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Feasibility of Cognitively-Based Compassion Training (CBCT) for breast cancer survivors: a randomized, wait list controlled pilot study

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Supportive Care in Cancer Aims and scope Submit manuscript

An Erratum to this article was published on 08 September 2015

Abstract

Purpose

This study assessed the feasibility of a meditation-based program called Cognitively-Based Compassion Training (CBCT) with breast cancer survivors. Enrollment and participant satisfaction with a novel intervention, adherence to program requirements, and differences between the intervention group and wait list controls on self-report measures were also assessed. Additionally, cortisol, a stress-related endocrine biomarker, was assessed.

Methods

Participants (n = 33) were randomly assigned to CBCT or the wait list. CBCT provided eight weekly, 2-h classes and a “booster” CBCT session 4 weeks later. CBCT participants were expected to attend classes and meditate between classes at least three times per week. Pre-/post-intervention and follow-up questionnaires measured symptom change (depression, intrusive thoughts, perceived stress, fear of cancer recurrence, fatigue/vitality, loneliness, and quality of life). Saliva samples were collected at the same periods to assess the slope of diurnal cortisol activity.

Results

Enrollment, class attendance, home practice time, and patient satisfaction exceeded expectations. Compared to controls, post-intervention, the CBCT group showed suggestions of significant improvements in depression, avoidance of intrusive thoughts, functional impairment associated with fear of recurrence, mindfulness, and vitality/fatigue. At follow-up, less perceived stress and higher mindfulness were also significant in the CBCT group. No significant changes were observed on any other measure including diurnal cortisol activity.

Conclusions

Within the limits of a pilot feasibility study, results suggest that CBCT is a feasible and highly satisfactory intervention potentially beneficial for the psychological well-being of breast cancer survivors. However, more comprehensive trials are needed to provide systematic evidence.

Relevance

CBCT may be very beneficial for improving depression and enhancing well-being during breast cancer survivorship.

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References

  1. Thewes B, Brebach R, Dzidowska M, Rhodes P, Sharpe L, Butow P (2014) Current approaches to managing fear of cancer recurrence: a descriptive survey of psychosocial and clinical health professionals. Psycho-Oncology 23:390–396

    Article  CAS  PubMed  Google Scholar 

  2. Thewes B, Butow P, Bell ML, Beith J, Stuart-Harris R, Grossi M, Capp A, Dalley D (2012) Fear of cancer recurrence in young women with a history of early-stage breast cancer: a cross-sectional study of prevalence and association with health behaviours. Support Care Cancer 20:2651–2659

    Article  CAS  PubMed  Google Scholar 

  3. Bleiker EM, Pouwer F, van der Ploeg HM, Leer JW, Ade’r HJ (2000) Psychological distress two years after diagnosis for breast cancer: frequency and prediction. Patient Educ Couns 40:209–217

    Article  CAS  PubMed  Google Scholar 

  4. Burgess C, Cornelius V, Love S, Graham J, Richards M, Ramirez A (2005) Depression and anxiety in women with early breast cancer: five-year observational cohort study. BMJ 330:702

    Article  PubMed Central  PubMed  Google Scholar 

  5. Bower JE, Ganz PA, Desmond KA, Rowland JH, Meyerowitz BE, Belin TR. (2000) Fatigue in breast cancer survivors: occurrence, correlates, and impact on quality of life. J Clin Onc 18:743–743.

  6. Bower JE, Ganz PA, Irwin MR, Kwan L, Breen EC, Cole SW (2011) Inflammation and behavioral symptoms after breast cancer treatment: do fatigue, depression, and sleep disturbance share a common underlying mechanism? J Clin Onc 29:3517–3522

    Article  Google Scholar 

  7. Rokach A (2000) Correlates of loneliness as perceived by the terminally ill. Curr Psychol 19(3):237–248

    Article  Google Scholar 

  8. Rosedale M (2009) Survivor loneliness of women following breast cancer. Onc Nurs Forum 36:175–183

    Article  Google Scholar 

  9. Kabat-Zinn J (1990) Full catastrophe living: using the wisdom of your body and mind to face stress, pain, and illness. Dell Publishing, New York

