Background: Despite improvements in the medical treatment of breast cancer, resulting in better prognoses, women diagnosed with the illness often experience psychosocial problems. As a result, many psychosocial intervention programs have been developed, usually with positive results. The aim of this study was to examine the effects of two 12-week psychosocial intervention programs for women with a primary, non-metastatic breast cancer diagnosis in comparison to women who were on a waiting list for these interventions for 3 months. Methods: Sixty-nine women with primary, non-metastatic breast cancer, but otherwise without psychosocial problems, were randomized to a group of patients treated with the intervention program (group psychotherapy or social support group) or a control group (on a waiting list). Differences between both groups in psychosocial adjustment, social support and coping at the short-term follow-up were described in this study. Results: Women who participated in the group intervention programs did not differ from women in the control group regarding psychosocial adjustment at the end of the study. Women who participated in the social support groups reported to receive more social support from others not very close to them. They also used more palliative coping than women from the psychotherapy group. Conclusions: Apparently, women who are being diagnosed with breast cancer, but otherwise have no psychosocial adjustment problems following the diagnosis, do not especially benefit from a short-term intervention program compared to women in the control group.

Keywords:
Breast cancer, Coping, Psychosocial adjustment, Psychosocial group intervention, Social support
1.
Marchant DJ: Invasive breast cancer. Surgical treatment alternatives. Obstet Gynecol Clin North Am 1994;21:659–679.
2.
Robert NJ: Adjuvant therapy in breast cancer. Obstet Gynecol Clin North Am 1994;21:693–707.
3.
Coebergh JWW, van der Heijden LH, Janssen-Heijnen MLG (eds): Cancer Incidence and Survival in the Southeast of The Netherlands 1955–1994: A report from the Eindhoven Cancer Registry. Eindhoven, Integraal Kankercentrum Zuid, 1995.
4.
Irvine D, Brown B, Crooks D, Roberts J, Browne G: Psychosocial adjustment in women with breast cancer. Cancer 1991;15:1097–1117.
5.
Kiebert GM, de Haes JCJM, van de Velde CJH: The impact of breast conserving treatment and mastectomy on the quality of life of early-stage breast cancer patients: A review. J Clin Oncol 1991;9:1059–1070.
6.
Helgeson VS, Cohen S: Social support and adjustment to cancer: Reconciling descriptive, correlational, and intervention research. Health Psychol 1996;15:135–148.
7.
Trijsburg RW, van Knippenberg FCE, Rijpma SE: Effects of psychological treatment on cancer patients: A critical review. Psychosom Med 1992;54:489–517.
8.
Meyer TJ, Mark MM: Effects of psychosocial interventions with adult cancer patients: A meta-analysis of randomized experiments. Health Psychol 1995;14:101–108.
9.
Leszcz M, Goodwin PJ: The rationale and foundations of group psychotherapy for women with metastatic breast cancer. Int J Group Psychother 1998;48:245–273.
10.
Spiegel D, Morrow GR, Classen C, Raubertas R, Stott PB, Mudaliar N, Pierce HI, Flynn PJ, Heard L, Riggs G: Group psychotherapy for recently diagnosed breast cancer patients: A multicenter feasibility study. Psychooncology 1999;8:482–493.
11.
Classen C, Butler LD, Koopman C, Miller E, DiMiceli S, Giese-Davis J, Fobair P, Carlson RW, Kraemer HC, Spiegel D: Supportive-expressive group therapy and distress in patients with metastatic breast cancer. Arch Gen Psychiatry 2001;58:494–501.
12.
Sheard T, Maguire P: The effect of psychological interventions on anxiety and depression in cancer patients: Results of two meta-analyses. Br J Cancer 1999;80:1770–1780.
13.
Baider l, Peretz T, Hadani PE, Koch U: Psychological intervention in cancer patients: A randomized study. Gen Hosp Psychiatry 2001;23:272–277.
14.
