Karen L Weihs

• M.D.
• University of Arizona

Objetivo: Los sobrevivientes de cáncer experimentan una reducción de la Calidad de Vida Relacionada con la Salud (HRQoL, por sus siglas en ingés) en comparación con la población general. Esta investigación evalúa y compara la eficacia de una intervención centrada en las emociones (CanCopeMind) y en el estilo de vida (CanCopeLifestyle) para mejorar...

Objective As survival rates from breast cancer increase, the post‐treatment period poses several challenges, including a high burden of cancer‐related symptoms that interfere with quality of life. This study aims to provide a better understanding of the relationship between coping (approach and avoidance), emotional processing (emotional awareness...

Background Conscious and unconscious emotional processing (EP) may be related to breast cancer survivors' (BCS) response to the stress of dealing with cancer and its treatment, and often entails myriad psychological and physical symptoms. Aims To examine the relationship between EP expressed by BCS in drawings made during art therapy and its relat...

Cancer survivors have elevated levels of proinflammatory cytokines, which could be associated with cancerrelated symptoms. Given that proinflammatory cytokines heighten negative affect by directly affecting the brain, we explored these direct associations and whether differences in levels of emotional awareness moderate the associations between pro...

Emotional awareness (EA) is thought to facilitate psychological health by aiding emotion regulation in oneself and garnering social support from others. This study tested these potential relationships within a one-year longitudinal study of 460 women (age 23–91 years, mean 56.4 years) recently diagnosed with breast cancer (i.e., within four months)...

The term “lovebirds” is often used to describe the loving behaviors and interactions between two romantic partners, but what specific processes distinguish these flourishing lovebird relationships from other committed but “numbed” relationships? The present study aimed to address this knowledge gap through the development and preliminary validation...

Background This study explored the association between emotion word repertoire (EWR), attachment, reflective functioning and personality organization (PO) and suicidal behavior in borderline personality disorder (BPD) patients. Methods The current study performed a secondary data analysis from a randomized control trial for BPD patients (all femal...

Introduction Individuals from different cultures differ in their values, which encompass belief systems that individuals develop based on their culture, and play a pivotal role in shaping their perspectives. These values may affect emotion processing (EP): the recognition, interpretation, expression and response to bodily sensations, translated as...

Introduction Emotional intelligence (EI) is associated with a range of positive health, wellbeing, and behavioral outcomes. The present article describes the development and validation of an online training program for increasing EI abilities in adults. The training program was based on theoretical models of emotional functioning and empirical lite...

Metaphors are pervasive in cancer discourse. However, little is known about how metaphor use develops over time within the same patient, and how metaphor use and its content relate to the mental health of the patient. Here, we analyzed metaphor use in personal essays written by breast cancer patients shortly after the time of diagnosis and nine mon...

Socioemotional skills, such as the ability to recognize, understand, and regulate the emotions of self and others, are associated with both physical and emotional health. The present study tested the effectiveness of a recently validated online training program for increasing these emotional skills in adults. In this study, 448 participants (323 fe...

Objectives: This trial assessed the efficacy of an emotion-focused, modular, Internet-delivered adaptation of the Unified Protocol (UP) in improving cancer survivors' emotion regulation strategies. Design: A two-arm randomized controlled trial (1:1) was used to compare the efficacy of two Internet-based interventions: UP-adapted CanCope Mind (CM...

Purpose: The study aims to provide a better understanding of the relationship between emotional processing, coping, and cancer-related sickness symptoms. Methods: The study used a cross-sectional, secondary analysis of data from 179 Israeli Jewish women who were breast cancer survivors (BCS) 3 to 18 months after completing primary treatment and who...

Background: Theoretical models of complicated grief (CG) suggest that maladaptive motivational tendencies (e.g., perseverative proximity-seeking of the deceased;excessive avoidance of reminders) interfere with a person’s ability to recover from their loved one’s death. Due in part to conflicting evidence, little mechanistic understanding of how the...

Psychological and physical health are known to improve with emotion processing, which is becoming aware of bodily sensations, accepting them as information that can be translated into emotion concepts and expressing them symbolically and linguistically as emotions. Art therapy utilizes the visual arts for processing emotions to facilitate self-expr...

Purpose: A single-arm trial evaluated the feasibility, acceptability, and outcomes of COPE-D, a collaborative care intervention for underserved cancer patients with depression. Methods: Bilingual (Spanish and English) care managers provided counseling and/or medication management in consultation with physicians. Outcomes were treatment improveme...

