Skip to main content

Advertisement

SpringerLink
Log in

The impact of a virtual mind-body program on resilience factors among international English-speaking adults with neurofibromatoses: secondary analysis of a randomized clinical trial

  • Research
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Purpose

To test the effects of the Relaxation Response Resiliency Program - Neurofibromatosis (3RP-NF), a mind-body resilience program for people with NF, on resilience factors from baseline to post-treatment and 6- and 12-month follow-up.

Methods

This is a secondary analysis of a fully powered randomized clinical trial (RCT) of 3RP-NF and health education control (HEP-NF). We recruited adults with NF1, NF2, or schwannomatosis who reported stress or difficulty coping with NF symptoms. Both conditions received 8 weekly 90-minute group sessions; 3RP-NF focused on building resilience skills. We measured resilience factors via the Measure of Current Status-A (adaptive coping), Cognitive and Affective Mindfulness Scale-Revised (mindfulness), Gratitude Questionnaire-6 (gratitude), Life Orientation Test Optimism Scale (optimism), and Medical Outcomes Study Social Support Survey (perceived social support) at baseline, post-intervention, and 6- and 12-month follow-up. We used linear mixed models with completely unstructured covariance across up to four repeated measurements (baseline, post-treatment, and 6- and 12-month follow-up) to investigate treatment effects on resilience factors.

Results

We enrolled 228 individuals (Mage=42.7, SD = 14.6; 74.5% female; 87.7% White; 72.8% NF1, 14.0% NF2, 13.2% schwannomatosis). Within groups, both 3RP-NF and HEP-NF showed statistically significant improvements in all outcomes across timepoints. 3RP-NF showed significantly greater improvement in adaptive coping compared to HEP-NF from baseline to post-intervention and baseline to 6 months (Mdifference= 0.29; 95% CI 0.13–0.46; p < 0.001; Mdifference= 0.25; 95% CI 0.07–0.33; p = 0.005); there were no other between-group differences amongst the remaining resilience factors.

Conclusion

3RP-NF showed promise in sustainably improving coping abilities amongst people with NF.

Trial registration Information

ClinicalTrials.gov Identifier: NCT03406208. Registration submitted December 6, 2017, first patient enrolled October 2017.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Mayo Clinic (2023) Neurofibromatosis - Symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/neurofibromatosis/symptoms-causes/syc-20350490. Accessed March 7,

  2. Friedman JM (2002) Epidemiology of neurofibromatosis type 1. Am J Med Genet 89:1–6

    Article  Google Scholar 

  3. Viskochil D, Buchberg AM, Xu G et al (1990) Deletions and a translocation interrupt a cloned gene at the neurofibromatosis type 1 locus. Cell 62(1):187–192. https://doi.org/10.1016/0092-8674(90)90252-A

    Article  CAS  PubMed  Google Scholar 

  4. Lin AL, Gutmann DH (2013) Advances in the treatment of neurofibromatosis-associated tumours. Nat Rev Clin Oncol 10(11):616–624. https://doi.org/10.1038/nrclinonc.2013.144

    Article  CAS  PubMed  Google Scholar 

  5. Vranceanu AM, Merker VL, Park E, Plotkin SR (2013) Quality of life among adult patients with neurofibromatosis 1, neurofibromatosis 2 and schwannomatosis: a systematic review of the literature. J Neurooncol 114(3):257–262. https://doi.org/10.1007/s11060-013-1195-2

    Article  PubMed  Google Scholar 

  6. Wang DL, Smith KB, Esparza S et al (2012) Emotional functioning of patients with neurofibromatosis tumor suppressor syndrome. Genet Med 14(12):977–982. https://doi.org/10.1038/gim.2012.85

    Article  PubMed  PubMed Central  Google Scholar 

  7. Fishbein NS, Vranceanu AM, Mace RA (2022) Baseline characteristics of adults with neurofibromatosis enrolled on a psychosocial randomized controlled trial. J Neurooncol 159(3):637–646. https://doi.org/10.1007/s11060-022-04104-6

    Article  PubMed  Google Scholar 

  8. Szanton SL, Gill JM (2010) Facilitating resilience using a society-to-cells Framework: a theory of nursing essentials Applied to Research and Practice. Adv Nurs Sci 33(4):329. https://doi.org/10.1097/ANS.0b013e3181fb2ea2

