Emotion Regulation and Depression in Breast Cancer Survivorship

乳腺癌幸存者的情绪调节和抑郁

• 批准号: 8193240
• 负责人: Annette L Stanton
• 金额: $ 57.83万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-04 至 2014-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8193240
• 关键词: Adverse effects; Alleles; Awareness; Basic Science; Behavior; Cancer Patient; Cancer Survivorship; Comorbidity; DNA; Depressive disorder; Diagnosis; Diagnostic; Disease; Disease susceptibility; Economic Burden; Economics; Emotional; Emotions; Employment; Endogenous depression; Enrollment; Environment; Epidemiologic Studies; Ethnic Origin; General Population; Genes; Genetic Polymorphism; Genetic Predisposition to Disease; Glean; Goals; Health; Health Resources; Incidence; Individual; International; Intervention; Interview; Life; Malignant Neoplasms; Measures; Mediating; Mediation; Mediator of activation protein; Medical; Mental Depression; Mental Health; Modeling; Neurotic Disorders; Outcome; Preventive Intervention; Process; Promoter Regions; Public Health; Questionnaires; Recording of previous events; Recruitment Activity; Recurrence; Research; Risk; Risk Factors; Science; Shapes; Specific qualifier value; Stress; Symptoms; Testing; Therapeutic Intervention; Time; To specify; Translational Research; Woman; age effect; biopsychosocial; breast cancer diagnosis; cancer therapy; chemotherapy; depressive symptoms; design; emotion regulation; experience; health economics; high risk; malignant breast neoplasm; next generation; novel; physical conditioning; prevent; psychologic; public health relevance; response; serotonin transporter; showing emotion; stressor; theories

DESCRIPTION (provided by applicant): Both in individuals living with cancer and in the general population, the experience of clinical depression exacts a profound psychological, physical, and economic toll. Little research has examined the unfolding risk for depressive symptoms and episodes after a breast cancer diagnosis with careful assessments repeated over time. Moreover, theory and research in depression and in emotion science have not been integrated and tested in sophisticated biopsychosocial models to advance understanding of risk and protective factors/processes for depression in cancer patients. Accordingly, this study has three specific aims. Aim 1 is to investigate how personal vulnerabilities, cancer-related (e.g., treatments/side effects) and noncancer-related stressors, and emotion regulation processes shape trajectories of depression in women following diagnosis of breast cancer. Personal vulnerabilities include general depressive diatheses (history of depression, neuroticism, harsh early environment) and emotion dysregulation diatheses (low emotional awareness and acceptance, high emotional suppression, no intimate confiding relationship). Aim 2 is to examine a diathesis- stress model, in which interactions of personal vulnerabilities, genetic factors (a functional polymorphism of the serotonin transporter gene), and stressors shape depressive response. Aim 3 is to examine a proximal model of how emotion regulation processes (approach and avoidance) mediate the effects of personal vulnerabilities on depressive symptoms and episodes. We will accomplish these aims in longitudinal research beginning within three months of diagnosis (Time 1) of 450 women (study completers) with new diagnoses of initial or recurrent invasive breast cancer and subsequent assessments every six weeks through six months (Time 2-5) and at 9 months (Time 6) and 12 months (Time 7). DNA extraction, validated questionnaires and interviews, and measures of expressive behavior will be administered. Primary dependent variables are depressive symptoms and depressive disorder. Effects of age, ethnicity, and mental health treatment receipt will be explored. Findings will influence public health by informing the next generation of targeted preventive and therapeutic interventions for depression in cancer patients, thereby reducing the disorder's health and economic burden. PUBLIC HEALTH RELEVANCE: Cancer patients are more likely than the general population to evidence depressive symptoms and clinical depression, but little is known about the factors that put individuals at risk for clinical depression when they have cancer. This project will provide information about who is at risk and factors contributing to high risk for depression, when they can be identified, and ingredients of interventions that are likely to be effective in reducing depression in women diagnosed with breast cancer. This research will help to target limited mental health resources to make the largest impact in preventing and treating depression in the face of cancer.

描述（由申请人提供）：无论是癌症患者还是普通人群，临床抑郁症都会造成严重的心理、身体和经济损失。很少有研究对乳腺癌诊断后抑郁症状和发作的风险进行调查，并随着时间的推移反复进行仔细评估。此外，抑郁症和情感科学的理论和研究尚未在复杂的生物心理社会模型中进行整合和测试，以增进对癌症患者抑郁症风险和保护因素/过程的理解。因此，本研究有三个具体目标。目标 1 是调查个人脆弱性、癌症相关（例如治疗/副作用）和非癌症相关压力源以及情绪调节过程如何影响乳腺癌诊断后女性的抑郁轨迹。个人脆弱性包括一般抑郁素质（抑郁史、神经质、恶劣的早期环境）和情绪失调素质（低情绪意识和接受度、高情绪压抑、没有亲密的倾诉关系）。目标 2 是检查素质-压力模型，其中个人脆弱性、遗传因素（血清素转运蛋白基因的功能多态性）和压力源的相互作用形成抑郁反应。目标 3 是检查情绪调节过程（接近和回避）如何调节个人脆弱性对抑郁症状和发作的影响的近端模型。我们将在诊断后三个月（时间 1）内开始纵向研究，对 450 名新诊断出初发或复发性浸润性乳腺癌的女性（研究完成者）开始纵向研究，并在每六周到六个月（时间 2-5）期间每六周进行一次后续评估，以实现这些目标。以及在 9 个月（时间 6）和 12 个月（时间 7）时。将进行 DNA 提取、经过验证的问卷和访谈以及表达行为测量。主要因变量是抑郁症状和抑郁障碍。将探讨年龄、种族和接受心理健康治疗的影响。研究结果将为下一代针对癌症患者抑郁症的有针对性的预防和治疗干预措施提供信息，从而影响公共健康，从而减轻该疾病的健康和经济负担。公共卫生相关性：癌症患者比一般人群更有可能出现抑郁症状和临床抑郁症，但人们对癌症患者面临临床抑郁症风险的因素知之甚少。该项目将提供有关哪些人面临抑郁症高风险的信息，以及导致抑郁症高风险的因素（何时可以识别），以及可能有效减少诊断为乳腺癌的女性抑郁症的干预措施的成分。这项研究将有助于利用有限的心理健康资源，在预防和治疗癌症带来的抑郁症方面发挥最大的影响。