Eric S. Zhou

Eric S. Zhou
Harvard Medical School | HMS · Department of Pediatrics

PhD

About

81
Publications
10,951
Reads
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3,149
Citations
Introduction
Eric Zhou, PhD, is currently an Assistant Professor at Harvard Medical School and a Staff Psychologist at the Dana-Farber Cancer Institute and Boston Children's Hospital in Boston, MA.
Additional affiliations
July 2015 - present
Dana-Farber Cancer Institute
Position
  • Medical Professional
July 2015 - present
Harvard Medical School
Position
  • Instructor
September 2012 - June 2015
Harvard Medical School
Position
  • Psychology Fellow

Publications

Publications (81)
Article
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Of the approximately 12,000 children and adolescents that will be diagnosed with cancer in 2013, it is expected that over 80% of them will become long-term adult survivors of childhood cancer. Although it has been well established that cancer treatment often has profound negative impact on sexual functioning, sexual functioning in adult survivors o...
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The notion that chronic stress fosters disease by activating the hypothalamic-pituitary-adrenocortical (HPA) axis is featured prominently in many theories. The research linking chronic stress and HPA function is contradictory, however, with some studies reporting increased activation, and others reporting the opposite. This meta-analysis showed tha...
Article
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Insomnia is a common late effect of cancer, affecting as many as 27% of cancer survivors. Although cognitive behavioral therapy for insomnia (CBT-I) is highly effective, treatment-associated burdens and limited availability of providers result in few survivors receiving this treatment. To address this gap, we developed the Sleep Treatment Education...
Article
Importance: Black women are at risk for insomnia disorder. Despite interest in addressing sleep health disparities, there is limited research investigating the efficacy of criterion-standard treatment (cognitive behavioral therapy for insomnia [CBT-I]) among this racial minority population. Objective: To compare the efficacy of a standard versio...
Article
Study Objectives The current review aims to examine factors that influence pediatric inpatient sleep and determine the effectiveness of sleep promotion interventions among hospitalized children. Methods A systematic literature search was conducted across PubMed, PsycINFO, CINAHL, Cochrane Central, Web of Science, Embase, and Scopus databases. Stud...
Article
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Chronic insomnia affects ∼25% of young adult cancer survivors (YACS) but is often overlooked in routine follow-up. A recently introduced three-item version of the Insomnia Severity Index (ISI-3) was compared with a diagnostic interview (SCID-5) in 250 YACS (ages 18-40) to evaluate its validity in this population. The ISI-3 had good discrimination c...
Chapter
Sleep disturbances are described as one of the most distressing symptoms associated with breast cancer diagnosis and treatment. Approximately half of patients continue to report sleep disturbances up to 5 years after treatment, when many other effects of the cancer and its treatment have subsided. Factors that exacerbate sleep disturbances and that...
Article
Black women are under‐represented in insomnia research. Further, cancer treatments increase the risk of late effects, thus affecting the sleep of psychologically and medically vulnerable cancer survivors. The Insomnia Severity Index (ISI) is widely used, but has not been researched in black women, and research in cancer survivors is limited. Prior...
Chapter
Sleep and circadian disruptions negatively impact health outcomes and quality of life for children and their families. Children and adolescents with serious, life-threatening illnesses are at increased risk of sleep and circadian disorders due to their disease and its medical treatment, and this at a time when they are at greatest need of care that...
Article
Purpose: Poor sleep is one of the most common side effects of cancer treatment. One increasingly popular approach to manage side effects of cancer treatment is use of medicinal cannabis (MC). Design: Cancer patients using MC participated in semi-structured interviews to assess their experiences with MC (n = 24). A multi-stage thematic analysis w...
Article
Objective Caregiving for hematopoietic stem cell transplant (HSCT) patients is associated with significant physical and psychological sequelae. While psychosocial interventions may reduce caregiver burden, knowledge regarding which caregivers may benefit the most from such interventions is limited. The purpose of this secondary analysis was to exam...
Article
Objectives Insomnia is a common problem affecting young adult cancer survivors (YACS) even years after treatment, yet it often goes unidentified and untreated. The Insomnia Severity Index is a widely-used insomnia measure, but has not been studied as an insomnia screener for YACS. The goal of this study was to validate the ISI in YACS by determinin...
Article
Introduction: Clinical psychologists often treat patients with a sleep disorder. Cognitive-behavioral treatments can independently, or in combination with medical interventions, effectively improve sleep health outcomes. No studies have examined sleep education and training among practicing clinical psychologists. Method: Actively practicing clinic...
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Introduction: The purpose of this systematic review is to provide supporting evidence for a clinical practice guideline on the use of behavioral and psychological treatments for chronic insomnia disorder in adult populations. Methods: The American Academy of Sleep Medicine commissioned a task force of nine experts in sleep medicine. A systematic...
