*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology; D016896:Treatment Outcome; D014555:Urination Disorders / Q000209:etiology / Q000523:psychology