Original Article

Annals of Behavioral Medicine

, Volume 44, Issue 1, pp 10-20

Stress, Coping, and Circadian Disruption Among Women Awaiting Breast Cancer Surgery

  • Eric DedertAffiliated withVeterans Affairs Medical CenterDepartment of Psychiatry and Behavioral Sciences, Duke University Medical Center
  • , Elizabeth LushAffiliated withDepartment of Psychological and Brain Sciences, University of Louisville
  • , Anees ChagparAffiliated withDepartment of Surgery, Yale University School of Medicine
  • , Firdaus S. DhabharAffiliated withDepartment of Psychiatry and Behavioral Sciences, Stanford University School of MedicineInstitute for Immunity, Transplantation, and Infection, Stanford University School of Medicine
  • , Suzanne C. SegerstromAffiliated withDepartment of Psychology, University of Kentucky
  • , David SpiegelAffiliated withDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine
  • , Ehab DayyatAffiliated withDepartment of Pediatrics, University of Louisville
  • , Meagan DaupAffiliated withDepartment of Psychological and Brain Sciences, University of Louisville
  • , Kelly McMastersAffiliated withVeterans Affairs Medical CenterDivision of Surgical Oncology, School of Medicine, University of LouisvilleJames Graham Brown Cancer Center
    • , Sandra E. SephtonAffiliated withVeterans Affairs Medical CenterDepartment of Psychological and Brain Sciences, University of LouisvilleJames Graham Brown Cancer Center Email author 

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Abstract

Background

Psychological distress and coping related to a breast cancer diagnosis can profoundly affect psychological adjustment, possibly resulting in the disruption of circadian rest/activity and cortisol rhythms, which are prognostic for early mortality in metastatic colorectal and breast cancers, respectively.

Purpose

This study aims to explore the relationships of cancer-specific distress and avoidant coping with rest/activity and cortisol rhythm disruption in the period between diagnosis and breast cancer surgery.

Methods

Fifty-seven presurgical breast cancer patients provided daily self-reports of cancer-specific distress and avoidant coping as well as actigraphic and salivary cortisol data.

Results

Distress and avoidant coping were related to rest/activity rhythm disruption (daytime sedentariness, inconsistent rhythms). Patients with disrupted rest/activity cycles had flattened diurnal cortisol rhythms.

Conclusions

Maladaptive psychological responses to breast cancer diagnosis were associated with disruption of circadian rest/activity rhythms. Given that circadian cycles regulate tumor growth, we need greater understanding of possible psychosocial effects in cancer-related circadian disruption.

Keywords

Breast cancer Circadian rhythm Actigraphy Cortisol Rest/activity Sleep