    Google Scholar 

  10. Carlson LE, Speca M, Patel KD, Goodey E (2003) Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress, and immune parameters in breast and prostate cancer outpatients. Psychosom Med 65:571–581

    Article  PubMed  Google Scholar 

  11. Witek-Janusek L, Albuquerque K, Chroniak KR, Chroniak C, Durazo-Arvizu R, Mathews HL (2008) Effect of mindfulness-based stress reduction on immune function, quality of life and coping in women newly diagnosed with early stage breast cancer. Brain Behav Immun 22:969–981

    Article  PubMed Central  PubMed  Google Scholar 

  12. Carlson LE, Beattie TL, Giese–Davis J, Faris P, Tamagawa R, Fick LJ, Degelman E, Speca M. (2014) Mindfulness-based cancer recovery and supportive-expressive therapy maintain telomere length relative to controls in distressed breast cancer survivors. Cancer 121:476–484.

  13. Ledesma D, Kumano H (2009) Mindfulness-based stress reduction and cancer: a meta-analysis. Psycho Oncology 18:571–579

    Article  PubMed  Google Scholar 

  14. Carlson LE, Doll R, Stephen J, Faris P, Tamagawa R, Drysdale E, Speca M (2013) Randomized controlled trial of mindfulness-based cancer recovery versus supportive expressive group therapy for distressed survivors of breast cancer (MINDSET). J Clin Onc 31:3119–3126

    Article  Google Scholar 

  15. Pinto-Gouveia J, Duarte C, Matos M, Fráguas S (2014) The protective role of self-compassion in relation to psychopathology symptoms and quality of life in chronic and in cancer patients. Clin Psych Psychot 21:311–323

    Article  Google Scholar 

  16. Hall CW, Row KA, Wuensch KL, Godley KR (2013) The role of self-compassion in physical and psychological well-being. J Psychol 147:311–323

    Article  PubMed  Google Scholar 

  17. Jazaieri H, Jinpa GT, McGonigal K, Rosenberg EL, Finkelstein J, Simon-Thomas E, Cullen M, Doty JR, Gross JJ, Goldin PR (2013) Enhancing compassion: a randomized controlled trial of a compassion cultivation training program. J Happiness Stud 14:1113–1126

    Article  Google Scholar 

  18. Pace TWW, Negi LT, Adame DD, Cole SP, Sivilli TI, Brown TD, Issa MJ, Raison CL (2009) Effect of compassion meditation on neuroendocrine, innate immune and behavioral responses to psychosocial stress. Psychoneuroendocrino 34(1):87–98

    Article  CAS  Google Scholar 

  19. Negi LT. (2013) Emory compassion meditation protocol: cognitively-based compassion training manual. Atlanta, Ga., Emory University.

  20. Ozawa-de Silva B, Dodson-Lavelle B. (2011) An education of heart and mind: practical and theoretical issues in teaching cognitively-based compassion training to children. Practical Matters 4:1–28, Atlanta, Ga, Emory University.

  21. StataCorp. (2013)Stata statistical software: release 13. College Station, TX: StataCorp LP.

  22. Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG (2009) Research electronic data capture (REDCap): a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42:377–381

    Article  PubMed Central  PubMed  Google Scholar 

  23. Cohen S, Kamarck T, Mermelstein R (1983) A global measure of perceived stress. J Health Soc Behav 24:385–396

    Article  CAS  PubMed  Google Scholar 

  24. Radloff LS (1977) The CES-D scale: a self-report depression scale for research in the general population. Appl Psych Measure 1(3):385–401

    Article  Google Scholar 

  25. Kohout FJ, Berkman LF, Evans DA, Cornoni-Huntley J (1993) Two shorter forms of the CES-D depression symptoms index. J Aging Health. 5:179–193

    Article  CAS  PubMed  Google Scholar 

  26. Simard S, Savard J (2009) Fear of cancer recurrence inventory: development and initial validation of a multidimensional measure of fear of cancer recurrence. Support Care Cancer 17:241–251