    Article  Google Scholar 

  9. Cal SF, de Sá LR, Glustak ME, Santiago MB (2015) Resilience in chronic diseases: a systematic review. Cogent Psychol 2(1):1024928. https://doi.org/10.1080/23311908.2015.1024928

    Article  Google Scholar 

  10. Ovaska-Stafford N, Maltby J, Dale M (2021) Literature Review: psychological resilience factors in people with neurodegenerative Diseases. Arch Clin Neuropsychol 36(2):283–306. https://doi.org/10.1093/arclin/acz063

    Article  PubMed  Google Scholar 

  11. Folkman S, Moskowitz JT (2004) Coping: pitfalls and promise. Annu Rev Psychol 55:745–774. https://doi.org/10.1146/annurev.psych.55.090902.141456

    Article  PubMed  Google Scholar 

  12. Creswell JD (2017) Mindfulness interventions. Annu Rev Psychol 68:491–516. https://doi.org/10.1146/annurev-psych-042716-051139

    Article  PubMed  Google Scholar 

  13. Pentz M (2005) Resilience among older adults with cancer and the importance of social support and spirituality-faith. J Gerontol Soc Work 44:3–22

    Article  Google Scholar 

  14. Carver CS, Scheier MF, Segerstrom SC (2010) Optimism. Clin Psychol Rev 30:879–889

    Article  PubMed  PubMed Central  Google Scholar 

  15. Horton TV, Wallander JL (2001) Hope and social support as resilience factors against psychological distress of mothers who care for children with chronic physical conditions. Rehabil Psychol 46:382–399

    Article  Google Scholar 

  16. Tsai J, Harpaz-Rotem I, Pietrzak RH, Southwick SM (2012) The role of coping, resilience, and social support in mediating the relation between PTSD and social functioning in veterans returning from Iraq and Afghanistan. Psychiatry 75:135–149

    Article  PubMed  Google Scholar 

  17. Meyers EE, Presciutti A, Shaffer KM et al (2020) The impact of resilience factors and anxiety during hospital admission on longitudinal anxiety among dyads of Neurocritical Care Patients without Major Cognitive Impairment and their family caregivers. Neurocrit Care 33(2):468–478. https://doi.org/10.1007/s12028-020-00913-7

    Article  PubMed  Google Scholar 

  18. Borrell-Carrió F, Suchman AL, Epstein RM (2004) The biopsychosocial model 25 years later: principles, practice, and scientific inquiry. Ann Fam Med 2(6):576–582. https://doi.org/10.1370/afm.245

    Article  PubMed  PubMed Central  Google Scholar 

  19. Carlson LE, Bultz BD (2003) Benefits of psychosocial oncology care: improved quality of life and medical cost offset. Health Qual Life Outcomes 1:8. https://doi.org/10.1186/1477-7525-1-8

    Article  PubMed  PubMed Central  Google Scholar 

  20. Samuelson M, Foret M, Baim M et al (2010) Exploring the effectiveness of a comprehensive mind-body intervention for medical symptom relief. J Altern Complement Med 16(2):187–192. https://doi.org/10.1089/acm.2009.0142

    Article  PubMed  Google Scholar 

  21. Vranceanu AM, Gonzalez A, Niles H et al (2014) Exploring the effectiveness of a modified comprehensive mind-body intervention for Medical and Psychologic Symptom Relief. Psychosomatics 55(4):386–391. https://doi.org/10.1016/j.psym.2014.01.005

    Article  PubMed  Google Scholar 

  22. Vranceanu AM, Merker VL, Plotkin SR, Park ER (2014) The relaxation response resiliency program (3RP) in patients with neurofibromatosis 1, neurofibromatosis 2, and schwannomatosis: results from a pilot study. J Neurooncol 120(1):103–109. https://doi.org/10.1007/s11060-014-1522-2

    Article  PubMed  Google Scholar 

  23. Vranceanu AM, Riklin E, Merker VL, Macklin EA, Park ER, Plotkin SR (2016) Mind-body therapy via videoconferencing in patients with neurofibromatosis: an RCT. Neurology 87(8):806–814. https://doi.org/10.1212/WNL.0000000000003005

    Article  PubMed  Google Scholar 

  24. Vranceanu AM, Manglani HR, Choukas NH et al (2023) Mind-body skills training for geographically diverse adults with neurofibromatosis: a fully remote randomized clinical trial. Manuscr under Rev JAMA Netw Open 6(6):e2320599

