The effects of a stress management intervention on anxiety and natural killer cell activity in women treated for breast cancer

Date of Award




Degree Name

Doctor of Philosophy (Ph.D.)



First Committee Member

Michael H. Antoni - Committee Chair


This study investigated the effects of a cognitive-behavioral stress management (CBSM) intervention on anxiety and natural killer (NK) cell function in 85 women recently diagnosed with stage 0--III breast cancer. Forty women participated in a 10-week closed-group CBSM intervention and 45 women were offered a 1-day didactic seminar summarizing the content of the full-length intervention. All women were assessed at baseline (within 2-8 weeks of surgery and prior to beginning adjuvant treatment) and at follow-ups that were 6- and 12-months from baseline. Anxiety measures included multiple self-report questionnaires and a structured interview assessment for clinician-rated anxiety symptoms. Immune measures included NKCC, IL-2 and IFN-gamma stimulated NK activity at multiple effector to target ratios. Participants in the intervention experienced a significant trend toward continued reductions in anxiety on 2 of the 5 measures (Hamilton anxiety score and IES-avoidance scores) compared to controls over the course of 1-year. No intervention effects emerged in NK function. Results are discussed in light of the pattern of CBSM effects on physical and behavioral symptoms of anxiety and distress as compared to cognitive and affective symptoms of anxiety and distress. Additionally, the need for research that examines the effects of various components of stress management interventions on specific manifestations of distress as well as on specific immune and neuroendocrine parameters is addressed.


Psychology, Clinical; Psychology, Physiological; Health Sciences, Oncology

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