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William E. Carson - One of the best experts on this subject based on the ideXlab platform.
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biobehavioral immune and health benefits following recurrence for Psychological Intervention participants
Clinical Cancer Research, 2010Co-Authors: Barbara L. Andersen, Lisa M. Thornton, William B Farrar, Charles L Shapiro, Bethany L Mundy, Haechung Yang, William E. CarsonAbstract:Purpose: A clinical trial was designed to test the hypothesis that a Psychological Intervention could reduce the risk of cancer recurrence. Newly diagnosed regional breast cancer patients (n = 227) were randomized to the Intervention-with-assessment or the assessment-only arm. The Intervention had positive Psychological, social, immune, and health benefits, and after a median of 11 years the Intervention arm was found to have reduced the risk of recurrence (hazard ratio, 0.55; P =0 .034). In follow-up, we hypothesized that the Intervention arm might also show longer survival after recurrence. If observed, we then would examine potential biobehavioral mechanisms. Experimental Design: All patients were followed; 62 recurred. Survival analyses included all 62. Upon recurrence diagnosis, those available for further biobehavioral study were accrued (n = 41, 23 Intervention and 18 assessment). For those 41, Psychological, social, adherence, health, and immune (natural killer cell cytotoxicity, T-cell proliferation) data were collected at recurrence diagnosis and 4, 8, and 12 months later. Results: Intent-to-treat analysis revealed reduced risk of death following recurrence for the Intervention arm (hazard ratio, 0.41; P = 0.014). Mixed-effects follow-up analyses with biobehavioral data showed that all patients responded with significant Psychological distress at recurrence diagnosis, but thereafter only the Intervention arm improved (P values < 0.023). Immune indices were significantly higher for the Intervention arm at 12 months (P values < 0.017). Conclusions: Hazards analyses augment previous findings in showing improved survival for the Intervention arm after recurrence. Follow-up analyses showing biobehavioral advantages for the Intervention arm contribute to our understanding of how improved survival was achieved. Clin Cancer Res; 16(12); 3270–8. ©2010 AACR.
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a Psychological Intervention reduces inflammatory markers by alleviating depressive symptoms secondary analysis of a randomized controlled trial
Psychosomatic Medicine, 2009Co-Authors: Lisa M. Thornton, Barbara L. Andersen, Tammy A. Schuler, William E. CarsonAbstract:Objectives:To test experimentally whether a Psychological Intervention reduces depression-related symptoms and markers of inflammation among cancer patients and to test one mechanism for the Intervention effects. Depression and inflammation are common among cancer patients. Data suggest that inflamm
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A Psychological Intervention reduces inflammatory markers by alleviating depressive symptoms: Secondary analysis of a randomized controlled trial
Psychosomatic Medicine, 2009Co-Authors: Lisa M. Thornton, Barbara L. Andersen, Tammy A. Schuler, William E. CarsonAbstract:OBJECTIVES: To test experimentally whether a Psychological Intervention reduces depression-related symptoms and markers of inflammation among cancer patients and to test one mechanism for the Intervention effects. Depression and inflammation are common among cancer patients. Data suggest that inflammation can contribute to depressive symptoms, although the converse remains untested. METHODS: As part of a randomized clinical trial, newly diagnosed breast cancer patients (n = 45) with clinically significant depressive symptoms were evaluated and randomized to Psychological Intervention with assessment or assessment only study arms. The Intervention spanned 12 months, with assessments at baseline, 4, 8, and 12 months. Mixed-effects modeling tested the hypothesis that the Intervention reduced self-reported depressive symptoms (Center for Epidemiological Studies Depression scale, Profile of Mood States Depression and Fatigue subscales, and Medical Outcomes Study-Short Form 36 Bodily Pain subscale) and immune cell numbers that are elevated in the presence of inflammation (white blood cell count, neutrophil count, and helper/suppressor ratio). Mediation analyses tested whether change in depressive symptoms, pain, or fatigue predicted change in white blood cell count, neutrophil count, or the helper/suppressor ratio. RESULTS: The Intervention reduced significantly depressive symptoms, pain, fatigue, and inflammation markers. Moreover, the Intervention effect on inflammation was mediated by its effect on depressive symptoms. CONCLUSIONS: This is the first experiment to test whether Psychological treatment effective in reducing depressive symptoms would also reduce indicators of inflammation. Data show that the Intervention reduced directly depressive symptoms and reduced indirectly inflammation. Psychological treatment may treat effectively depressive symptoms, pain, and fatigue among cancer patients.