    Article  Google Scholar 

  25. Cohen S (1988) Perceived stress in a probability sample of the United States. The Social psychology of Health. Sage Publications, Inc., pp 31–67

  26. Cohen S, Kamarck T, Mermelstein R (1983) A global measure of perceived stress. J Health Soc Behav 24(4):385–396

    Article  CAS  PubMed  Google Scholar 

  27. Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG (2009) Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42(2):377–381. https://doi.org/10.1016/j.jbi.2008.08.010

    Article  PubMed  Google Scholar 

  28. Carver CS, Measure of Current Status (2006) https://local.psy.miami.edu/faculty/ccarver/sclMOCS.phtml. Accessed March 7, 2023

  29. Feldman G, Hayes A, Kumar S, Greeson J, Laurenceau JP (2007) Mindfulness and emotion regulation: the Development and initial validation of the cognitive and affective mindfulness scale-revised (CAMS-R). J Psychopathol Behav Assess 29(3):177–190. https://doi.org/10.1007/s10862-006-9035-8

    Article  Google Scholar 

  30. Mccullough ME, Emmons RA, Tsang J-A (2002) The grateful disposition: a conceptual and empirical topography. J Pers Soc Psychol 82:112–127

    Article  PubMed  Google Scholar 

  31. Scheier MF, Carver CS (1985) Optimism, coping, and health: assessment and implications of generalized outcome expectancies. Health Psychol 4:219–247

    Article  CAS  PubMed  Google Scholar 

  32. Sherbourne CD, Stewart AL (1991) The MOS social support survey. Soc Sci Med 32:705–714

    Article  CAS  PubMed  Google Scholar 

  33. Vranceanu AM, Zale EL, Funes CJ et al (2018) Mind-body treatment for International English-Speaking adults with neurofibromatosis via live videoconferencing: protocol for a single-blind randomized controlled trial. JMIR Res Protoc 7(10):e11008. https://doi.org/10.2196/11008

    Article  PubMed  PubMed Central  Google Scholar 

  34. Park ER, Traeger L, Vranceanu AM et al (2013) The development of a patient-centered program based on the relaxation response: the Relaxation Response Resiliency Program (3RP). Psychosomatics 54(2):165–174. https://doi.org/10.1016/j.psym.2012.09.001

    Article  PubMed  Google Scholar 

  35. Benson H, Rosner BA, Marzetta BR, Klemchuk HM (1974) Decreased blood-pressure in pharmacologically treated hypertensive patients who regularly elicited the relaxation response. Lancet Feb 23(7852):289–291. https://doi.org/10.1016/s0140-6736(74)92596-3

    Article  Google Scholar 

  36. Benson H, Klemchuk HP, Graham JR (1974) The usefulness of the relaxation response in the therapy of headache. Headache 14(1):49–52. https://doi.org/10.1111/j.1526-4610.1974.hed1401049.x

    Article  CAS  PubMed  Google Scholar 

  37. Benson H, Rosner BA, Marzetta BR, Klemchuk HP (1974) Decreased blood pressure in borderline hypertensive subjects who practiced meditation. J Chronic Dis 27(3):163–169. https://doi.org/10.1016/0021-9681(74)90083-6

    Article  CAS  PubMed  Google Scholar 

  38. Beary JF, Benson H (1974) A simple psychophysiologic technique which elicits the hypometabolic changes of the relaxation response. Psychosom Med 36(2):115–120. https://doi.org/10.1097/00006842-197403000-00003

    Article  CAS  PubMed  Google Scholar 

  39. Peters RK, Benson H, Peters JM (1977) Daily relaxation response breaks in a working population: II. Effects on blood pressure. Am J Public Health 67(10):954–959. https://doi.org/10.2105/ajph.67.10.954

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Greenwood MM, Benson H (1977) The efficacy of progressive relaxation in systematic desensitization and a proposal for an alternative competitive response–the relaxation response. Behav Res Ther 15(4):337–343. https://doi.org/10.1016/0005-7967(77)90065-1

    Article  CAS  PubMed  Google Scholar 

  41. Benson H, Klipper M (2000) Relaxation response. HarperCollins Publishers

  42. Dusek JA, Otu HH, Wohlhueter AL et al (2008) Genomic counter-stress changes induced by the relaxation response. PLoS ONE 3(7):e2576. https://doi.org/10.1371/journal.pone.0002576

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Mahaffey BL, Mackin DM, Vranceanu AM et al (2020) The Stony Brook Health Enhancement Program (SB-HEP): the development of an active control Condition for mind-body interventions. J Health Psychol 25(13–14):2129–2140. https://doi.org/10.1177/1359105318787024

    Article  PubMed  Google Scholar 

  44. Benjamini Y, Hochberg Y (1995) Controlling the false Discovery rate: a practical and powerful Approach to multiple testing. J Roy Stat Soc: Ser B (Methodol) 57(1):289–300. https://doi.org/10.1111/j.2517-6161.1995.tb02031.x

    Article  Google Scholar 

  45. Little RJ, Rubin DB (2002) Missing data in experiments. Stat Anal missing data Aug 26:24–40

    Google Scholar 

  46. Scarf D, Moradi S, McGaw K et al (2016) Somewhere I belong: long-term increases in adolescents’ resilience are predicted by perceived belonging to the in-group. Br J Soc Psychol 55(3):588–599. https://doi.org/10.1111/bjso.12151

    Article  PubMed  Google Scholar 

  47. Slavich GM, Roos LG, Zaki J (2022) Social belonging, compassion, and kindness: key ingredients for fostering resilience, recovery, and growth from the COVID-19 pandemic. Anxiety Stress Coping 35(1):1–8. https://doi.org/10.1080/10615806.2021.1950695

    Article  PubMed  Google Scholar 

  48. Muldoon OT, Haslam SA, Haslam C, Cruwys T, Kearns M, Jetten J (2019) The social psychology of responses to trauma: social identity pathways associated with divergent traumatic responses. Eur Rev Social Psychol 30(1):311–348. https://doi.org/10.1080/10463283.2020.1711628

    Article  Google Scholar 

  49. Steinhardt M, Dolbier C (2008) Evaluation of a resilience intervention to enhance coping strategies and protective factors and decrease symptomatology. J Am Coll Health 56(4):445–453. https://doi.org/10.3200/JACH.56.44.445-454

    Article  PubMed  Google Scholar 

  50. Tait L, Birchwood M, Trower P (2004) Adapting to the challenge of psychosis:personal resilience and the use of sealing-over (avoidant) coping strategies. Br J Psychiatry 185:410–415. https://doi.org/10.1192/bjp.185.5.410

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This study was funded by a clinical trial grant awarded to AMV by the Department of Defense (DOD; W81XWH-17-1-0121). The sponsor was not involved in the review or approval of this manuscript for publication. We thank the study participants, Children’s Tumor Foundation, and NF chapter and organizations that aided with recruitment.

Author information

Authors and Affiliations

  1. Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, 1 Bowdoin Sq, Boston, MA, 02114, USA

    Alexander M. Presciutti, Ethan G. Lester, Emily C. Woodworth, Jonathan Greenberg, Jafar Bakhshaie, Julia E. Hooker, Katherine A. McDermott & Ana-Maria Vranceanu

  2. Department of Psychiatry, Harvard Medical School, Boston, MA, USA

    Alexander M. Presciutti, Ethan G. Lester, Jonathan Greenberg, Jafar Bakhshaie, Julia E. Hooker, Katherine A. McDermott & Ana-Maria Vranceanu

Authors
  1. Alexander M. Presciutti
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ethan G. Lester
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Emily C. Woodworth
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jonathan Greenberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jafar Bakhshaie
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Julia E. Hooker
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Katherine A. McDermott
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ana-Maria Vranceanu
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

AMP: design, drafting of main text, critical revisions; EGL: data acquisition, drafting of main text, critical revisions; ECW: drafting of main text, critical revisions, preparation of references and figures; JG: drafting of main text, critical revisions; JB: design, data analysis, drafting of main text, critical revisions; JEH: drafting of abstract, critical revisions; KAM: drafting of abstract, critical revisions; AMV: conceptualization, design, data acquisition, critical revisions.

Corresponding author

Correspondence to Ana-Maria Vranceanu.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Presciutti, A.M., Lester, E.G., Woodworth, E.C. et al. The impact of a virtual mind-body program on resilience factors among international English-speaking adults with neurofibromatoses: secondary analysis of a randomized clinical trial. J Neurooncol 163, 707–716 (2023). https://doi.org/10.1007/s11060-023-04389-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11060-023-04389-1

Keywords

Search

Navigation