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担忧和正念对乳腺癌幸存者治疗后症状负担的影响不同:一项随机交叉试验的结果。

Worry and Mindfulness Differentially Impact Symptom Burden Following Treatment Among Breast Cancer Survivors: Findings From a Randomized Crossover Trial.

机构信息

School of Psychology, The University of Southern Mississippi, Hattiesburg, MS, USA.

Department of Psychology, The Ohio State University, Columbus, OH, USA.

出版信息

Ann Behav Med. 2023 Sep 13;57(10):888-898. doi: 10.1093/abm/kaad032.

DOI:10.1093/abm/kaad032
PMID:37335884
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10498820/
Abstract

BACKGROUND

Breast cancer survivors often experience many somatic and cognitive side effects resulting from their cancer diagnosis and treatment, including higher rates of pain, fatigue, and memory/concentration problems. Emotion regulation offers opportunities to either enhance or dampen physical health.

PURPOSE

In a secondary analysis of a double-blind randomized controlled trial (RCT) using a typhoid vaccine to assess factors associated with breast cancer survivors' inflammatory responses, we assessed how two specific aspects of emotion regulation, mindfulness, and worry, corresponded to acute changes in focus problems, memory problems, and fatigue along with performance on pain sensitivity and cognitive tasks across two visits among breast cancer survivors.

METHODS

Breast cancer survivors (N = 149) completed two 8.5-hr visits at a clinical research center. Survivors were randomized to either the vaccine/saline placebo or a placebo/vaccine sequence. Worry and mindfulness questionnaires provided data on trait-level emotion regulation abilities. Fatigue, memory problems, and focus difficulties were assessed via Likert scales six times-once before the injections and then every 90 min for 7.5 hr thereafter. Women also completed a pain sensitivity task and several cognitive tasks at each visit.

RESULTS

Findings from this study showed that breast cancer survivors who worried more and were less mindful experienced subjective memory problems, focus problems, and cold pain sensitivity across two visits and irrespective of injection type. Lower mindfulness also corresponded to higher subjective fatigue and hot pain sensitivity and objective ratings. Emotion regulation skills did not predict objective pain sensitivity or cognitive problems.

CONCLUSION

Results from this study highlight the benefits of adaptive emotion regulation in helping mitigate symptoms associated with breast cancer survivorship.

摘要

背景

乳腺癌幸存者经常经历许多来自癌症诊断和治疗的躯体和认知副作用,包括更高的疼痛、疲劳和记忆/注意力问题发生率。情绪调节提供了增强或减弱身体健康的机会。

目的

在使用伤寒疫苗评估与乳腺癌幸存者炎症反应相关因素的双盲随机对照试验(RCT)的二次分析中,我们评估了情绪调节的两个特定方面,即正念和担忧,如何与乳腺癌幸存者的焦点问题、记忆问题和疲劳的急性变化相对应,以及在两个访视期间的疼痛敏感性和认知任务表现。

方法

乳腺癌幸存者(N=149)在临床研究中心完成了两次 8.5 小时的访视。幸存者被随机分配到疫苗/生理盐水安慰剂或安慰剂/疫苗序列。担忧和正念问卷提供了特质水平情绪调节能力的数据。疲劳、记忆问题和焦点困难通过李克特量表六次评估-在注射前一次,然后在随后的 7.5 小时内每 90 分钟评估一次。女性还在每次访视时完成一项疼痛敏感性任务和几项认知任务。

结果

这项研究的结果表明,更多担忧和更少正念的乳腺癌幸存者在两次访视中经历了主观记忆问题、焦点问题和冷痛敏感性,而与注射类型无关。较低的正念也与更高的主观疲劳和热痛敏感性以及客观评分相对应。情绪调节技能不能预测客观疼痛敏感性或认知问题。

结论

这项研究的结果强调了适应性情绪调节在帮助减轻与乳腺癌生存相关的症状方面的益处。

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Int J Behav Med. 2023 Aug;30(4):463-472. doi: 10.1007/s12529-022-10115-4. Epub 2022 Jul 13.
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Breast cancer survivors' typhoid vaccine responses: Chemotherapy, obesity, and fitness make a difference.乳腺癌幸存者的伤寒疫苗反应:化疗、肥胖和健康状况有影响。
Brain Behav Immun. 2022 Jul;103:1-9. doi: 10.1016/j.bbi.2022.03.019. Epub 2022 Apr 1.
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A review and novel theoretical model of how negative emotions influence inflammation: The critical role of emotion regulation.负面情绪如何影响炎症的综述及新理论模型:情绪调节的关键作用
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Dispositional Mindfulness and Acute Heat Pain: Comparing Stimulus-Evoked Pain With Summary Pain Assessment.性格正念与急性热痛:比较刺激诱发痛与综合疼痛评估。
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Pain sensitivity and shoulder function among breast cancer survivors compared to matched controls: a case-control study.乳腺癌幸存者与匹配对照者的疼痛敏感性和肩部功能比较:病例对照研究。
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Insomnia and Fatigue Symptom Trajectories in Breast Cancer: A Longitudinal Cohort Study.乳腺癌患者失眠和疲劳症状轨迹:一项纵向队列研究。
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