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distress reduction from a Psychological Intervention contributes to improved health for cancer patients
Brain Behavior and Immunity, 2007Co-Authors: Barbara L. Andersen, William B Farrar, Deanna M Goldenkreutz, Charles F Emery, Ronald Glaser, Timothy R Crespin, William E. CarsonAbstract:PURPOSE Psychological Interventions are efficacious in reducing emotional distress for cancer patients. However, it is not clear whether Psychological improvements are, in turn, related to improved health. A clinical trial tests whether a Psychological Intervention for cancer patients can do so, and also tests two routes to achieve better health: a) reducing patients’ emotional distress, and/or b) enhancing their functional immunity.
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Psychological behavioral and immune changes after a Psychological Intervention a clinical trial
Journal of Clinical Oncology, 2004Co-Authors: Barbara L. Andersen, William B Farrar, Deanna M Goldenkreutz, Charles F Emery, Ronald Glaser, Timothy R Crespin, Charles L Shapiro, William E. CarsonAbstract:Purpose This randomized clinical trial tests the hypothesis that a Psychological Intervention can reduce emotional distress, improve health behaviors and dose-intensity, and enhance immune responses. Patients and Methods We studied 227 women who were surgically treated for regional breast cancer. Before adjuvant therapy, women completed interviews and questionnaires assessing emotional distress, social adjustment, and health behaviors. A 60-mL blood sample was drawn for immune assays. Patients were randomly assigned to either the Intervention group or assessment only group. The Intervention was conducted in small patient groups, with one session per week for 4 months. The sessions included strategies to reduce stress, improve mood, alter health behaviors, and maintain adherence to cancer treatment and care. Reassessment occurred after completion of the Intervention. Results As predicted, patients receiving the Intervention showed significant lowering of anxiety, improvements in perceived social support, improved dietary habits, and reduction in smoking (all P .05). Analyses of adjuvant chemotherapy dose-intensity revealed significantly more variability (ie, more dispersion in the dose-intensity values) for the assessment arm (P .05). Immune responses for the Intervention patients paralleled their Psychological and behavioral improvements. T-cell proliferation in response to phytohemagglutinin and concanavalin A remained stable or increased for the Intervention patients, whereas both responses declined for Assessment patients; this effect was replicated across three concentrations for each assay (all P .01). Conclusion These data show a convergence of significant Psychological, health behavior, and biologic effects after a Psychological Intervention for cancer patients. J Clin Oncol 22:3570-3580. © 2004 by American Society of Clinical Oncology
Barbara L. Andersen - One of the best experts on this subject based on the ideXlab platform.
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biobehavioral immune and health benefits following recurrence for Psychological Intervention participants
Clinical Cancer Research, 2010Co-Authors: Barbara L. Andersen, Lisa M. Thornton, William B Farrar, Charles L Shapiro, Bethany L Mundy, Haechung Yang, William E. CarsonAbstract:Purpose: A clinical trial was designed to test the hypothesis that a Psychological Intervention could reduce the risk of cancer recurrence. Newly diagnosed regional breast cancer patients (n = 227) were randomized to the Intervention-with-assessment or the assessment-only arm. The Intervention had positive Psychological, social, immune, and health benefits, and after a median of 11 years the Intervention arm was found to have reduced the risk of recurrence (hazard ratio, 0.55; P =0 .034). In follow-up, we hypothesized that the Intervention arm might also show longer survival after recurrence. If observed, we then would examine potential biobehavioral mechanisms. Experimental Design: All patients were followed; 62 recurred. Survival analyses included all 62. Upon recurrence diagnosis, those available for further biobehavioral study were accrued (n = 41, 23 Intervention and 18 assessment). For those 41, Psychological, social, adherence, health, and immune (natural killer cell cytotoxicity, T-cell proliferation) data were collected at recurrence diagnosis and 4, 8, and 12 months later. Results: Intent-to-treat analysis revealed reduced risk of death following recurrence for the Intervention arm (hazard ratio, 0.41; P = 0.014). Mixed-effects follow-up analyses with biobehavioral data showed that all patients responded with significant Psychological distress at recurrence diagnosis, but thereafter only the Intervention arm improved (P values < 0.023). Immune indices were significantly higher for the Intervention arm at 12 months (P values < 0.017). Conclusions: Hazards analyses augment previous findings in showing improved survival for the Intervention arm after recurrence. Follow-up analyses showing biobehavioral advantages for the Intervention arm contribute to our understanding of how improved survival was achieved. Clin Cancer Res; 16(12); 3270–8. ©2010 AACR.
