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Cited by 108Cancer survivorship and careMindfulness and Compassion InterventionsWomen's cancer prevention and management

Brief cognitive-behavioral and relaxation training interventions for breast cancer: a randomized controlled trial

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Gudenkauf, Lisa M., Antoni, Michael H., Stagl, Jamie M., Lechner, Suzanne C., Jutagir, Devika R., Bouchard, Laura C., Blomberg, Bonnie B., Glück, Stefan +5 more·2015·Journal of Consulting and Clinical Psychology
DOI 10.1037/ccp0000020PMC PMC4516670
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Abstract

OBJECTIVE: Women with breast cancer (BCa) report elevated distress postsurgery. Group-based cognitive-behavioral stress management (CBSM) following surgery improves psychological adaptation, though its key mechanisms remain speculative. This randomized controlled dismantling trial compared 2 interventions featuring elements thought to drive CBSM effects: a 5-week cognitive-behavioral training (CBT) and 5-week relaxation training (RT) versus a 5-week health education (HE) control group. METHOD: Women with stage 0-III BCa (N = 183) were randomized to CBT, RT, or HE condition 2-10 weeks postsurgery. Psychosocial measures were collected at baseline (T1) and postintervention (T2). Repeated-measures analyses of variance (ANOVAs) tested whether CBT and RT treatments improved primary measures of psychological adaptation and secondary measures of stress management resource perceptions from pre- to postintervention relative to HE. RESULTS: Both CBT and RT groups reported reduced depressive affect. The CBT group reported improved emotional well-being/quality of life and less cancer-specific thought intrusions. The RT group reported improvements on illness-related social disruption. Regarding stress management resources, the CBT group reported increased reliability of social support networks, while the RT group reported increased confidence in relaxation skills. Psychological adaptation and stress management resource constructs were unchanged in the HE control group. CONCLUSIONS: Nonmetastatic breast cancer patients participating in 2 forms of brief, 5-week group-based stress management intervention after surgery showed improvements in psychological adaptation and stress management resources compared with an attention-matched control group. Findings provide preliminary support suggesting that using brief group-based stress management interventions may promote adaptation among nonmetastatic breast cancer patients.

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Crossref · 10.1037/ccp0000020

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  • Gudenkauf 2015 had low risk of other bias.

    “Other bias Low risk”

    From Psychological interventions for women with non-metastatic breast cancer (2023) · cites this paper as Gudenkauf 2015

    The paper does not describe the study as having low risk of other bias. In the Discussion (Strengths and Limitations), it says baseline differences between groups create an ambiguity about the results that cannot be entirely discounted; the Results (Sample Demographics) identify those differences. (LLM, conf=0.84)

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  • The parent study has power to detect effects of the medium magnitude typically reported in psychosocial intervention trials among cancer patients.

    “The parent study is powered to detect effect sizes consistent with the medium effect sizes generally observed in other studies of psychosocial interventions in cancer patients [34–39].”

    From Living Well: Protocol for a web-based program to improve quality of life in rural and urban ovarian cancer survivors (2024) · cites this paper as [37]

    The Method > Analytic Approach passage (page unavailable) reports that the study was designed for 75% power to detect a medium effect (d = 0.5), and the Discussion > Strengths and Limitations says it had sufficient power for medium-sized effects. The paper does not establish that medium effects are generally observed across other psychosocial intervention studies in cancer patients. (LLM, conf=0.84)

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  • Gudenkauf 2015 had low risk of attrition bias.

    “Incomplete outcome data (attrition bias) All outcomes Low risk”

    From Psychological interventions for women with non-metastatic breast cancer (2023) · cites this paper as Gudenkauf 2015

    Results report that retention did not differ significantly by group, which supports part of a low-attrition-bias assessment. But only 138 of 183 randomized women completed follow-up, and Method > Analytic Approach says analyses used list-wise deletion for missing values. The paper does not establish low risk from incomplete outcome data for all outcomes. Our copy provides no page numbers for these passages. (LLM, conf=0.84)

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  • In studies not screening patients for enrollment, CBT plus BT (relaxation) and education plus self-care significantly improved depression.

    “In studies not screening patients for enrollment, CBT plus BT (relaxation) 77,100 and education plus self-care 123 significantly improved depression.”

    From Management of Anxiety and Depression in Adult Survivors of Cancer: ASCO Guideline Update (2023) · cites this paper as [77]

    The Discussion (Strengths and Limitations) says the trial had no minimum cancer-related distress requirement for enrollment. The Results (Psychological Adaptation Indicators) report significant reductions in depressive affect, but CBT and relaxation training were separate treatment groups, not a combined intervention. The education-plus-self-care claim carries a different citation and is not assessed here. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Gudenkauf 2015 had low risk of reporting bias.

    “Selective reporting (reporting bias) Low risk”

    From Psychological interventions for women with non-metastatic breast cancer (2023) · cites this paper as Gudenkauf 2015

    The Method sections (pages unavailable) identify four primary outcomes and a trial registration number, but do not assess selective reporting or compare reported outcomes with a prespecified protocol. The Discussion mentions potential self-report bias, which is a different issue. Searches for reporting bias, prespecified outcomes, and trial registration did not establish the claimed low-risk rating. (LLM, conf=0.70)

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Research works printed but not linked: 1

  1. Cutrona C Russell D The provisions of social relationships adaptation to stress Advances in Personal Relationships 1987 1 ed 37 67 Greenwich JAI Press

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Authors
Gudenkauf, L. M., Antoni, M. H., Stagl, J. M., Lechner, S. C., Jutagir, D. R., Bouchard, L. C., Blomberg, B. B., Glück, S., Derhagopian, R. P., Giron, G. L., Avisar, E., Torres-Salichs, M. A., & Carver, C. S.
Affiliations
  • University of Miami (US)
  • Celgene (United States) (US)
ORCID
Venue
Journal of Consulting and Clinical Psychology
Publisher
American Psychological Association (APA)
Published
2015-08
Volume
83
Issue
4
Pages
677-688
ISSN
  • 0022-006X (ISSN-L)
  • 1939-2117
DOI
10.1037/ccp0000020
PMC
PMC4516670
OpenAlex
W2342311501
Cited by
108
References
53
Citations by year
2026: 8 · 2025: 7 · 2024: 7 · 2023: 9 · 2022: 13 · 2021: 19 · 2020: 12 · 2019: 13 · 2018: 8 · 2017: 6 · 2016: 6
FWCI
2.91
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Consulting and Clinical Psychology (publishedVersion, other-oa)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (2R01-CA-064710)
  • Sylvester Comprehensive Cancer Center
Topics
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
Keywords
breast cancer, cognitive-behavioral training, relaxation training, stress management, psychological adjustment, depressive affect, quality of life, social support, relaxation techniques, health education, group intervention
MeSH terms
Adaptation, Psychological, Adult, Aged, Breast Neoplasms, Female, Humans, Interpersonal Relations, Middle Aged, Neoplasm Staging, Psychotherapy, Brief, Quality of Life, Relaxation Therapy, Social Support, Stress, Psychological, Cognitive Behavioral Therapy, Single-Blind Method

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