Early adversity has been consistently linked to mental health outcomes, but the underlying pathways remain unclear. One previous study found an association between early adversity and trait emotional awareness (EA), which has itself been linked to health outcomes, but links to mental health were not explicitly examined. The aim of the current study...

Background: Storytelling has long been regarded as an effective means of communication, allowing the teller to process their emotions in light of particular life challenges. Effects on the listener have also been demonstrated to be beneficial, especially if the listener is faced with a similar life challenge. Less is known regarding the potential...

People often use the term “lovebirds” to describe the ongoing loving behaviors between two romantic partners. What aspects of love distinguish “lovebird” relationships from other adult committed primary relationships? The present study aimed to answer this question through the development and validation of a novel self-report measure of relationshi...

Recent theoretical work suggests that emotional awareness (EA) depends on the harshness/predictability of early social interactions—and that low EA may in fact be adaptive in harsh environments that lack predictable interpersonal interactions. In evolutionary psychology, this process of psychological “calibration” to early environments corresponds...

Background Cancer survivors are vulnerable to experiencing symptoms of anxiety and depression and may benefit from accessible interventions focused on improving emotion regulation. CanCope Mind (CM) was developed as an internet-delivered intervention adapted from the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders to improve e...

BACKGROUND Cancer survivors are vulnerable to experiencing symptoms of anxiety and depression and may benefit from accessible interventions focused on improving emotion regulation. CanCope Mind was developed as an internet-delivered intervention adapted from the Unified Protocol (UP) for Transdiagnostic Treatment of Emotional Disorders to improve e...

Objective: Sleep disturbances are under-identified and under-treated in oncology settings, especially for underserved populations and those with psychiatric comorbidities. This study examined the prevalence and correlates of poor subjective sleep quality as well as clinical sleep recommendations among a socioeconomically and ethnically diverse pop...

Objective CanCope is an internet-delivered, cognitive-behavioural intervention adapted from the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders to improve emotion regulation and support the mental health of cancer survivors. Four separate pilot studies evaluated each of CanCope’s modules for (1) feasibility and participant sat...

Introduction: Un Abrazo Para La FamiliaTM [Embracing the Family] (Abrazo) is a 3-hr psychoeducational intervention designed for low-income informal caregivers who are cosurvivors of cancer. A rehabilitation-informed preventive intervention, Abrazo reflects the importance of family, culture, and socioeconomic background. A pilot study was conducted...

Recent theoretical work suggests that emotional awareness (EA) depends on the harshness/predictability of early social interactions – and that low EA may actually be adaptive in harsh environments that lack predictable interpersonal interactions. In evolutionary psychology, this process of psychological “calibration” to early environments correspon...

Emotional intelligence (EI) is associated with a range of positive outcomes, and methods to increase EI are greatly needed. The present study tests the effectiveness of an online training program for increasing EI in adults. After an initial design and refinement process, 326 participants were randomly assigned to complete an EI training program or...

Background: Depression in cancer patients predicts lower survival, and early identification of individuals at highest risk for depression is needed. In the general population, depression is higher in contexts of both childhood adversity and chronic interpersonal stress, but their collective influence on depressive outcomes in the first year after b...

The objective of this study was to determine whether: (a) cancer-related coping profiles change across time; (b) coping profile transition types predict changes in depressive and physical symptoms. Latent transition analysis was conducted with repeated measures of seven cancer-related coping processes from 460 women recently diagnosed with breast c...

Due to publisher processing error, brackets and asterisks noting statistically significant differences in Fig. 3 were omitted.

Objective: Insomnia and fatigue are common, although not inevitable, during breast cancer. This study is one of the first aiming to describe distinct trajectory classes of insomnia and fatigue symptoms, and their correlates, from diagnosis through treatment. Methods: This longitudinal cohort study was conducted at a comprehensive cancer center and...

Introduction Patients with breast cancer (BC) cope with depression which is linked to functional limitations in survivorship and to physical symptoms. Pain and fatigue are prominent symptoms that affect the well-being of cancer survivors. Emotional processing has been associated with improved physical and psychological health in survivors. Art ther...

Affective agnosia, an impairment in knowing how one feels emotionally, has been described as an extreme deficit in the experience and expression of emotion that may confer heightened risk for adverse medical outcomes. Alexithymia, by contrast, has been proposed as an over-arching construct that includes a spectrum of deficits of varying severity, i...

