title: Emotional acceptance, inflammation, and sickness symptoms across the first two years following breast cancer diagnosis.
abstract: OBJECTIVE
  Breast cancer diagnosis and treatment are associated with increased inflammatory activity, which can induce sickness symptoms. We examined whether emotional acceptance moderates the association between proinflammatory cytokines and self-reported sickness symptoms in women recently diagnosed with breast cancer.
  
  
  METHODS
  Women (N=136) diagnosed with stage 0-III breast cancer within the previous 6months provided plasma samples and completed the FACT: Physical Well-Being Scale, as well as the Acceptance of Emotion Scale every 3months for 2years. At each time point, we quantified interleukin (IL)-6, IL-8, IL-10, and tumor necrosis factor (TNF)-α using a high sensitivity multiplex assay.
  
  
  RESULTS
  Higher within-subject mean TNF-α across all time-points predicted higher mean sickness symptoms. At individual time-points, higher IL-6 and IL-8 levels were associated with higher sickness symptoms. Mean emotional acceptance across all time-points moderated the relationship between mean IL-8 and sickness symptoms, with sickness symptoms remaining persistently high in women with low emotional acceptance even when IL-8 levels were low. At individual time-points, emotional acceptance positively moderated the correlations of IL-8 and TNF-α with sickness symptoms, such that the associations between higher levels of these proinflammatory cytokines and higher sickness symptoms were attenuated when emotional acceptance was high.
  
  
  CONCLUSIONS
  Emotional acceptance was shown for the first time to moderate the associations of cytokines with sickness symptoms in breast cancer patients over time following diagnosis and treatment. The association between emotional acceptance and sickness symptoms was significantly different from zero but relatively small in comparison to the range of sickness symptoms. Results suggest that targeting emotion regulation may help to break the cycle between inflammation and sickness symptoms in women with breast cancer.
authors.affiliation: Division of Family Studies and Human Development, College of Agriculture and Life Sciences, The University of Arizona, Tucson, AZ, USA; Department of Psychology, College of Arts and Sciences, University of Kentucky, Lexington, KY, USA. Electronic address: rebecca.reed@uky.edu.
authors.forename: Rebecca G
authors.initials: RG
authors.lastname: Reed
authors.affiliation: Department of Psychiatry, College of Medicine, The University of Arizona, Tucson, AZ, USA.
authors.forename: Karen L
authors.initials: KL
authors.lastname: Weihs
authors.affiliation: Department of Psychology, College of Social and Behavioral Sciences, The University of Arizona, Tucson, AZ, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Sbarra
authors.affiliation: Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, CA, USA.
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Breen
authors.affiliation: Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, CA, USA.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Irwin
authors.affiliation: Division of Family Studies and Human Development, College of Agriculture and Life Sciences, The University of Arizona, Tucson, AZ, USA.
authors.forename: Emily A
authors.initials: EA
authors.lastname: Butler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000097:blood* / Q000523:psychology*; D016207:Cytokines / Q000097:blood*; D004644:Emotions / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D055809:Illness Behavior / Q000502:physiology*; D007249:Inflammation / Q000097:blood*; D008875:Middle Aged; D000068356:Self-Control
chemical_list: D016207:Cytokines
keywords: Breast cancer; Emotion regulation; Inflammation; Proinflammatory cytokines; Sickness symptoms