Originally published as JCO Early Release 10.1200/JCO.2007.11.7093 on November 12 2007

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Scheier, M. F. Articles by Gerszten, K. Search for Related Content PubMed PubMed Citation Articles by Scheier, M. F. Articles by Gerszten, K.

Moderators of Interventions Designed to Enhance Physical and Psychological Functioning Among Younger Women With Early-Stage Breast Cancer

Michael F. Scheier, Vicki S. Helgeson, Richard Schulz, Suzanne Colvin, Sarah L. Berga, Judy Knapp, Kristina Gerszten

From Carnegie Mellon University; University of Pittsburgh, Pittsburgh, PA; and Emory University, Atlanta, GA

Address reprint requests to Michael F. Scheier, PhD, Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, 15213; e-mail: scheier{at}cmu.edu

Purpose: To identify factors that condition or moderate the impact of a previously described set of interventions on psychological and physical adjustment after diagnosis and treatment for early-stage breast cancer.

Patients and Methods: Younger women (age < 51 years, N = 252) with early-stage breast cancer within 2 months of having completed active nonhormonal adjuvant therapy were randomly assigned to a three-arm clinical trial, consisting of a control arm, an education arm, and a nutrition arm. Primary end points, assessed before random assignment and 4 and 13 months later, included mental functioning, physical functioning, and depressive symptoms. Four types of moderator variables were identified, including two sets reflecting psychosocial resources, specifically personality factors and factors related to the person's social environment, a set reflecting demographic variables, and a set reflecting treatment and disease variables (including comorbidities).

Results: Psychosocial factors were more likely to moderate treatment effects than were demographic and disease-related factors, but the moderating effects of these psychosocial factors were limited to patients receiving the nutrition intervention. Patients with lower psychosocial resources benefited from the nutrition intervention, whereas patients with a greater amount of psychosocial resources did not.

Conclusion: Future trials of this type should stratify by or select for the moderating variables identified here (ie, dispositional pessimism, unmitigated communion, and negative social interaction) to establish more firmly their role in responses to psychosocial interventions. Effort should also be made to collect data to inform the delivery of interventions to those who might benefit the most.

published online ahead of print at www.jco.org on November 12, 2007.

Supported by funds awarded to the Pittsburgh Mind-Body Center at the University of Pittsburgh and Carnegie Mellon University (Grants No. NIH HL076852 and HL076858), and by National Institutes of Health Grants No. CA104078, NR08272, MH071944, AG024827, AG028015, and AG015321.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.