Purpose Cancer diagnosis and treatment can generate substantial distress for both survivors and their family caregivers. The primary aim of this investigation is to test a model of dyadic interdependence in distress experienced by cancer survivors and their caregivers to determine if each influences the other. Methods To test this prediction, 209...

Introduction Diagnoses of cancer and depression are independent predictors of poor sleep, but less is known about subjective sleep quality among patients with both of these potential risk factors or about recommendations made by physicians for improving sleep among this population. This study examines correlates of poor subjective sleep quality and...

Cancer diagnosis and treatment can generate substantial distress for both survivors and their informal caregivers, defined as family members or friends who provide care and assistance to the cancer survivor. The primary aim of this investigation is to test a model of dyadic interdependence in distress experienced by Latina breast cancer survivors a...

We present an interdisciplinary framework for understanding the expanded capacity in humans (relative to other animals) to be consciously aware of emotions (emotional awareness; EA). To do so, we provide a synthesis of many different bodies of work, including those on cognitive and computational neuroscience, evolutionary psychology, and comparativ...

Emotional characteristics and processes are robust predictors of the development and course of major medical illnesses and premature mortality, as are a variety of indicators of the presence and quality of personal relationships. Despite clear evidence of close interconnection between these two domains of risk and protection, affective characterist...

Objective: The purpose of this study was to test two 2-month psychosocial interventions (Telephone Interpersonal Counseling [TIPC] and Supportive Health Education [SHE]) to improve quality of life (QOL) outcomes for Latinas with breast cancer and their informal caregivers. Methods: Two hundred and forty-one Latinas with breast cancer and their care...

Emotional awareness and acceptance of emotion are associated with improved health in breast cancer (BC) patients. Art therapy (AT) uses visual art-making for expression and communication and has been shown to reduce psychological and physical symptoms in individuals with cancer. A major objective of AT is to encourage increases in emotion processin...

Objective Apply the NIH Stage Model to design and test an intervention to prevent depression in breast cancer patients at risk for depression. Methods We identified mindful emotion awareness, along with approach and avoidance strategies for cancer‐related coping and emotion regulation, as targets for a preventive intervention adapted from the Unif...

Objectives: This study examined word use as an indicator of interpersonal positive reframing in daily conversations of couples coping with breast cancer and as a predictor of stress. Design: The Electronically Activated Recorder (EAR) and Linguistic Inquiry and Word Count (LIWC) were used to examine naturally occurring word use conceptually linked...

OBJECTIVE: Two distinct perspectives - typically referred to as the biopsychosocial and biomedical models - currently guide clinical practice. While the role of psychosocial factors in contributing to physical and mental health outcomes is widely recognized, the biomedical model remains dominant. This is due in part to 1) the largely non-mechanisti...

Objective: Although numerous studies address the relationships of depression with coping processes directed toward approaching or avoiding stressful experiences, the large majority are cross-sectional in design, assess coping processes at only one timepoint, or solely include prediction of the linear slope of depressive symptoms. In this research,...

Objective: To compare the effectiveness of two interventions to reduce diabetes distress (DD) and improve glycemic control among adults with type 1 diabetes (T1D). Research design and methods: Individuals with T1D (n = 301) with elevated DD and HbA1c were recruited from multiple settings and randomly assigned to OnTrack, an emotion-focused inter...

Objective Our goal in this study was to determine if we could replicate initial findings when providing the intervention, Un Abrazo Para La Familia (“Abrazo”). Abrazo is a community‐focused psychoeducational preventive intervention addressing the cancer information and coping needs of low‐income, underserved family members of cancer survivors, deve...

Background After cancer diagnosis, depressive symptoms are elevated on average and decline over time, but substantial variability is apparent. Few studies have examined to what extent chronic stress in distinct life domains affects depressive symptoms. Purpose Chronic stress in vocational and intimate partner life domains, and their interaction, w...

Objective This study revealed the landscape of non‐cancer conversations, identifying topics and types of everyday conversation, and examined links to psychological adjustment among couples coping with breast cancer. Methods Fifty‐two couples wore the Electronically Activated Recorder (EAR) over one weekend and self‐reported psychological adjustmen...

Breast cancer patients often experience adverse physical side effects of medical treatments. According to the biobehavioral model of cancer stress and disease, life stress during diagnosis and treatment may negatively influence the trajectory of women's physical health-related adjustment to breast cancer. This longitudinal study examined chronic an...

Objectives: To evaluate the short-term efficacy and safety of desvenlafaxine (25-50 mg/d) compared with placebo in children and adolescents with major depressive disorder (MDD). Methods: Outpatient children (7-11 years) and adolescents (12-17 years) who met DSM-IV-TR criteria for MDD and had screening and baseline Children's Depression Rating Sc...