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a Psychological Intervention reduces inflammatory markers by alleviating depressive symptoms secondary analysis of a randomized controlled trial
Psychosomatic Medicine, 2009Co-Authors: Lisa M. Thornton, Barbara L. Andersen, Tammy A. Schuler, William E. CarsonAbstract:Objectives:To test experimentally whether a Psychological Intervention reduces depression-related symptoms and markers of inflammation among cancer patients and to test one mechanism for the Intervention effects. Depression and inflammation are common among cancer patients. Data suggest that inflamm
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A Psychological Intervention reduces inflammatory markers by alleviating depressive symptoms: Secondary analysis of a randomized controlled trial
Psychosomatic Medicine, 2009Co-Authors: Lisa M. Thornton, Barbara L. Andersen, Tammy A. Schuler, William E. CarsonAbstract:OBJECTIVES: To test experimentally whether a Psychological Intervention reduces depression-related symptoms and markers of inflammation among cancer patients and to test one mechanism for the Intervention effects. Depression and inflammation are common among cancer patients. Data suggest that inflammation can contribute to depressive symptoms, although the converse remains untested. METHODS: As part of a randomized clinical trial, newly diagnosed breast cancer patients (n = 45) with clinically significant depressive symptoms were evaluated and randomized to Psychological Intervention with assessment or assessment only study arms. The Intervention spanned 12 months, with assessments at baseline, 4, 8, and 12 months. Mixed-effects modeling tested the hypothesis that the Intervention reduced self-reported depressive symptoms (Center for Epidemiological Studies Depression scale, Profile of Mood States Depression and Fatigue subscales, and Medical Outcomes Study-Short Form 36 Bodily Pain subscale) and immune cell numbers that are elevated in the presence of inflammation (white blood cell count, neutrophil count, and helper/suppressor ratio). Mediation analyses tested whether change in depressive symptoms, pain, or fatigue predicted change in white blood cell count, neutrophil count, or the helper/suppressor ratio. RESULTS: The Intervention reduced significantly depressive symptoms, pain, fatigue, and inflammation markers. Moreover, the Intervention effect on inflammation was mediated by its effect on depressive symptoms. CONCLUSIONS: This is the first experiment to test whether Psychological treatment effective in reducing depressive symptoms would also reduce indicators of inflammation. Data show that the Intervention reduced directly depressive symptoms and reduced indirectly inflammation. Psychological treatment may treat effectively depressive symptoms, pain, and fatigue among cancer patients.
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distress reduction from a Psychological Intervention contributes to improved health for cancer patients
Brain Behavior and Immunity, 2007Co-Authors: Barbara L. Andersen, William B Farrar, Deanna M Goldenkreutz, Charles F Emery, Ronald Glaser, Timothy R Crespin, William E. CarsonAbstract:PURPOSE Psychological Interventions are efficacious in reducing emotional distress for cancer patients. However, it is not clear whether Psychological improvements are, in turn, related to improved health. A clinical trial tests whether a Psychological Intervention for cancer patients can do so, and also tests two routes to achieve better health: a) reducing patients’ emotional distress, and/or b) enhancing their functional immunity.
