Effect of interpersonal dysfunction on treatment response to a cognitive-behavioral stress management intervention in men treated for early stage prostate cancer

Date of Award




Degree Name

Doctor of Philosophy (Ph.D.)


Clinical Psychology

First Committee Member

Frank J. Penedo - Committee Chair


The present study sought to evaluate the efficacy of a 10-week, group based intervention in promoting sexual function and in decreasing biological markers of distress in older men recovering from localized prostate cancer. Additionally, investigators attempted to determine the effect of certain underlying personality traits (i.e., interpersonal problems) on the efficacy of this intervention. Participants were 215 middle-aged and older men (M age = 64.8, SD = 7.6) recovering from localized (i.e., Stage I-II) prostatic carcinoma, and had undergone either radical prostatectomy or external beam radiotherapy. Participants were randomized into either a 10-week, group based Cognitive-Behavioral Stress Management (CBSM) intervention (experimental condition) or a one-day educational seminar (control condition). Self-report and biological measures were completed prior to randomization and again following CBSM or control interventions. Dependent measures included the Functional Assessment of Cancer Therapies, the Psychosocial Adjustment to Illness Scale and urinary catecholamine production. Interpersonal dysfunction was measured using the Inventory of Interpersonal Problems. Hypotheses were evaluated using both structural equation modeling and moderated regression. Results suggested that the CBSM intervention was effective in promoting sexual satisfaction and sexual functioning in men treated with radical prostatectomy, but not in men treated with radiotherapy. Further, the effect on sexual functioning in men treated with radical prostatectomy was highest for participants reporting greater levels of interpersonal dysfunction at baseline. There was no effect on urinary catecholamine production. The fact that the CBSM intervention was effective primarily for men recovering from radical prostatectomy is discussed in terms of its timing, i.e. the placement of the intervention within the natural trajectory of recovery following surgical treatment. Results also suggest that individuals with higher levels of interpersonal dysfunction may make the greatest gains from group-based interventions, presumably related to lower baseline mood and quality of life and greater room to grow.


Psychology, Clinical

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