title: Social support predicts inflammation, pain, and depressive symptoms: longitudinal relationships among breast cancer survivors.
abstract: OBJECTIVE
  Pain and depressive symptoms are commonly experienced by cancer survivors. Lower social support is linked to a variety of negative mental and physical health outcomes among survivors. Immune dysregulation may be one mechanism linking low social support to the development of pain and depressive symptoms over time. Accordingly, the goal of the present study was to examine the relationships among survivors' social support, pain, depressive symptoms, and inflammation.
  
  
  METHODS
  Breast cancer survivors (N=164, stages 0-IIIA) completed two study visits, one before any cancer treatment and the other 6 months after the completion of surgery, radiation, or chemotherapy, whichever came last. Women completed self-report questionnaires assessing social support, pain, and depressive symptoms, and provided a blood sample at both visits.
  
  
  RESULTS
  Survivors with lower social support prior to treatment experienced higher levels of pain and depressive symptoms over time than their more socially supported counterparts. Furthermore, women with lower pretreatment social support had higher levels of IL-6 over time, and these elevations in IL-6 predicted marginally larger increases in depressive symptoms.
  
  
  CONCLUSIONS
  The results of this study suggest that social support at the time of diagnosis predicts the post-treatment development of pain, depressive symptoms, and inflammation. Consequently, early interventions targeting survivors' social networks could improve quality of life during survivorship.
authors.affiliation: Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH 43210, USA; Department of Psychology, The Ohio State University, Columbus, OH 43210, USA. Electronic address: Spenser.Hughes@osumc.edu.
authors.forename: Spenser
authors.initials: S
authors.lastname: Hughes
authors.affiliation: Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH 43210, USA.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Jaremka
authors.affiliation: National Cancer Institute, Bethesda, MD 20892, USA.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Alfano
authors.affiliation: Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH 43210, USA; Department of Molecular Virology, Immunology and Medical Genetics, The Ohio State University College of Medicine, Columbus, OH 43210, USA; Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH 43210, USA; Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH 43210, USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Glaser
authors.affiliation: Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH 43210, USA; Department of Surgery, The Ohio State University College of Medicine, Columbus, OH 43210, USA.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Povoski
authors.affiliation: Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH 43210, USA; Department of Surgery, The Ohio State University College of Medicine, Columbus, OH 43210, USA.
authors.forename: Adele M
authors.initials: AM
authors.lastname: Lipari
authors.affiliation: Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH 43210, USA; Department of Surgery, The Ohio State University College of Medicine, Columbus, OH 43210, USA.
authors.forename: Doreen M
authors.initials: DM
authors.lastname: Agnese
authors.affiliation: Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH 43210, USA; Department of Surgery, The Ohio State University College of Medicine, Columbus, OH 43210, USA.
authors.forename: William B
authors.initials: WB
authors.lastname: Farrar
authors.affiliation: Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH 43210, USA; Department of Surgery, The Ohio State University College of Medicine, Columbus, OH 43210, USA.
authors.forename: Lisa D
authors.initials: LD
authors.lastname: Yee
authors.affiliation: Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH 43210, USA; Department of Surgery, The Ohio State University College of Medicine, Columbus, OH 43210, USA.
authors.forename: William E
authors.initials: WE
authors.lastname: Carson
authors.affiliation: Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH 43210, USA; Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH 43210, USA; Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH 43210, USA.
authors.forename: William B
authors.initials: WB
authors.lastname: Malarkey
authors.affiliation: Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH 43210, USA; Department of Psychology, The Ohio State University, Columbus, OH 43210, USA; Department of Psychiatry, The Ohio State University College of Medicine, Columbus, OH 43210, USA; Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH 43210, USA.
authors.forename: Janice K
authors.initials: JK
authors.lastname: Kiecolt-Glaser
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000523:psychology; D008137:Longitudinal Studies; D008875:Middle Aged; D010146:Pain / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology; D012944:Social Support; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*
keywords: Cancer survivors; Depressive symptoms; IL-6; Inflammation; Pain; Social support