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Psychological behavioral and immune changes after a Psychological Intervention a clinical trial
Journal of Clinical Oncology, 2004Co-Authors: Barbara L. Andersen, William B Farrar, Deanna M Goldenkreutz, Charles F Emery, Ronald Glaser, Timothy R Crespin, Charles L Shapiro, William E. CarsonAbstract:Purpose This randomized clinical trial tests the hypothesis that a Psychological Intervention can reduce emotional distress, improve health behaviors and dose-intensity, and enhance immune responses. Patients and Methods We studied 227 women who were surgically treated for regional breast cancer. Before adjuvant therapy, women completed interviews and questionnaires assessing emotional distress, social adjustment, and health behaviors. A 60-mL blood sample was drawn for immune assays. Patients were randomly assigned to either the Intervention group or assessment only group. The Intervention was conducted in small patient groups, with one session per week for 4 months. The sessions included strategies to reduce stress, improve mood, alter health behaviors, and maintain adherence to cancer treatment and care. Reassessment occurred after completion of the Intervention. Results As predicted, patients receiving the Intervention showed significant lowering of anxiety, improvements in perceived social support, improved dietary habits, and reduction in smoking (all P .05). Analyses of adjuvant chemotherapy dose-intensity revealed significantly more variability (ie, more dispersion in the dose-intensity values) for the assessment arm (P .05). Immune responses for the Intervention patients paralleled their Psychological and behavioral improvements. T-cell proliferation in response to phytohemagglutinin and concanavalin A remained stable or increased for the Intervention patients, whereas both responses declined for Assessment patients; this effect was replicated across three concentrations for each assay (all P .01). Conclusion These data show a convergence of significant Psychological, health behavior, and biologic effects after a Psychological Intervention for cancer patients. J Clin Oncol 22:3570-3580. © 2004 by American Society of Clinical Oncology
Lisa M. Thornton - One of the best experts on this subject based on the ideXlab platform.
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biobehavioral immune and health benefits following recurrence for Psychological Intervention participants
Clinical Cancer Research, 2010Co-Authors: Barbara L. Andersen, Lisa M. Thornton, William B Farrar, Charles L Shapiro, Bethany L Mundy, Haechung Yang, William E. CarsonAbstract:Purpose: A clinical trial was designed to test the hypothesis that a Psychological Intervention could reduce the risk of cancer recurrence. Newly diagnosed regional breast cancer patients (n = 227) were randomized to the Intervention-with-assessment or the assessment-only arm. The Intervention had positive Psychological, social, immune, and health benefits, and after a median of 11 years the Intervention arm was found to have reduced the risk of recurrence (hazard ratio, 0.55; P =0 .034). In follow-up, we hypothesized that the Intervention arm might also show longer survival after recurrence. If observed, we then would examine potential biobehavioral mechanisms. Experimental Design: All patients were followed; 62 recurred. Survival analyses included all 62. Upon recurrence diagnosis, those available for further biobehavioral study were accrued (n = 41, 23 Intervention and 18 assessment). For those 41, Psychological, social, adherence, health, and immune (natural killer cell cytotoxicity, T-cell proliferation) data were collected at recurrence diagnosis and 4, 8, and 12 months later. Results: Intent-to-treat analysis revealed reduced risk of death following recurrence for the Intervention arm (hazard ratio, 0.41; P = 0.014). Mixed-effects follow-up analyses with biobehavioral data showed that all patients responded with significant Psychological distress at recurrence diagnosis, but thereafter only the Intervention arm improved (P values < 0.023). Immune indices were significantly higher for the Intervention arm at 12 months (P values < 0.017). Conclusions: Hazards analyses augment previous findings in showing improved survival for the Intervention arm after recurrence. Follow-up analyses showing biobehavioral advantages for the Intervention arm contribute to our understanding of how improved survival was achieved. Clin Cancer Res; 16(12); 3270–8. ©2010 AACR.
