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: 7736596
• 负责人: Annette L Stanton
• 金额: $ 67.04万
• 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 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7736596
• 关键词: Adverse effects; Alleles; Awareness; Behavior; Cancer Patient; Cancer Survivorship; DNA; Depressive disorder; Diagnosis; Diagnostic; Disease; Disease susceptibility; Economic Burden; Economics; Emotional; Emotions; Employment; Endogenous depression; Enrollment; Environment; Epidemiologic Studies; Ethnic Origin; Face; 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 Health; Modeling; Morbidity - disease rate; Neurotic Disorders; Outcome; Preventive; Process; Promoter Regions; Psychological Factors; 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; depression; 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）：无论是在患有癌症的人和普通人群中，临床抑郁症的经验都严重的心理，身体和经济损失。很少的研究研究了乳腺癌诊断后的抑郁症状和发作风险的发展风险，并且随着时间的推移重复进行了仔细的评估。此外，抑郁症和情绪科学中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，以提高对癌症患者抑郁症的风险和保护因素/过程的了解。因此，这项研究具有三个具体目标。 AIM 1是研究个人脆弱性，与癌症相关（例如治疗/副作用）和与非癌症相关的压力源以及情绪调节过程如何塑造乳腺癌诊断后女性抑郁症的轨迹。个人脆弱性包括一般的抑郁素性（抑郁史，神经质的历史，严酷的早期环境）和情绪失调素质（情绪低落和接受度，情绪低落，高情绪抑制，没有亲密的封闭关系）。 AIM 2是检查一个素质应力模型，其中个人脆弱性，遗传因素（羟色胺转运蛋白基因的功能多态性）的相互作用以及压力源形成抑郁反应。 AIM 3是检查情绪调节过程（方法和回避）如何介导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450名妇女（研究完成者）的三个月内从纵向研究中实现这些目标，并具有初始或复发性浸润性乳腺癌的新诊断，并随后每六周至六个月（时间2-5）和9个月（时间2-5）和9个月（时间6）（时间6）和12个月（时间7）（时间7）进行评估。 DNA提取，经过验证的问卷和访谈以及表达行为的衡量标准。主要的因变量是抑郁症状和抑郁症。将探讨年龄，种族和心理健康治疗收入的影响。调查结果将通过告知下一代癌症患者抑郁症的有针对性的预防和治疗性干预措施，从而影响公共卫生，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与证据抑郁症状和临床抑郁症，但对使人患有癌症时临床抑郁症风险的因素知之甚少。该项目将提供有关谁处于风险和有助于抑郁症的高风险的因素，以及可以识别出高风险的因素，以及可能有效减少被诊断出患有乳腺癌的妇女的抑郁症的干预措施的成分。这项研究将有助于针对有限的心理健康资源，从而在面对癌症的情况下对抑郁症产生最大的影响。