Spiegel D, Bloom JR, Yalom I: Group support for patients with metastatic cancer. A randomised prospective outcome study. Arch Gen Psychiatry 1981;38:527–533.
15.
Telch CF, Telch MJ: Group coping skills instruction and supportive group therapy for cancer patients: A comparison of strategies. J Consult Clin Psychol 1986;54:802–808.
16.
Fawzy FI, Cousins N, Fawzy NW, Kemeny ME, Elashoff R, Morton D: A structured psychiatric intervention for cancer patients. Arch Gen Psychiatry 1990;47:720–725
17.
Cunningham AJ, Lockwood GA, Edmonds CV: Which patients benefit most from a brief, group coping skills program? Int J Psychiatry Med 1993;23:383–398.
18.
van der Pompe G: Mind-body interactions in breast cancer. Neuroendocrine and immune aspects of acute psychological stress and psychosocial intervention in breast cancer patients; dissertation, Erasmus University Rotterdam, 1997.
19.
Edelman S, Bell DR, Kidman AD: A group cognitive behaviour therapy programme with metastatic breast cancer patients. Psychooncology 1999;8:295–305.
20.
Helgeson VS, Cohen S, Schulz R, Yasko J: Education and peer discussion group interventions and adjustment to breast cancer. Arch Gen Psychiatry 1999;56:340–347.
21.
Bloom JR, Spiegel D: The relationship of two dimensions of social support to the psychological well-being and social functioning of women with advanced breast cancer. Soc Sci Med 1984;19:831–837.
22.
Lichtman RR, Taylor SE, Wood JV: Social support and marital adjustment to breast cancer. J Psychosoc Oncol 1987;5:47–74.
23.
Hoskins CN, Baker S, Sherman D, Bohlander J, Bookbinder M, Budin W, Ekstrom D, Knauer C, Maislin G: Social support and patterns of adjustment to breast cancer. Sch Inq Nurs Pract 1996;10:99–123.
24.
Hitch PJ, Fielding RG, Llewelyn SP: Effectiveness of self-help and support groups for cancer patients: A review. Psychol Health 1994;9:437–448.
25.
Samarel N, Fawcett J, Tulman L: Effect of support groups with coaching on adaptation to early stage breast cancer. Res Nurs Health 1997;20:15–26.
26.
Helgeson VS, Cohen S, Schulz R, Yasko J: Group support interventions for women with breast cancer: Who benefits from what? Health Psychol 2000;19:107–114.
27.
Bottemley A, Hunton S, Roberts G, Jones L, Bradley C: A pilot study of cognitive behavioral therapy and social support group interventions with newly diagnosed cancer patients. J Psychosoc Oncol 1996;14:65–83.
28.
Edmonds CVI, Lockwood GA, Cunningham AJ: Psychological response to long term group therapy: A randomized trial with metastatic breast cancer patients. Psychooncology 1999;8:74–91.
29.
Badger TA, Braden CJ, Longman AJ, Mishel MM: Depression burden, self-help interventions, and social support in women receiving treatment for breast cancer. J Psychosoc Oncol 1999;17:17–35.
30.
Schreurs PJG, van de Willige G, Brosschat JF, Tellegen B, Graus GMH: De Utrechtse Coping Lijst: UCL. Omgaan met Problemen en Gebeurtenissen. Lisse, Swets & Zeitlinger, 1993.
31.
De Bruin EJ, van Dijk M: Health and Disease Inventories. Een meetinstrument voor Aanpassingen aan Kanker. Handleiding. Lisse, Swets & Zeitlinger, 1996.
32.
de Haes JCJM: Kwaliteit van leven van kankerpatiënten; dissertation, Rijksuniversiteit Leiden. Lisse, Swets & Zeitlinger, 1988.
33.
de Groot MH: Psychometrische aspecten van een stemmingsschaal (verkorte POMS). Gedrag Gezondheid 1991;20:46–51.
34.
