title: Stress, coping, and circadian disruption among women awaiting breast cancer surgery.
abstract: BACKGROUND
  Psychological distress and coping related to a breast cancer diagnosis can profoundly affect psychological adjustment, possibly resulting in the disruption of circadian rest/activity and cortisol rhythms, which are prognostic for early mortality in metastatic colorectal and breast cancers, respectively.
  
  
  OBJECTIVE
  This study aims to explore the relationships of cancer-specific distress and avoidant coping with rest/activity and cortisol rhythm disruption in the period between diagnosis and breast cancer surgery.
  
  
  METHODS
  Fifty-seven presurgical breast cancer patients provided daily self-reports of cancer-specific distress and avoidant coping as well as actigraphic and salivary cortisol data.
  
  
  RESULTS
  Distress and avoidant coping were related to rest/activity rhythm disruption (daytime sedentariness, inconsistent rhythms). Patients with disrupted rest/activity cycles had flattened diurnal cortisol rhythms.
  
  
  CONCLUSIONS
  Maladaptive psychological responses to breast cancer diagnosis were associated with disruption of circadian rest/activity rhythms. Given that circadian cycles regulate tumor growth, we need greater understanding of possible psychosocial effects in cancer-related circadian disruption.
authors.affiliation: Veterans Affairs Medical Center, Durham, NC, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Dedert
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Lush
authors.forename: Anees
authors.initials: A
authors.lastname: Chagpar
authors.forename: Firdaus S
authors.initials: FS
authors.lastname: Dhabhar
authors.forename: Suzanne C
authors.initials: SC
authors.lastname: Segerstrom
authors.forename: David
authors.initials: D
authors.lastname: Spiegel
authors.forename: Ehab
authors.initials: E
authors.lastname: Dayyat
authors.forename: Meagan
authors.initials: M
authors.lastname: Daup
authors.forename: Kelly
authors.initials: K
authors.lastname: McMasters
authors.forename: Sandra E
authors.initials: SE
authors.lastname: Sephton
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000523:psychology* / Q000601:surgery; D002940:Circadian Rhythm; D005260:Female; D006801:Humans; D008875:Middle Aged; D057566:Self Report; D012890:Sleep; D013315:Stress, Psychological / Q000175:diagnosis* / Q000523:psychology; D013997:Time Factors; D014930:Women / Q000523:psychology*