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a Psychological Intervention reduces inflammatory markers by alleviating depressive symptoms secondary analysis of a randomized controlled trial
Psychosomatic Medicine, 2009Co-Authors: Lisa M. Thornton, Barbara L. Andersen, Tammy A. Schuler, William E. CarsonAbstract:Objectives:To test experimentally whether a Psychological Intervention reduces depression-related symptoms and markers of inflammation among cancer patients and to test one mechanism for the Intervention effects. Depression and inflammation are common among cancer patients. Data suggest that inflamm
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A Psychological Intervention reduces inflammatory markers by alleviating depressive symptoms: Secondary analysis of a randomized controlled trial
Psychosomatic Medicine, 2009Co-Authors: Lisa M. Thornton, Barbara L. Andersen, Tammy A. Schuler, William E. CarsonAbstract:OBJECTIVES: To test experimentally whether a Psychological Intervention reduces depression-related symptoms and markers of inflammation among cancer patients and to test one mechanism for the Intervention effects. Depression and inflammation are common among cancer patients. Data suggest that inflammation can contribute to depressive symptoms, although the converse remains untested. METHODS: As part of a randomized clinical trial, newly diagnosed breast cancer patients (n = 45) with clinically significant depressive symptoms were evaluated and randomized to Psychological Intervention with assessment or assessment only study arms. The Intervention spanned 12 months, with assessments at baseline, 4, 8, and 12 months. Mixed-effects modeling tested the hypothesis that the Intervention reduced self-reported depressive symptoms (Center for Epidemiological Studies Depression scale, Profile of Mood States Depression and Fatigue subscales, and Medical Outcomes Study-Short Form 36 Bodily Pain subscale) and immune cell numbers that are elevated in the presence of inflammation (white blood cell count, neutrophil count, and helper/suppressor ratio). Mediation analyses tested whether change in depressive symptoms, pain, or fatigue predicted change in white blood cell count, neutrophil count, or the helper/suppressor ratio. RESULTS: The Intervention reduced significantly depressive symptoms, pain, fatigue, and inflammation markers. Moreover, the Intervention effect on inflammation was mediated by its effect on depressive symptoms. CONCLUSIONS: This is the first experiment to test whether Psychological treatment effective in reducing depressive symptoms would also reduce indicators of inflammation. Data show that the Intervention reduced directly depressive symptoms and reduced indirectly inflammation. Psychological treatment may treat effectively depressive symptoms, pain, and fatigue among cancer patients.
Gill Livingston - One of the best experts on this subject based on the ideXlab platform.
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effectiveness of start Psychological Intervention in reducing abuse by dementia family carers randomized controlled trial
International Psychogeriatrics, 2016Co-Authors: Claudia Cooper, Julie Barber, Mark Griffin, Penny Rapaport, Gill LivingstonAbstract:BACKGROUND: Family carers of people with dementia frequently report acting abusively toward them and carer Psychological morbidity predicts this. We investigated whether START (STrAtegies for RelaTives), a Psychological Intervention which reduces depression and anxiety in family carers also reduces abusive behavior in carers of people living in their own homes. We also explored the longitudinal course of carer abusive behavior over two year. METHODS: We included self-identified family carers who gave support at least weekly to people with dementia referred in the previous year to three UK mental health services and a neurological dementia service. We randomly assigned these carers to START, an eight-session, manual-based coping Intervention, or treatment as usual (TAU). Carer abusive behavior (Modified Conflict Tactic Scale (MCTS) score ≥2 representing significant abuse) was assessed at baseline, 4, 8, 12, and 24 months. RESULTS: We recruited 260 carers, 173 to START and 87 to TAU. There was no evidence that abusive behavior levels differed between randomization groups or changed over time. A quarter of carers still reported significant abuse after two years, but those not acting abusively at baseline did not become abusive. CONCLUSION: There was no evidence that START, which reduced carer anxiety and depression, reduced carer abusive behavior. For ethical reasons, we frequently intervened to manage concerning abuse reported in both groups, which may have disguised an Intervention effect. Future dementia research should include elder abuse as an outcome, and consider carefully how to manage detected abuse.