Objectives: Theories and research regarding cognitive and emotional processing during the experience of profound stressors suggest that the presence of intrusive thoughts and feelings predicts greater use of avoidance and that the use of avoidance paradoxically predicts more intrusions. However, empirical investigations of their purported bidirect...

Objective: Create a brief, self-report screener for recently diagnosed breast cancer patients to identify patients at risk of future depression. Methods: Breast cancer patients (N = 410) within 2 ± 1 months after diagnosis provided data on depression vulnerability (DV). Depression outcomes were defined as a high depressive symptom trajectory or...

Among individuals coping with cancer, emotional approach coping—expressing and processing emotions following negative events—has been identified as a potentially adaptive form of emotion regulation. However, its mental health benefits may depend on social-cognitive factors and on how it is implemented. This study examined loneliness as a determinan...

Introduction: Breast cancer survivors (BCSs) often report fatigue that persists for years following treatment. Despite a growing body of evidence for meditative movement practices to improve symptoms among BCSs, few studies have explored using Qigong/Tai Chi to reduce fatigue. Additionally, few have examined the biological mechanisms through which...

The purpose of this study is to describe the reasons 88 Latinas with breast cancer selected specific supportive others to participate in an 8-week psychosocial intervention. Participants were asked one open-ended question during the baseline assessment for a larger clinical trial: “Could you tell me more about why you selected [insert name] to part...

Objective: Emerging models of stress point to a dynamic formulation where stressors and internalizing symptoms reciprocally influence each other. This study tested whether this dynamic interplay is the result of a general internalizing process underlying both depression and anxiety, and whether it varies with neuroticism. Method: 426 adults (51%...

Psycho-oncology is a specialized area of clinical practice and research that addresses the psychological and social well-being of cancer patients and their family members, as well as the integration of patient-centered care with the entire oncology treatment team. Psycho-oncology interventions contribute to cancer prevention, detection, treatment,...

This textbook provides a highly coordinated, interdisciplinary model for future clinical cancer supportive care programs in National Cancer Institute (NCI)-designated Clinical and Comprehensive Cancer Centers and NCI Community Oncology Research Programs (NCORPs). At the same time, it is intended to serve as an up-to-date resource for oncologists an...

Purpose: Breast cancer diagnosis and treatment are associated with increased inflammatory activity, which can induce sickness symptoms. We examined whether emotional acceptance moderates the association between proinflammatory cytokines and self-reported sickness symptoms in women recently diagnosed with breast cancer. Methods: Women (N = 136) d...

Background Few studies examine whether dispositional approach and avoidance coping and stressor-specific coping strategies differentially predict physical adjustment to cancer-related stress. Purpose This study examines dispositional and situational avoidance and approach coping as unique predictors of the bother women experience from physical symp...

Depression carries serious psychosocial, physical, and economic consequences for cancer survivors. Study goals were to characterize patterns and predictors of depressive symptoms and major depressive episodes in recently diagnosed breast cancer patients. Consecutively recruited women (N = 460) completed a validated interview (CIDI) and questionnair...

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 a...

We describe a new type of agnosia consisting of an impairment in the ability to mentally represent or know what one is feeling. Freud the neurologist coined the term "agnosia" in 1891 before creating psychoanalysis in 1895 but the term has not been previously applied to the domain of affective processing. We propose that the concept of "affective a...

Underemployed workers-those receiving less pay, working fewer hours, or using fewer skills than they would prefer-appear to experience negative mental health outcomes similar to the unemployed. Prior cross-sectional research provides mixed empirical evidence for this conclusion, however. The current study sought to clarify the impact of underemploy...

Background: Many breast cancer survivors experience fatigue, mood, and sleep disturbances. Purpose: This study aims to compare a meditative movement practice, Qigong/Tai Chi Easy (QG/TCE) with sham Qigong (SQG), testing effects of meditation/breath aspects of QG/TCE on breast cancer survivors' persistent fatigue and other symptoms. Methods: Th...

Background Primary cilia are microtubule-based organelles that protrude from the cell surface. Primary cilia play a critical role in development and disease through regulation of signaling pathways including the Hedgehog pathway. Recent mouse models have also linked ciliary dysfunction to cancer. However, little is known about the role of primary c...

This study addressed two questions concerning the interplay between adult romantic attachment and exposure to stressful circumstances: do stressful events predict fluctuation in romantic attachment during a period of unemployment, and does attachment measured at one point predict later changes in stressors? Stressors and attachment were measured ov...

