title: Test of mindfulness and hope components in a psychological intervention for women with cancer recurrence.
abstract: OBJECTIVE
  Psychological interventions can attenuate distress and enhance coping for those with an initial diagnosis of cancer, but there are few intervention options for individuals with cancer recurrence. To address this gap, we developed and tested a novel treatment combining Mindfulness, Hope Therapy, and biobehavioral components.
  
  
  METHODS
  An uncontrolled, repeated measures design was used. Women (N = 32) with recurrent breast or gynecologic cancers were provided 20 treatment sessions in individual (n = 12) or group (n = 20) formats. On average, participants were middle aged (M = 58) and Caucasian (81%). Independent variables (i.e., hope and mindfulness) and psychological outcomes (i.e., depression, negative mood, worry, and symptoms of generalized anxiety disorder) were assessed pre-treatment and 2, 4, and 7 months later. Session-by-session therapy process (positive and negative affect, quality-of-life) and mechanism (use of intervention-specific skills) measures were also included.
  
  
  RESULTS
  Distress, anxiety, and negative affect decreased, whereas positive affect and mental-health-related quality-of-life increased over the course of treatment, as demonstrated in mixed-effects models with the intent-to-treat sample. Both hope and mindfulness increased, and use of mindfulness skills was related to decreased anxiety.
  
  
  CONCLUSIONS
  This treatment was feasible to deliver and was acceptable to patients. The trial serves as preliminary evidence for a multi-component intervention tailored to treat difficulties specific to recurrent cancer. The blending of the components was novel as well as theoretically and practically consistent. A gap in the literature is addressed, providing directions for testing interventions designed for patients coping with the continuing stressors and challenges of cancer recurrence.
authors.affiliation: Department of Psychology.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Thornton
authors.affiliation: Department of Psychology.
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Cheavens
authors.affiliation: Center for Counseling and Student Development, University of Delaware.
authors.forename: Carolyn A
authors.initials: CA
authors.lastname: Heitzmann
authors.affiliation: Department of Psychology.
authors.forename: Caroline S
authors.initials: CS
authors.lastname: Dorfman
authors.affiliation: Department of Psychology.
authors.forename: Salene M
authors.initials: SM
authors.lastname: Wu
authors.affiliation: Department of Psychology.
authors.forename: Barbara L
authors.initials: BL
authors.lastname: Andersen
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000339:Affect; D001007:Anxiety / Q000209:etiology / Q000517:prevention & control; D001008:Anxiety Disorders / Q000209:etiology / Q000517:prevention & control; D003863:Depression / Q000209:etiology / Q000517:prevention & control; D003865:Major Depressive Disorder / Q000209:etiology / Q000517:prevention & control; D005260:Female; D005833:Genital Neoplasms, Female / Q000517:prevention & control*; D065026:Hope; D006801:Humans; D008603:Mental Health; D008875:Middle Aged; D064866:Mindfulness; D009341:Negativism; D009364:Neoplasm Recurrence, Local / Q000523:psychology*; D013315:Stress, Psychological / Q000209:etiology* / Q000628:therapy*