title: Mindfulness based stress reduction (MBSR(BC)) in breast cancer: evaluating fear of recurrence (FOR) as a mediator of psychological and physical symptoms in a randomized control trial (RCT).
abstract: To investigate the mechanism(s) of action of mindfulness based stress reduction (MBSR(BC)) including reductions in fear of recurrence and other potential mediators. Eighty-two post-treatment breast cancer survivors (stages 0-III) were randomly assigned to a 6-week MBSR(BC) program (n = 40) or to usual care group (UC) (n = 42). Psychological and physical variables were assessed as potential mediators at baseline and at 6 weeks. MBSR(BC) compared to UC experienced favorable changes for five potential mediators: (1) change in fear of recurrence problems mediated the effect of MBSR(BC) on 6-week change in perceived stress (z = 2.12, p = 0.03) and state anxiety (z = 2.03, p = 0.04); and (2) change in physical functioning mediated the effect of MBSR(BC) on 6-week change in perceived stress (z = 2.27, p = 0.02) and trait anxiety (z = 1.98, p = 0.05). MBSR(BC) reduces fear of recurrence and improves physical functioning which reduces perceived stress and anxiety. Findings support the beneficial effects of MBSR(BC) and provide insight into the possible cognitive mechanism of action.
authors.affiliation: University of South Florida College of Nursing, 12901 Bruce B. Downs Blvd, MDC 22, Tampa, FL, 33612-4766, USA, clengach@health.usf.edu.
authors.forename: Cecile A
authors.initials: CA
authors.lastname: Lengacher
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Shelton
authors.forename: Richard R
authors.initials: RR
authors.lastname: Reich
authors.forename: Michelle K
authors.initials: MK
authors.lastname: Barta
authors.forename: Versie
authors.initials: V
authors.lastname: Johnson-Mallard
authors.forename: Manolete S
authors.initials: MS
authors.lastname: Moscoso
authors.forename: Carly
authors.initials: C
authors.lastname: Paterson
authors.forename: Sophia
authors.initials: S
authors.lastname: Ramesar
authors.forename: Pinky
authors.initials: P
authors.lastname: Budhrani
authors.forename: Irina
authors.initials: I
authors.lastname: Carranza
authors.forename: Jean
authors.initials: J
authors.lastname: Lucas
authors.forename: Paul B
authors.initials: PB
authors.lastname: Jacobsen
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Goodman
authors.forename: Kevin E
authors.initials: KE
authors.lastname: Kip
mesh_terms: D001943:Breast Neoplasms / Q000150:complications / Q000523:psychology*; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D064866:Mindfulness; D012008:Recurrence; D013315:Stress, Psychological / Q000150:complications / Q000517:prevention & control* / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome