Journal of Behavioral Medicine

, Volume 35, Issue 6, pp 658–673 | Cite as

Who benefits from psychosocial interventions in oncology? A systematic review of psychological moderators of treatment outcome

  • Rie Tamagawa
  • Sheila Garland
  • Marcus Vaska
  • Linda E. Carlson
Article
First Online:
Received:
Accepted:

Abstract

Medical and demographic characteristics and psychological morbidity of individuals with cancer prior to a psychosocial intervention can influence the efficacy of interventions. However, little is known about the moderating role of patients’ psychosocial characteristics on intervention effects. This review sought to identify and synthesize the impacts of psychosocial moderators of the effect of psychosocial interventions on the psychological well-being of cancer patients. A systematic review of the published literature was conducted. Databases searched included PsycINFO, PubMed, MEDLINE, Scopus, CINAHL, Web of Science, and Psychology and Behavioural Sciences Collection. Randomized controlled studies examining a moderator effect of patients’ psychosocial characteristics other than baseline depression and anxiety levels were included. Of 199 potential papers, a total of 20 studies, involving 3,340 heterogeneous cancer patients are included. Of the 17 potential psychosocial moderators examined in this review, 14 significantly moderated the effects of interventions. Moderators were categorized into personality traits, mental and physical quality of life, social environment, and self-efficacy. Patients with poorer quality of life, interpersonal relationships and sense of control benefitted more from interventions than those who already had adequate resources. Patients with low levels of optimism and neuroticism, high levels of emotional expressiveness, interpersonal sensitivity, and dispositional hypnotizability also showed greater benefits from various interventions. This review adds to the growing literature aimed at personalizing psychosocial cancer treatment by identifying who benefits from which psychosocial interventions.

Keywords

Cancer Psychosocial intervention Personality Social support Self-efficacy Quality of life 
This is a preview of subscription content, log in to check access.

Notes

Acknowledgments

Preparation of this article was supported by the Alberta Innovates—Health Solutions Fellowship and the Psychosocial Oncology Research Training Post-doctoral Fellowship awarded to Dr. Rie Tamagawa, and a grant from the Canadian Cancer Society Research Institute, the Transdisciplinary Understanding and Training on Research—Primary Health Care initiative training fellowship, and the Psychosocial Oncology Research Training Doctoral Fellowship awarded to Sheila Garland. Dr. Linda E. Carlson holds the Enbridge Research Chair in Psychosocial Oncology, co-funded by the Alberta Cancer Foundation and the Canadian Cancer Society Alberta/NWT Division. She is also an Alberta Heritage Foundation for Medical Research Health Scholar.

References

  1. Antoni, M. H., Lehman, J. M., Klibourn, K. M., Boyers, A. E., Culver, J. L., Alferi, S. M.,… Carver, C. S. (2001). Cognitive-behavioral stress management intervention decreases the prevalence of depression and enhances benefit finding among women under treatment for early-stage breast cancer. Health Psychology, 20, 20–32.Google Scholar
  2. Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.PubMedCrossRefGoogle Scholar
  3. Boutron, I., Moher, D., Altman, D. G., Schulz, K. F., & Ravaud, P. (2008). Extending the CONSORT statement to randomized trials of nonpharmacologic treatment: Explanation and elaboration. Annals of Internal Medicine, 148, 295–309.PubMedGoogle Scholar
  4. Butler, L. D., Koopman, C., Neri, E., GieseDavis, J., Palesh, O., ThorneYocam, K. A.,… Spiegel, D. (2009). Effects of supportive-expressive group therapy on pain in women with metastatic breast cancer. Health Psychology, 28, 579–587.Google Scholar
  5. Canadian Cancer Society. (2011). Canadian cancer statistics 2011. Retrieved from http://www.cancer.ca/Canada-wide/Publications.aspx?sc_lang=en
  6. Canadian Counseling and Psychotherapy Association. (2011). Retrieved from http://www.ccacc.ca/en/theprofession/whoarecounsellors/
  7. Carlson, L. E., Angen, M., Cullum, J., Goodey, E., Koopmans, J., Lamont, L.,… Bultz, B. D. (2004). High levels of untreated distress and fatigue in cancer patients. British Journal of Cancer, 90, 2297–2304.Google Scholar
  8. Costa, P. T., & McCrae, R. R. (1980). Influence of extraversion and neuroticism on subjective well-being: Happy and unhappy people. Journal of Personality and Social Psychology, 38, 668–678.PubMedCrossRefGoogle Scholar
  9. Creswell, J. D., Lam, S., Stanton, A. L., Taylor, S. E., Bower, J. E., & Sherman, D. K. (2007). Does self-affirmation, cognitive processing, or discovery of meaning explain cancer-related health benefits of expressive writing?. Personality and Social Psychology Bulletin, 33, 238–250. doi: 10.1177/0146167206294412 PubMedCrossRefGoogle Scholar
  10. Cunningham, A. J., Lockwood, G. A., & Edmonds, C. V. (1993). Which cancer patients benefit most from a brief, group, coping skills program?. International Journal of Psychiatry in Medicine, 23, 383–398.PubMedCrossRefGoogle Scholar
  11. de Moor, J. S., Moye, L., Low, M. D., Rivera, E., Singletary, S. E., Fouladi, R. T., et al. (2008). Expressive writing as a presurgical stress management intervention for breast cancer patients. Journal of the Society for Integrative Oncology, 6, 59–66.PubMedGoogle Scholar
  12. Doorenbos, A., Given, B., Given, C., & Verbitsky, N. (2006). Physical functioning: Effect of behavioral intervention for symptoms among individuals with cancer. Nursing Research, 55, 161–171.PubMedCrossRefGoogle Scholar
  13. Edgar, L., Rosberger, Z., & Nowlis, D. (1992). Coping with cancer during the first year after diagnosis. Assessment and intervention. Cancer, 69, 817–828.PubMedCrossRefGoogle Scholar
  14. Escalante, C. P. (2003). Treatment of cancer-related fatigue: An update. Supportive Care in Cancer, 11, 79–83.PubMedGoogle Scholar
  15. Gonzalez-Angulo, A. M., Hennessy, B. T., & Mills, G. B. (2010). Future of personalized medicine in oncology: A systems biology approach. Journal of Clinical Oncology, 28, 2777–2783.PubMedCrossRefGoogle Scholar
  16. Gore, J. L., Gollapudi, K., Bergman, J., Kwan, L., Krupski, T. L., & Litwin, M. S. (2010). Correlates of bother following treatment for clinically localized prostate cancer. Journal of Urology, 184, 1309–1315.PubMedCrossRefGoogle Scholar
  17. Grassi, L., Sabato, S., Rossi, E., Marmai, L., & Biancosino, B. (2009). Effects of supportive-expressive group therapy in breast cancer patients with affective disorders: A pilot study. Psychotherapy and Psychosomatics, 79, 39–47.PubMedCrossRefGoogle Scholar
  18. Helgeson, V. S., Cohen, S., Schulz, R., & Yasko, J. (2000). Group support interventions for women with breast cancer: Who benefits from what?. Health Psychology, 19, 107–114.PubMedCrossRefGoogle Scholar
  19. Helgeson, V. S., Lepore, S. J., & Eton, D. T. (2006). Moderators of the benefits of psychoeducational interventions for men with prostate cancer. Health Psychology, 25, 348–354.PubMedCrossRefGoogle Scholar
  20. Higgins, J. P. T., & Altman, D. G. (2008). Assessing risk of bias in included studies. In J. P. T. Higgins, & S. Green (Eds.), Cochrane handbook for systematic reviews of interventions version 5.0.0, the Cochrane collaboration. Available from http://www.cochrane-handbook.org/
  21. Jacobsen, P. B., & Jim, H. S. (2008). Psychosocial interventions for anxiety and depression in adult cancer patients: Achievements and challenges. Ca-a Cancer Journal for Clinicians, 58, 214–230. doi: 10.3322/CA.2008.0003 PubMedCrossRefGoogle Scholar
  22. Lepore, S. J., & Helgeson, V. S. (1998). Social constraints, intrusive thoughts, and mental health after prostate cancer. Journal of Social and Clinical Psychology, 17, 89–106.CrossRefGoogle Scholar
  23. Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gotzsche, P. C., Ioannidis, J. P.,… Moher, D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration. Journal of Clinical Epidemiology, 62, e1–34.Google Scholar
  24. Low, C. A., Stanton, A. L., Bower, J. E., & Gyllenhammer, L. (2010). A randomized controlled trial of emotionally expressive writing for women with metastatic breast cancer. Health Psychology, 29, 460–466. doi: 10.1037/a0020153 PubMedCrossRefGoogle Scholar
  25. Manne, S. L., Rubin, S., Edelson, M., Rosenblum, N., Bergman, C., Hernandez, E.,… Winkel, G. (2007). Coping and communication-enhancing intervention versus supportive counseling for women diagnosed with gynecological cancers. Journal of Consulting and Clinical Psychology, 75, 615–628.Google Scholar
  26. Minisini, A., Atalay, G., Bottomley, A., Puglisi, F., Piccart, M., & Biganzoli, L. (2004). What is the effect of systemic anticancer treatment on cognitive function?. Lancet Oncology, 5, 273–282.PubMedCrossRefGoogle Scholar
  27. Molton, I. R., Siegel, S. D., Penedo, F. J., Dahn, J. R., Kinsinger, D., Traeger, L. N.,… Antoni, M. H. (2008). Promoting recovery of sexual functioning after radical prostatectomy with group-based stress management: The role of interpersonal sensitivity. Journal of Psychosomatic Research, 64, 527–536.Google Scholar
  28. Naaman, S., Radwan, K., Fergusson, D., & Johnson, S. (2009). Status of psychological trials in breast cancer patients: A report of three meta-analyses. Psychiatry: Interpersonal and Biological Processes, 72, 50–69.Google Scholar
  29. National Comprehensive Cancer Network. (1999). NCCN practice guidelines for the management of psychosocial distress. Oncology, 13, 113–147.Google Scholar
  30. Newell, S. A., Sanson-Fisher, R. W., & Savolainen, N. J. (2002). Systematic review of psychological therapies for cancer patients: Overview and recommendations for future research. Journal of the National Cancer Institute, 94, 558–584.PubMedCrossRefGoogle Scholar
  31. Pilkonis, P. A., Kim, Y., Proietti, J. M., & Barkham, M. (1996). Scales for personality disorders developed from the inventory of interpersonal problems. Journal of Personality Disorders, 10, 355–369.CrossRefGoogle Scholar
  32. Pitceathly, C., & Maguire, P. (2003). The psychological impact of cancer on patients’ partners and other key relatives: A review. European Journal of Cancer, 39, 1517–1524.PubMedCrossRefGoogle Scholar
  33. Reich, M., Lesur, A., & Perdrizet-Chevallier, C. (2008). Depression, quality of life and breast cancer: A review of the literature. Breast Cancer Research and Treatment, 110, 9–17.PubMedCrossRefGoogle Scholar
  34. Rodin, G., Lloyd, N., Katz, M., Green, E., Mackay, J. A., Wong, R. K., et al. (2007). The treatment of depression in cancer patients: A systematic review. Supportive Care in Cancer, 15, 123–136.PubMedCrossRefGoogle Scholar
  35. Roffe, L., Schmidt, K., & Ernst, E. (2005). A systematic review of guided imagery as an adjuvant cancer therapy. Psycho-Oncology, 14, 607–617.PubMedCrossRefGoogle Scholar
  36. Ross, L., Boesen, E. H., Dalton, S. O., & Johansen, C. (2002). Mind and cancer: Does psychosocial intervention improve survival and psychological well-being?. European Journal of Cancer, 38, 1447–1457.PubMedCrossRefGoogle Scholar
  37. Savard, J., Simard, S., Blanchet, J., Ivers, H., & Morin, C. M. (2001). Prevalence, clinical characteristics, and risk factors for insomnia in the context of breast cancer. Sleep, 24, 583–590.PubMedGoogle Scholar
  38. Scheier, M. F., & Carver, C. S. (1985). Optimism, coping, and health: Assessment and implications of generalized outcome expectancies. Health Psychology, 4, 219–247.PubMedCrossRefGoogle Scholar
  39. Scheier, M. F., Helgeson, V. S., Schulz, R., Colvin, S., Berga, S. L., Knapp, J., et al. (2007). Moderators of interventions designed to enhance physical and psychological functioning among younger women with early-stage breast cancer. Journal of Clinical Oncology, 25, 5710–5714. doi: 10.1200/JCO.2007.11.7093 PubMedCrossRefGoogle Scholar
  40. Schneider, S., Moyer, A., KnappOliver, S., Sohl, S., Cannella, D., & Targhetta, V. (2010). Pre-intervention distress moderates the efficacy of psychosocial treatment for cancer patients: A meta-analysis. Journal of Behavioral Medicine, 33, 1–14.PubMedCrossRefGoogle Scholar
  41. Sheard, T., & Maguire, P. (1999). The effect of psychological interventions on anxiety and depression in cancer patients: Results of two meta-analyses. British Journal of Cancer, 80, 1770–1780.PubMedCrossRefGoogle Scholar
  42. Stanton, A. L., Danoff-Burg, S., Sworowski, L. A., Collins, C. A., Branstetter, A. D., Rodriguez-Hanley, A.,… Austenfeld, J. L. (2002). Randomized, controlled trial of written emotional expression and benefit finding in breast cancer patients. Journal of Clinical Oncology, 20, 4160-4168.Google Scholar
  43. Stanton, A. L., Ganz, P. A., Kwan, L., Meyerowitz, B. E., Bower, J. E., Krupnick, J. L.,… Belin, T. R. (2005). Outcomes from the moving beyond cancer psychoeducational, randomized, controlled trial with breast cancer patients. Journal of Clinical Oncology, 23, 6009–6018. doi: 10.1200/JCO.2005.09.101
  44. Stiegelis, H. E., Hagedoorn, M., Sanderman, R., Bennenbroek, F. T. C., Buunk, B. P., Van den Bergh, A. C. M.,… Ranchor, A. V. (2004). The impact of an informational self-management intervention on the association between control and illness uncertainty before and psychological distress after radiotherapy. Psycho-Oncology, 13, 248–259.Google Scholar
  45. Taylor, C. L. C., de Moor, C., BasenEngquist, K., Smith, M. A., Dunn, A. L., Badr, H.,… Gritz, E. R. (2007). Moderator analyses of participants in the active for life after cancer trial: Implications for physical activity group intervention studies. Annals of Behavioral Medicine, 33, 99–104.Google Scholar
  46. Taylor, K. L., Lamdan, R. M., Siegel, J. E., Shelby, R., MoranKlimi, K., & Hrywna, M. (2003). Psychological adjustment among African American breast cancer patients: One-year follow-up results of a randomized psychoeducational group intervention. Health Psychology, 22, 316–323.PubMedCrossRefGoogle Scholar
  47. Vodermaier, A., Caspari, C., Wang, L., Koehm, J., Ditsch, N., & Untch, M. (2011). How and for whom are decision aids effective? long-term psychological outcome of a randomized controlled trial in women with newly diagnosed breast cancer. Health Psychology, 30, 12–19.PubMedCrossRefGoogle Scholar
  48. Watson, D., & Clark, L. A. (1984). Negative affectivity: The disposition to experience aversive emotional states. Psychological Bulletin, 96, 465–490.PubMedCrossRefGoogle Scholar
  49. Williams, S., & Dale, J. (2006). The effectiveness of treatment for depression/depressive symptoms in adults with cancer: A systematic review. British Journal of Cancer, 94, 372–390.PubMedCrossRefGoogle Scholar
  50. Zabora, J., Blanchard, C. G., Smith, E. D., Roberts, C. S., Glajchen, M., Sharp, J. W.,… Hedlund, S. C. (1997). Prevalence of psychological distress among cancer patients across the disease continuum. Journal of Psychosocial Oncology, 15, 73–87.Google Scholar
  51. Zakowski, S. G., Herzer, M., Barrett, S. D., Milligan, J. G., & Beckman, N. (2011). Who benefits from emotional expression? An examination of personality differences among gynaecological cancer patients participating in a randomized controlled emotional disclosure intervention trial. British Journal of Psychology, 102, 355–372. doi: 10.1348/000712610X524949 PubMedCrossRefGoogle Scholar
  52. Zakowski, S. G., Ramati, A., Morton, C., Johnson, P., & Flanigan, R. (2004). Written emotional disclosure buffers the effects of social constraints on distress among cancer patients. Health Psychology, 23, 555–563.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Rie Tamagawa
    • 1
    • 2
  • Sheila Garland
    • 3
  • Marcus Vaska
    • 4
  • Linda E. Carlson
    • 1
    • 2
    • 3
  1. 1.Department of Oncology, Faculty of MedicineUniversity of CalgaryCalgaryCanada
  2. 2.Department of Psychosocial Resources, Tom Baker Cancer CentreAlberta Health ServicesCalgaryCanada
  3. 3.Department of Psychology, Faculty of ArtsUniversity of CalgaryCalgaryCanada
  4. 4.Health Information Network Calgary, Holy Cross SiteAlberta Health ServicesCalgaryCanada

Personalised recommendations