title: The Impact of Goal Disturbance after Cancer on Cortisol Levels over Time and the Moderating Role of COMT.
abstract: Due to physical hindrance and time spent in hospital, a cancer diagnosis can lead to disturbance of personally important goals. Goal disturbance in cancer patients has been related to poorer psychological well-being. However, the relation with physiological measures is yet unknown. The purpose of the current study is to examine the impact of goal disturbance on cortisol as a measure of response to stress over time, and a possibly moderating role of a DNA genotype associated with HPA-axis functioning, Catechol-O-Methyl transferase (COMT). We examined the predictive value of goal disturbance on Cortisol Awakening Response (CAR) and Diurnal Cortisol Slope (DCS) over two periods: 1-7 and 7-18 months post-diagnosis, and the moderating role of COMT during these periods. Hierarchical regression analyses showed that goal disturbance 7 months post-diagnosis significantly predicted a steeper CAR a year later. During that period, the slow COMT variant moderated the relation, in that patients reporting high goal disturbance and had the Met/Met variant, had a more flattened CAR. No other significant effects were found. As steeper CARs have been related to adverse health outcomes, and COMT genotype may modify this risk, these results indicate that goal disturbance and genotype may be important factors to consider in maintaining better psychological and physical health in the already vulnerable population of cancer patients.
authors: Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors: Moniek
authors: M
authors: Janse
authors: Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors: Martijn van
authors: Mv
authors: Faassen
authors: Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors: Ido
authors: I
authors: Kema
authors: Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors: Ans
authors: A
authors: Smink
authors: Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors: Adelita V
authors: AV
authors: Ranchor
authors: Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors: Joke
authors: J
authors: Fleer
authors: Department of Medical Psychology, University of Amsterdam, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
authors: Mirjam A G
authors: MA
authors: Sprangers
mesh_terms: D000368:Aged; D002394:Catechol O-Methyltransferase / Q000235:genetics*; D002940:Circadian Rhythm / Q000502:physiology*; D005260:Female; D014644:Genetic Variation / Q000235:genetics*; D006040:Goals; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008297:Male; D009369:Neoplasms / Q000175:diagnosis / Q000201:enzymology* / Q000235:genetics / Q000523:psychology*
chemical_list: D002394:Catechol O-Methyltransferase; D006854:Hydrocortisone