title: Racial disparities in posttraumatic stress after diagnosis of localized breast cancer: the BQUAL study.
abstract: BACKGROUND
  Little is known about the development of posttraumatic stress disorder (PTSD) over time among women diagnosed with breast cancer. This study examines changes in PTSD symptoms in the first 6 months after diagnosis and assesses racial/ethnic differences in PTSD symptomatology over time.
  
  
  METHODS
  We recruited women with newly diagnosed breast cancer, stages I to III, from three sites in the United States. Three telephone interviews were conducted: baseline at about 2 to 3 months after diagnosis, first follow-up at 4 months after diagnosis, and second follow-up at 6 months after diagnosis. We measured traumatic stress in each interview using the Impact of Events Scale; recorded sociodemographic, tumor, and treatment factors; and used generalized estimating equations and polytomous logistic regression modeling to examine the associations between variables of interest and PTSD.
  
  
  RESULTS
  Of 1139 participants, 23% reported symptoms consistent with a diagnosis of PTSD at baseline, 16.5% at first follow-up, and 12.6% at the second follow-up. Persistent PTSD was observed among 12.1% participants, as defined by having PTSD at two consecutive interviews. Among participants without PTSD at baseline, 6.6% developed PTSD at the first follow-up interview. Younger age at diagnosis, being black (odds ratio [OR] = 1.48 vs white, 95% confidence interval [CI] =1.04 to 2.10), and being Asian (OR = 1.69 vs white, 95% CI = 1.10 to 2.59) were associated with PTSD.
  
  
  CONCLUSIONS
  Nearly one-quarter of women newly diagnosed with breast cancer reported symptoms consistent with PTSD shortly after diagnosis, with increased risk among black and Asian women. Early identification of PTSD may present an opportunity to provide interventions to manage symptoms.
authors: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
authors: Neomi
authors: N
authors: Vin-Raviv
authors: Grace Clarke
authors: GC
authors: Hillyer
authors: Dawn L
authors: DL
authors: Hershman
authors: Sandro
authors: S
authors: Galea
authors: Nicole
authors: N
authors: Leoce
authors: Dana H
authors: DH
authors: Bovbjerg
authors: Lawrence H
authors: LH
authors: Kushi
authors: Candyce
authors: C
authors: Kroenke
authors: Lois
authors: L
authors: Lamerato
authors: Christine B
authors: CB
authors: Ambrosone
authors: Heidis
authors: H
authors: Valdimorsdottir
authors: Lina
authors: L
authors: Jandorf
authors: Jeanne S
authors: JS
authors: Mandelblatt
authors: Wei-Yann
authors: WY
authors: Tsai
authors: Alfred I
authors: AI
authors: Neugut
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D001213:Asian / Q000523:psychology / Q000706:statistics & numerical data*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000523:psychology*; D004522:Educational Status; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007182:Income; D016015:Logistic Models; D017533:Marital Status; D008875:Middle Aged; D009367:Neoplasm Staging; D016017:Odds Ratio; D011446:Prospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000209:etiology; D013315:Stress, Psychological / Q000453:epidemiology* / Q000209:etiology; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data