Sprangers MAG, Groenvold M, Arraras JI, Franklin J, te Velde A, Muller M, Franzini L, Williams A, de Haes HCJM, Hopwood P, Cull A, Aaronson NK: The EORTC Breast Cancer-Specific Quality of Life Module (QLQ-BR32): First results from a three-country field study. J Clin Oncol 1996;14:2756–2768.
35.
Osoba D, Aaronson N, Zee B, Sprangers M, te Velde A: Modification of the EORTC QLQ-C30 (version 2.0) based on content validity and reliability testing in large samples of patients with cancer. Qual Life Res 1997;6:103–108.
36.
Bergner M, Bobbit RA, Carter WB, Gilson BS: The sickness impact profile: Development and final revision of a health status measure. Med Care 1981;19:787–805.
37.
Yalom ID: Existential Psychotherapy. New York, Basic Books, 1980.
38.
Remie ME, Vos PJ, Maex E, Visser AP, Garssen B: Psychotherapeutische Begeleiding van Vrouwen met Borstkanker. Internal Report, Helen Dowling Institute, Rotterdam, 1997.
39.
Cohen J, Cohen P: Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences, ed 2. Hillsdale, Erlbaum, 1983.
40.
Glantz SA, Slinker BK: Primer of Applied Regression and Analysis of Variance. New York, McGraw-Hill, 1990.
41.
Tarrier N, Maguire P: Treatment of psychological distress following mastectomy: An initial report. Behav Res Ther 1984;22:81–84.
42.
Berglund G, Bolund C, Gustafsson UL, Sjodens PO: A randomised study of a rehabilitation program for cancer patients: The ‘starting again’ group. Psychooncology 1994;3:109–120.
43.
Cain EN, Kohorn EI, Quinlan DM, Latimer K, Schwartz PE: Psychosocial benefits of a cancer support group. Cancer 1986;57:183–189.
44.
Youssef FA: Crisis intervention: A group-therapy approach for hospitalised breast cancer patients. J Adv Nurs 1984;9:307–313.
45.
Helgeson VS, Cohen S, Schulz R, Yasko J: Group support interventions for people with cancer; in Baum A, Andersen BL (eds): Psychosocial Interventions for Cancer. Washington, American Psychological Association, 2001, pp 269–286.
46.
Edelman S, Craig A, Kidman AD: Group interventions with cancer patients: Efficacy of psychoeducational versus supportive groups. J Psychosoc Oncol 2000;18:67–85.
47.
Carver CS, Pozo C, Harris SD, Noriega V, Scheier MF, Robinson DS, Ketcham AS, Moffat FL Jr, Clark KC: How coping mediates the effect of optimism on distress: A study of women with early stage breast cancer. J Pers Soc Psychol 1993;65:375–390.
48.
Schover LR, Yetman RJ, Tuason LJ, Meisler E, Esselstyn CB, Hermann RE, Grundfest-Broniatowski S, Dowden RV: Partial mastectomy and breast reconstruction. A comparison of their effects on psychosocial adjustment, body image and sexuality. Cancer 1995;75:54–64.
49.
McCaul K, Sandgren AK, King B, O’Donnell S, Brandstetter A, Foreman G: Coping and adjustment to breast cancer. Psychooncology 1999;8:230–236.
50.
Schnoll RA, Harlow LL, Stolbach LL, Brandt U: A structural model of the relationships among stage of disease, age, coping and psychological adjustment in women with breast cancer. Psychooncology 1998;7:69–77.
51.
Edgar L, Rosberger Z, Nowlis D: Coping with cancer during the first year after diagnosis. Assessment and intervention. Cancer 1992;69:817–828.
52.
Edgar L, Rosberger Z, Collet JP: Lessons learned: Outcomes and methodology of a coping skills intervention trial comparing individual and group formats for patients with cancer. Int J Psychiatry Med 2001;31:289–304.
© 2004 S. Karger AG, Basel
2004
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.