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long term clinical and cost effectiveness of Psychological Intervention for family carers of people with dementia a single blind randomised controlled trial
The Lancet Psychiatry, 2014Co-Authors: Julie Barber, Mark Griffin, Penny Rapaport, Gill Livingston, Martin Knapp, Derek King, Renee Romeo, Debbie Livingston, Cath MummeryAbstract:Summary Background Two-thirds of people with dementia live at home supported mainly by family carers. These carers frequently develop clinical depression or anxiety, which predicts care breakdown. We aimed to assess the clinical effectiveness (long-term reduction of depression and anxiety symptoms in family carers) and cost-effectiveness of a Psychological Intervention called START (STrAtegies for RelaTives). Methods We did a randomised, parallel-group trial with masked outcome assessments in three UK mental-health services and one neurological-outpatient dementia service. We included self-identified family carers of people with dementia who had been referred in the previous year and gave support at least once per week to the person with dementia. We randomly assigned these carers, via an online computer-generated randomisation system from an independent clinical trials unit, to either START, an 8-session, manual-based coping Intervention delivered by supervised psychology graduates, or treatment as usual (TAU). The primary long-term outcomes were affective symptoms (Hospital Anxiety and Depression Scale total score [HADS-T]) 2 years after randomisation and cost-effectiveness (health and social care perspectives) over 24 months. Analysis was by intention to treat, excluding carers with data missing at both 12 and 24 months. This trial is registered ISCTRN70017938. Findings From November 4, 2009, to June 8, 2011, we recruited 260 carers. 173 carers were randomly assigned to START and 87 to TAU. Of these 260 participants, 209 (80%) were included in the clinical efficacy analysis (140 START, 69 TAU). At 24 months, compared with TAU the START group was significantly better for HADS-T (mean difference −2·58 points, 95% CI −4·26 to −0·90; p=0·003). The Intervention is cost effective for both carers and patients (67% probability of cost-effectiveness at the £20 000 per QALY willingness-to-pay threshold, and 70% at the £30 000 threshold). Interpretation START is clinically effective, improving carer mood and anxiety levels for 2 years. Carers in the control TAU group were seven times more likely to have clinically significant depression than those receiving START. START is cost effective with respect to carer and patient outcomes, and National Institute for Health and Care Excellence (NICE) thresholds. The number of people with dementia is rapidly growing, and policy frameworks assume that their families will remain the frontline providers of (unpaid) support. This cost-neutral Intervention, which substantially improves family-carers' mental health and quality of life, should therefore be widely available. Funding National Institute for Health Research Health Technology Assessment programme 08/14/06.
Tammy A. Schuler - One of the best experts on this subject based on the ideXlab platform.
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a Psychological Intervention reduces inflammatory markers by alleviating depressive symptoms secondary analysis of a randomized controlled trial
Psychosomatic Medicine, 2009Co-Authors: Lisa M. Thornton, Barbara L. Andersen, Tammy A. Schuler, William E. CarsonAbstract:Objectives:To test experimentally whether a Psychological Intervention reduces depression-related symptoms and markers of inflammation among cancer patients and to test one mechanism for the Intervention effects. Depression and inflammation are common among cancer patients. Data suggest that inflamm
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A Psychological Intervention reduces inflammatory markers by alleviating depressive symptoms: Secondary analysis of a randomized controlled trial
Psychosomatic Medicine, 2009Co-Authors: Lisa M. Thornton, Barbara L. Andersen, Tammy A. Schuler, William E. CarsonAbstract:OBJECTIVES: To test experimentally whether a Psychological Intervention reduces depression-related symptoms and markers of inflammation among cancer patients and to test one mechanism for the Intervention effects. Depression and inflammation are common among cancer patients. Data suggest that inflammation can contribute to depressive symptoms, although the converse remains untested. METHODS: As part of a randomized clinical trial, newly diagnosed breast cancer patients (n = 45) with clinically significant depressive symptoms were evaluated and randomized to Psychological Intervention with assessment or assessment only study arms. The Intervention spanned 12 months, with assessments at baseline, 4, 8, and 12 months. Mixed-effects modeling tested the hypothesis that the Intervention reduced self-reported depressive symptoms (Center for Epidemiological Studies Depression scale, Profile of Mood States Depression and Fatigue subscales, and Medical Outcomes Study-Short Form 36 Bodily Pain subscale) and immune cell numbers that are elevated in the presence of inflammation (white blood cell count, neutrophil count, and helper/suppressor ratio). Mediation analyses tested whether change in depressive symptoms, pain, or fatigue predicted change in white blood cell count, neutrophil count, or the helper/suppressor ratio. RESULTS: The Intervention reduced significantly depressive symptoms, pain, fatigue, and inflammation markers. Moreover, the Intervention effect on inflammation was mediated by its effect on depressive symptoms. CONCLUSIONS: This is the first experiment to test whether Psychological treatment effective in reducing depressive symptoms would also reduce indicators of inflammation. Data show that the Intervention reduced directly depressive symptoms and reduced indirectly inflammation. Psychological treatment may treat effectively depressive symptoms, pain, and fatigue among cancer patients.