    Article  PubMed  Google Scholar 

  27. Weiss DS, Marmar CR (1996) The impact of event scale—revised. In: Wilson J, Keane TM (eds) Assessing psychological trauma and PTSD. Guilford, New York, pp. 399–411

    Google Scholar 

  28. Russell D, Peplau LA, Cutrona CE (1980) The Revised UCLA Loneliness Scale: concurrent and discriminant validity evidence. J Person Soc Psychol 39:472–480

    Article  CAS  Google Scholar 

  29. Russell DW (1996) UCLA Loneliness Scale (version 3): reliability, validity, and factor structure. J Personality Assessment 66(1):20–40

    Article  CAS  Google Scholar 

  30. Dussault M, Fernet C, Austin S, Leroux M (2009) Revisiting the factorial validity of the Revised UCLA Loneliness Scale: a test of competing models in a sample of teachers. Psychol Rep 105:849–856

    Article  PubMed  Google Scholar 

  31. Ware J, Kosinski M, Keller SD (1996) A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 34:220–233

    Article  PubMed  Google Scholar 

  32. Feldman G, Hayes A, Kumar S, Greeson J, Laurenceau JP (2007) Mindfulness and emotion regulation: the development and initial validation of the Cognitive and Affective Mindfulness Scale-Revised (CAMS-R). J Psychopathol Behav Assess 29:177–190

    Article  Google Scholar 

  33. McCullough ME, Emmons RA, Tsang JA (2002) The grateful disposition: a conceptual an empirical topography. J Person Soc Psychol 82:112–127

    Article  Google Scholar 

  34. Jansen, C, Beunckens, MG, Kenward, C, Mallinckrodt, Carroll, RJ. (2004). Analyzing incomplete longitudinal clinical trial data. Biostatistics 5(3):445–464.

  35. Satin JR, Linden W, Phillips MJ (2009) Depression as a predictor of disease progression and mortality in cancer patients. Cancer 115:5349–5361

    Article  PubMed  Google Scholar 

  36. Pinquart M, Duberstein PR (2010) Depression and cancer mortality: a meta-analysis. Psychol Med 40:1797–1810

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  37. Groenvold M, Petersen MA, Idler E, Bjorner JB, Fayers PM, Mouridsen HT (2007) Psychological distress and fatigue predicted recurrence and survival in primary breast cancer patients. Breast Cancer Res Treatment 105:209–219

    Article  Google Scholar 

  38. Giese-Davis J, Collie K, Rancourt KM, Neri E, Kraemer HC, Spiegel D (2011) Decrease in depression symptoms is associated with longer survival in patients with metastatic breast cancer: a secondary analysis. J Clin Onc 29:413–420

    Article  Google Scholar 

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Acknowledgments

We extend our deepest gratitude to the breast cancer survivors who participated in this study, to Ole Thienhaus, M.D., Chair of the Department of Psychiatry; to research personnel Laura Eparvier, Martha Barron, Angelica Medrano-Hernandez, and Mary Nielsen; and to Timothy Harrison of the Emory-Tibet Science Initiative without whom this study would not have been possible.

Conflict of interest

The authors declare that they have no competing interests.

Author information

Authors and Affiliations

  1. University of Arizona College of Medicine, Tucson, AZ, 85724, USA

    Sally E. Dodds, Charles L. Raison & Karen L. Weihs

  2. University of Arizona College of Nursing, Tucson, AZ, 85721, USA

    Thaddeus W.W. Pace

  3. University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, AZ, 85724, USA

    Melanie L. Bell & Mallorie Fiero

  4. Emory University, Atlanta, GA, 30322, USA

    Lobsang Tenzin Negi

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  1. Sally E. Dodds
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Correspondence to Sally E. Dodds.

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Dodds, S.E., Pace, T.W., Bell, M.L. et al. Feasibility of Cognitively-Based Compassion Training (CBCT) for breast cancer survivors: a randomized, wait list controlled pilot study. Support Care Cancer 23, 3599–3608 (2015). https://doi.org/10.1007/s00520-015-2888-1

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