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Introduction: This guideline establishes clinical practice recommendations for the use of behavioral and psychological treatments for chronic insomnia disorder in adults. Methods: The American Academy of Sleep Medicine (AASM) commissioned a task force of experts in sleep medicine to develop recommendations and assign strengths based on a systema...
Article
Background Insomnia is common among adolescent and young adult (AYA) cancer survivors. Cognitive‐behavioral therapy for insomnia (CBT‐I) is considered the gold standard treatment. Standard CBT‐I was designed for adults and not adapted to the unique medical, psychosocial, and developmental needs of AYA cancer survivors, which can exacerbate their in...
Article
Background: Poor sleep is common for children during cancer treatment, but there is limited understanding of the nature of children's sleep throughout the treatment trajectory. The current exploratory study used an explanatory sequential mixed method approach to examine quantitative associations among sleep problems in children with cancer, parent...
Article
Background and purpose: Inadequate sleep is highly prevalent among socioeconomically disadvantaged and racial/ethnic minority communities and is often related to maladaptive sleep behaviors and stress. There is scant research investigating the delivery of these interventions in underserved communities. The purpose of this study was to develop and t...
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Background: Despite the high prevalence of inadequate sleep in racially/ethnically diverse, low-income adults, there is scant research targeting sleep health interventions among underserved populations. Sleep hygiene (SH) recommendations may help promote sleep health for the general population; however, they likely require tailoring to optimize up...
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Background: Nightshift work is a plausible risk factor for hematologic cancer, but epidemiological evidence remains sparse, especially for individual subtypes. We prospectively examined the association of rotating nightshift work with hematopoietic cancer risk. Methods: This cohort study included US women from the Nurses' Health Study (NHS: n =...
Article
BACKGROUND: Most patients with myelodysplastic syndromes (MDS) describe difficulty sleeping (Luskin et al Br J Haem 2017) and sleep disturbance is a likely contributor to the fatigue experienced by patients with MDS and acute leukemia. Data are sparse regarding the sleep of this patient population as formally assessed with sleep-focused survey inst...
Article
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Sleep and circadian rhythms are closely related to physical and psychosocial well‐being. However, sleep and circadian rhythm disruptions are often overlooked in children with cancer, as they are frequently considered temporary side effects of therapy that resolve when treatment ends. Yet, evidence from adult oncology suggests a bidirectional relati...
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Study Objective To assess whether perceived racial discrimination is associated with insomnia among Black women. Methods Data on everyday and lifetime racism and insomnia symptoms were collected from questionnaires administered in the Black Women’s Health Study, an ongoing prospective cohort of Black women recruited in 1995 from across the U.S. In...
Article
Background: Insomnia is common among cancer survivors. Although behavioral treatments for insomnia are effective, access is limited. Stepped care delivery models may provide insomnia treatment that is more efficient and accessible to cancer survivors. Methods: Fifty-one survivors (mean age, 55 years) with elevated Insomnia Severity Index (ISI) s...
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Purpose Cancer-related fatigue (CRF) is a common and challenging late effect for many cancer survivors. Clinical trials demonstrate robust placebo effects on CRF in blinded trials. Recently, open-label placebo (OLP) has been shown to improve a variety of symptoms in other populations. We conducted a randomized controlled trial to investigate the ef...
Article
Introduction Insomnia prevalence varies throughout the cancer trajectory. There is limited understanding of insomnia in the young adult (YA) cancer population, how risk for insomnia changes after diagnosis, and what factors contribute to this risk in YA cancer survivors. Methods YAs between the age of 18-39 (N=508) from across Canada completed the...
Article
Introduction Traumatic events in childhood are associated with negative long-term health consequences, including sleep disturbances. The chronic stress of foster care involvement is associated with heightened physiological responses. Little research has examined associations between sleep and health in this at-risk population. The present study inv...
Article
Introduction Cancer treatments are associated with many long-term health consequences. Insomnia is one of the most common. Though behavioral treatments for insomnia are effective, access is limited, especially at cancer centers. There is increasing interest in the implementation of stepped care models in the treatment of insomnia to potentially imp...
Article
Objective Sleep disorders are associated with psychological and physical health, though reports in long‐term survivors of childhood cancer are limited. We characterized the prevalence and risk factors for behaviors consistent with sleep disorders in survivors and examined longitudinal associations with emotional distress and physical health outcome...
Article
Objective Insomnia is commonly associated with cancer treatment. Cancer treatments increase risk for numerous psychological and medical late effects, thus making cancer survivors psychologically and medically vulnerable. Prior research examined psychometric properties of the Insomnia Severity Index (ISI) with various populations, including the Fren...
