Social Support and Endocrine Function: A Randomized Trial with Breast Cancer Patients

摘要

While there is clear evidence that psychological/behavioral interventions with cancer patients provide adjustment and coping benefits (Mark & Meyer, 1995) as well as positive immune and survival benefits (Fawzy et al., 1993; Speigel et al., 1989), the mechanisms for the benefits of such groups are not clearly understood. We propose that one of the mechanisms for the success of intervention groups may be through the provision of social support. Thus, by receiving needed support, patients may be 'buffered' or protected from the more negative effects of the cancer stressor (e.g., depressive symptoms, Spiker, Trijsburg, & Duivenvoorden, 1997; and immune down- regulation, Andersen et al., 1998). Therefore, we are studying the impact of a psychological/behavioral intervention with 231 breast cancer patients, using treatment (intervention) and control (no intervention) arms, on social support and endocrine responses. We found (1) The intervention participants do not have significantly higher levels of social support than the assessment only subjects. Although there are trends that suggest that the intervention participants maintain support levels while the assessment only subjects report lower support over time. (2) The intervention participants do have significantly lower levels of stress hormones than the assessment only subjects. Furthermore, psychological stress (ie., perceived stress and life events), across groups, is associated with depressive symptoms. (3) There is no support for the stress buffering hypothesis of social support in this sample. In fact, those women who belong to 1 or more groups show higher stress hormones in comparison to women who do not. However, women in the intervention, regardless of outside group participation, show stable or decreasing stress hormone levels over time. Intervention effects, however, over time (12-months), are not well-maintained and may well be related to transitioning from weekly meetings to monthly ones.