This study explored the feasibility and potentials of a naturalistic observation approach to studying dyadic coping in everyday life. Specifically, it examined the natural context and content of the spontaneous cancer conversations of couples coping with cancer, and how they relate to patients' and spouses' psychological adjustment. Women with brea...

This study investigated the differences between adolescents' own perceptions of their psychopathology and perceptions by clinically depressed parents of their adolescents' psychopathology. The study also examined parental characteristics that accounted for discrepancies between parents and adolescents. The clinical sample consisted of 61 adolescent...

The development and evaluation of Un Abrazo Para La Familia, [A Hug for the Family] is described. Un Abrazo is discussed as an effective model of education, information-sharing, and skill-building for use with low-income co-survivors of cancer. Sixty co-survivors participated. The majority were women and all reported being Hispanic. Using quantitat...

Background: This study examined how language reflective of emotional and social processes during a cancer-related discussion relates to patient, couple, and family adjustment after breast cancer. It investigated whether emotional expression or relational focus, manifested in language use, indicates healthy family coping following breast cancer. M...

Objective: This study aims to test two telephone-delivered interventions for their efficacy in improving quality of life (QOL) (psychological, physical, social, and spiritual) among Latinas with breast cancer and their family members or friends (labeled supportive partners in this study). Methods: Latinas with breast cancer and their supportive...

Multiple factors place adults with haemophilia at risk for depression. Health outcomes can be compromised in depressed patients secondary to increased risk taking behaviour and poor compliance with treatment recommendations. To assess the prevalence and risk factors associated with depression in adult patients with haemophilia treated at a haemophi...

PURPOSE/SPECIFIC AIMS: This study examined the effectiveness of two psychosocial interventions for Latinas with breast cancer and their supportive partners. Supportive partners are defined in this study as anyone the cancer survivor selects to participate in the intervention with her. The interventions were designed for delivery over the telephone...

Low cardiac vagal control (CVC) has been associated with state and trait anxiety and anxiety spectrum disorders. Studies indicate that diagnosis and treatments for breast cancer may be associated with anxiety. The current study examined whether CVC prospectively predicted a trajectory of change in anxiety following breast cancer diagnosis. Forty-th...

Un Abrazo Para La Familia (A Hug for the Family) is an intervention designed to increase the accessibility of cancer information to low-income and medically underserved co-survivors of cancer. Co-survivors are family members or friends of an individual diagnosed with cancer. Our goal was to increase socio-emotional support for these co-survivors an...

Recent work on comorbidity finds evidence for hierarchical structure of mood and anxiety disorders and symptoms. This study tests whether a higher-order internalizing factor accounts for variation in depression and anxiety symptom severity and change over time in a sample experiencing a period of major life stress. Data on symptoms of depression, c...

Although recent work has recognized that the influence and consequences of cancer extend beyond the individual receiving the diagnosis, no studies have focused on the specific psychosocial intervention needs of female co-survivors in low-income populations. In this qualitative study, the co-survivors, 16 women, representing 10 low-income families a...

The goal of this study was to explore the intra- and interpersonal consequences of swearing. Specifically, it investigated what implications swearing has for coping with and adjustment to illness. Methods: The present project combined data from two pilot studies of 13 women with rheumatoid arthritis and 21 women with breast cancer. Participants wor...

Major depressive disorder (MDD) is a common psychiatric illness affecting nearly 20% of adults in the United States at least once during their lifetime. MDD is frequently diagnosed and treated in the primary care setting. Management of the disease may be complicated by patients and family members feeling stigmatized by the diagnosis and not underst...

Cancer is a family experience, and family members often have as much, or more, difficulty in coping with cancer as does the person diagnosed with cancer. Using both family systems and sociocultural frameworks, we call for a new model of health promotion and psychosocial intervention that builds on the current understanding that family members, as w...

The goal of this study was to explore the intra- and interpersonal consequences of swearing. Specifically, it investigated what implications swearing has for coping with and adjustment to illness. The present project combined data from two pilot studies of 13 women with rheumatoid arthritis and 21 women with breast cancer. Participants wore the Ele...

Purpose: The purpose of this study was to compare expected utility preferences of various health outcomes of chemotherapy treatment among ovarian-cancer patients receiving chemotherapy, ovarian cancer patients who were post-treatment (eg, under surveillance), and oncologists who treat this disease. Methods: Participants were asked to score 6 hypoth...