Publication Date



Open access

Embargo Period


Degree Type


Degree Name

Doctor of Philosophy (PHD)


Psychology (Arts and Sciences)

Date of Defense


First Committee Member

Michael H. Antoni

Second Committee Member

Gail H. Ironson

Third Committee Member

Charles S. Carver

Fourth Committee Member

Frank J. Penedo

Fifth Committee Member

Suzanne C. Lechner


Breast cancer diagnosis and treatment constitute stressors that can lead to both temporary and long-lasting problems with psychosocial adaptation. The types of stressors and available coping resources may vary by point in cancer treatment (e.g., immediately after surgery versus months after the completion of adjuvant treatment). Cognitive-behavioral stress management (CBSM) is an intervention aimed to buffer against the negative effects of having breast cancer by enhancing protective factors that may facilitate psychosocial adaptation (i.e., use of relaxation, adaptive coping strategies, and social support). Two studies at the University of Miami have assessed the effects of a 10-week CBSM program among women with early-stage breast cancer: one study delivered CBSM in the weeks following surgical treatment (Coping and Recovery [C&R]; N=197) and the other study delivered CBSM in the months following completion of all surgical and adjuvant treatment (Coping After Treatment [CAT]; N=122). Both studies used randomized, controlled designs with a one-day psychoeducation seminar as the comparison group. For my doctoral dissertation, I have used these samples to examine whether point in treatment moderates intervention effects on coping resources (i.e., the proximal intervention outcomes) from pre- to post-intervention and in trajectories of change across four time points (pre-intervention, immediately post-intervention, and two follow-ups). Measures include selected subscales of the Measure of Current Status, Sources of Social Support Scale, Brief COPE, Emotional Approach Coping Scale, Benefit Finding scale, Affect Balance Scale, and Sickness Impact Profile (i.e., social disruption). Missing data was examined and estimated using multiple imputation. Specific aims were tested using repeated measures analysis of covariance in SPSS software as well as multiple group latent-growth modeling in MPLUS software. A moderation effect by sample was found for cancer-related interference in recreations and pastimes using RMANCOVA analysis of changes from Time 1 to Time 2 such that there was less interference over time in the CAT sample and slightly more interference over time in the C&R sample. Time by condition effects on relaxation were replicated in this sample, and time by condition effects were also found for bonding with other breast cancer patients and benefit finding.


cognitive-behavioral stress management; breast cancer; coping