Article
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Introduction Inadequate sleep is highly prevalent among socioeconomically disadvantaged and racial/ethnic minority communities, and is often related to sleep health behaviors, stress, and adverse environmental conditions. While socio-contextually appropriate sleep health education and yoga interventions may improve sleep and mitigate adverse effect...
Article
Introduction Sleep disorders are related to emotional and physical health in the general population; research in childhood cancer survivors is limited. This study characterized sleep behaviors in survivors and examined associations among sleep, cancer diagnoses, treatment exposures, and emotional functioning. Methods Childhood cancer survivors (≥5...
Article
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Purpose: Cancer patients are likely to experience sleep problems. Understanding their perception of sleep problems is important as subjective symptom experience is associated with treatment-seeking behavior. We explored the prevalence of sleep problems and its correlates in a large sample of cancer patients at an important but understudied stage o...
Article
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The Society of Behavioral Medicine recommends school officials start middle and high school classes at 8:30 am or later. Such a schedule promotes students’ sleep health, resulting in improvements in physical health, psychological well-being, attention and concentration, academic performance, and driving safety. In this position statement, we propos...
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140 Background: Insomnia is a burdensome late-effect for up to 30% of long-term survivors. Behavioral insomnia treatments are highly effective, but are not available to most affected survivors. Treatment barriers include lack of trained clinicians and resource demands for standard treatment of 6-8 individual sessions. To address these barriers we i...
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Introduction Insomnia is recognized as a public health issue. The objectives of this study were to characterize and compare the prevalence of insomnia symptoms in the Canadian population in 2002 and 2012, and to identify sociodemographic and psychosocial predictors of trouble sleeping. Methods Data from adult participants in the Canadian Community...
Article
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Insomnia disorder is common in patients undergoing cancer treatment. There is compelling evidence demonstrating that cognitive-behavioral therapy for insomnia (CBT-I) should be the initial treatment, but there has been insufficient research has been conducted among cancer patients. This population presents with unique physical and psychosocial heal...
Article
Sexual dysfunction is a common concern for many patients with cancer after treatment. Hormonal changes as a result of cancer-directed therapy can affect both male and female sexual health. This has the potential to significantly impact patients' quality of life, but is underreported and undertreated in the oncology setting. This review discusses co...
Article
Difficulty initiating and/or maintaining sleep is a common issue. Patients experiencing insomnia symptoms frequently self-treat their symptoms with sleep medications. However, there remains concern regarding acute and long-term health impact of sleep medications. This review discusses the evidence supporting integrative approaches to insomnia treat...
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Background: Breast cancer is a leading cause of cancer death in women. Sleep has been linked with mortality among cancer-free population; however, its association with survival among women with breast cancer is understudied. Methods: Breast cancer patients (N=3682) reported their average sleep duration post diagnosis. Subsamples also provided th...
Chapter
Cancer survivors are at significantly elevated risk for the development of sexual dysfunction following treatment. These issues are often complex in nature, weaving together physiological, psychological, and social components that interact with one another. To assist therapists who may be unfamiliar with the nuances of how cancer-directed treatment...
Article
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Purpose Insomnia is commonly experienced by cancer survivors. Chronic insomnia is associated with significant physical and psychosocial consequences if not properly treated. Both the National Cancer Institute (NCI) and the National Comprehensive Cancer Network (NCCN) recommend the evaluation of sleep disturbances and evidence-based treatment of ins...
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Mindfulness-based interventions (MBIs) for insomnia and sleep disturbances are receiving increasing clinical and research attention. This paper provides a critical appraisal of this growing area investigating the application of MBIs for people with insomnia and sleep disturbance. First, we discuss the theoretical justification for how mindfulness m...
Article
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Pediatric insomnia, defined as chronic and clinically significant difficulty with initiating and/or maintaining sleep in children and adolescents, can profoundly impact functioning and well-being on both the child and their family. Behavioral interventions for insomnia in pediatric populations have been shown to be highly effective. This review exp...
Article
Objective: Many men diagnosed with prostate cancer (PC) will experience physical and psychosocial late effects of treatment. Their interest/preferences for receiving information about addressing common sequelae is not well understood. We examined long-term PC survivors' level of interest, whether this differed based upon symptomatology, and their...
Article
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Adolescent and young adult cancer survivors (AYACS) are at risk for the development of insomnia, though it remains vastly undertreated. Limited research has evaluated cognitive-behavioral treatment for insomnia (CBT-I) in AYACS. The present study piloted adapted CBT-I designed to improve treatment accessibility by delivering a three-session interve...
Article
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Context: Cancer is a challenging experience and there is evidence that psychosocial interventions are effective at improving adjustment following treatment. At our cancer center, 14 cancer survivors (breast, prostate and blood cancers) completed a four-session cognitive-behavioral stress program. The first session was delivered at the survivor's l...
