Publication Date

2013-06-27

Availability

Open access

Embargo Period

2013-06-27

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PHD)

Department

Psychology (Arts and Sciences)

Date of Defense

2012-05-10

First Committee Member

Frank J. Penedo

Second Committee Member

Maria M. Llabre

Third Committee Member

Michael H. Antoni

Fourth Committee Member

Youngmee Kim

Fifth Committee Member

Suzanne Lechner

Abstract

Treatment for prostate cancer (PC) often leads to sexual side effects that impact patients, partners, and relationship functioning. Research has focused on the direct effects of sexual dysfunction (i.e., physiologic impairment) on quality of life (QOL); empirical evaluation of psychological and relational domains of sexuality is limited. Psychosocial adjustment to sexual dysfunction (i.e., sexual adjustment) may be one mechanism by which post-treatment sexual side effects impact QOL. Furthermore, the extent to which men perceive their partners as being (un)supportive may affect sexual adjustment processes and QOL. It is unknown how changes in sexual adjustment, partner-specific social support, and QOL are related. The current study used latent growth modeling (LGM) to explore the effects of a cognitive behavioral stress management (CBSM) intervention on sexual adjustment, perceptions of partner-specific social support, and general QOL. After testing main effects, cross-domain LGMs were used to explore whether trajectories of sexual adjustment, social support, and QOL were related over time. The CBSM intervention was associated with significant improvements in QOL over a 12-month follow-up period. Among men treated with radical prostatectomy, intervention-related improvements in psychological adjustment to sexual dysfunction were observed at the trend level. There were no intervention effects on partner-specific social support. Evaluation of cross-domain relationships indicated that domains of psychological and relationship adjustment to sexual dysfunction, positive aspects of partner-specific social support, and QOL were related at baseline and improvements in psychological adjustment to sexual dysfunction and QOL were also related over time. This study contributes to a limited amount of empirical research that has evaluated the effects of PC treatment on psychosocial domains of sexuality and suggests that the degree to which men are able to psychologically adjust to sexual side effects may be related to long-term changed in QOL. Psychosocial interventions should be designed to target psychosocial adjustment processes in patients who may be at increased risk for experiencing difficulties related to their sexual side effects.

Keywords

psychoncology; prostate cancer; sexual dysfunction; quality of life; social support; psychosocial intervention

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