Article
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Background: Cognitive-behavioral therapy for insomnia (CBT-Insomnia) is effective, yet rarely available for cancer survivors. This is unfortunate because survivors are at elevated risk for insomnia, which is associated with significant health consequences in this already at-risk population. Barriers to delivering CBT-Insomnia in oncology settings...
Chapter
Survivors of childhood cancer are a growing population that has complex medical, educational, psychological, and social needs that change over time based on age, developmental level, and societal expectations. While many childhood cancer survivors do not experience significant psychological distress, there are a number of challenges they face that...
Article
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Objective: Children diagnosed with brain tumors are at risk for insomnia. We evaluated insomnia symptoms, medical and psychosocial correlates, and medical documentation of sleep-related issues in a neuro-oncology clinic. METHODS: 98 adult survivors of pediatric brain tumors provided data about sleep, psychological distress, and health-related qual...
Article
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Young women (<45 years of age) diagnosed with breast cancer face increased risk of sexual dysfunction as a result of their cancer-directed treatment. We will review the recent literature examining this critical challenge and discuss current efforts to address sexual dysfunction. In the period since 2013, the literature has focused on sexual issues...
Article
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There is a large and growing population of long-term cancer survivors. Primary care physicians (PCPs) are playing an increasingly greater role in the care of these patients across the continuum of cancer survivorship. In this role, PCPs are faced with the responsibility of managing a range of medical and psychosocial late effects of cancer treatmen...
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BACKGROUND Epidemiological studies have shown prostate cancer (PC) survivors are at an increased risk of suicide compared with the general population, but to the authors' knowledge very little is known regarding what factors are associated with this increased risk. The current study examined the prevalence of suicidal ideation (SI) and its associat...
Article
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Advanced prostate cancer patients often undergo androgen deprivation therapy (ADT). Advanced disease and adverse ADT side effects are often debilitating and negatively impact mood. Social support has been shown to mitigate detrimental effects of stress on mood. Objective This study sought to characterize positive and negative mood in this select pa...
Article
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Purpose: Prostate cancer (PC) survivors are at elevated risk for completed suicide even many years post-treatment. Despite this risk, practical and efficient methods for assessing these symptoms have not been established. We sought to determine if suicidal symptoms could be effectively and efficiently identified in a cohort of PC survivors, and wh...
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IntroductionMen with advanced prostate cancer (APC) undergoing androgen deprivation therapy (ADT) often experience distressing sexual side effects. Sexual bother is an important component of adjustment. Factors associated with increased bother are not well understood.AimsThis study sought to describe sexual dysfunction and bother in APC patients un...
Article
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Purpose: Insomnia is a common problem affecting cancer survivors even years after completion of therapy. Childhood cancer survivors may be at particular risk due to vulnerability to the effects of treatment and medical late effects which impact normal sleep development. Using an indicator of clinically significant insomnia (sleep efficiency), we e...
Article
9529 Background: Prostate cancer (PC) is associated with an increased risk of suicide, even a decade after diagnosis. Prior research has relied largely on registry data collected at diagnosis, so little is known about the role of post-treatment functioning on the development of suicidal ideation (SI) in long-term prostate cancer survivors (PCS). To...
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Background: There is a gap in the current breast cancer survivorship literature identifying potential sample biases that may result from recruiting participants via different methods. Purpose: To document whether participant recruitment method influences baseline demographic or psychosocial variables and trial participation among breast cancer s...
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Advanced prostate cancer (APC) is associated with disruptions that compromise health related quality of life (HRQOL). Treatment often includes androgendeprivation therapy (ADT), which results in a range of side effects (e.g., fatigue, urinary dysfunction) that further impact HRQOL. Despite these challenges, there are limited evaluations of the impa...
Article
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Coping with the physical and mental side effects of diagnosis and treatment for advanced prostate cancer (APC) is a challenge for both survivors and their spousal caregivers. There is a gap in our current understanding of the dyadic adjustment process on marital satisfaction in this population. The current study sought to: (1) document levels of ph...
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There is evidence that cancer generates existential and spiritual concerns for both survivors and caregivers, and that the survivor's spiritual well-being (SWB) is related to his/her own quality of life (QOL). Yet the degree to which the SWB of each member of the couple has an independent association with the partner's QOL is unknown. Thus, this st...
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To examine the longitudinal effect of social support on general health-related quality of life (HRQOL) in men treated for localized prostate cancer, and to evaluate the role of perceived stress as a potential mediator of that relationship, in an ethnically and demographically diverse sample. Psychosocial assessments were administered to a sample of...
Article
s: AACR International Conference on the Science of Cancer Health Disparities‐‐ Sep 30-Oct 3, 2010; Miami, FL Ethnic group differences exist in the diagnosis and treatment outcomes of prostate cancer (PC). African American men have the highest PC incidence, are more likely to be diagnosed at an advanced stage, and are twice as likely to die of PC t...