Michael Antoni

Michael Antoni
University of Miami and Sylvester Comprehensive Cancer Center · Psychology

Ph.D.

About

501
Publications
53,903
Reads
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21,186
Citations
Additional affiliations
January 2002 - present
University of Miami Sylvester Cancer Center
Position
  • Program co-Leader
Description
  • I co-lead the Cancer Prevention Control and Survivorship program and lead Theme 3 research on a "Adaptation to Cancer Treatment and Survivorship Across the Lifespan"
January 2000 - present
Sylvester Comprehensive Cancer Center
Position
  • Leader Behavioral Intervention Theme Cancer Control
August 1987 - present
University of Miami
Position
  • Professor (Full) of Psychology
Description
  • I teach graduate courses in Psychoneuroimmunology, and in Clinical Applications in Health Psychology I teach a graduate course in Biobehavioral Oncology to cancer biology PhD students. I teach undergraduate course in Psychology and Cancer

Publications

Publications (501)
Article
Background: Patients taking adjuvant endocrine therapy (AET) after breast cancer face adherence challenges and symptom-related distress. We conducted a randomized trial to evaluate the feasibility, acceptability, and preliminary efficacy of a telehealth intervention (Symptom-Targeted Randomized Intervention for Distress and Adherence to Adjuvant E...
Article
568 Background: Women living in disadvantaged neighborhoods consistently having worse breast cancer (BC) survival. Recent studies have identified that disparities by neighborhood disadvantage persist after controlling for patient, tumor, and National Comprehensive Cancer Network-guideline concordant treatment. This persistent disparity suggests una...
Article
Background: Overweight and obese (OW/OB) body mass index (BMI) is associated with greater inflammation and poorer outcomes in breast cancer (BC). Stress management interventions using cognitive behavioral therapy (CBT) and relaxation training (RT) have reduced inflammation in BC patients but have not been tested specifically in OW/OB patients unde...
Article
Women with breast cancer experience social disruption during and after treatment. Brief cognitive-behavioral (CBT) and relaxation (RT) interventions may improve social disruption by increasing positive affect. Using the Broaden-and-Build Theory as a framework, this study examined whether short-term CBT- and RT-related increases in positive affect m...
Article
Greater inflammatory signaling has been shown to promote breast cancer disease progression and poorer clinical outcomes. Lower social support and social well-being have been related to greater inflammatory signaling and poorer clinical outcomes in women with non-metastatic breast cancer, and this appears to be independent of depression. However, li...
Article
Background: The objectives of this study were to examine benefits and consequences of the COVID-19 pandemic for patients diagnosed with cancer and their family caregivers. Methods: A 23-item questionnaire assessing COVID-19-related issues, the Patient Health Questionnaire-2, Generalized Anxiety Disorder-2, Pittsburgh Sleep Quality Index, and the...
Article
Full-text available
The relationship between psychosocial factors and cancer has intrigued people for centuries. In the last several decades there has been an expansion of mechanistic research that has revealed insights regarding how stress activates neuroendocrine stress-response systems to impact cancer progression. Here, we review emerging mechanistic findings on k...
Article
Full-text available
PurposeThe aim of this study was to examine the link between psychological, behavioral, and social factors and survival in patients diagnosed with gastrointestinal cancer.MethodsA cohort of gastrointestinal cancer patients were administered a battery of questionnaires that assessed trauma, depression, social support, sleep, diet, exercise, quality...
Article
Full-text available
PurposeDespite life-saving potential, many women struggle to adhere to adjuvant endocrine therapy (AET) for their breast cancer (BCa). Prior research has demonstrated that emotional distress is a barrier to AET adherence. We followed women from a trial to test the long-term effects of two 5-week post-surgical group-based stress management intervent...
Article
Full-text available
Adjuvant endocrine therapy (AET) prevents recurrence after early stage, hormone sensitive breast cancer; however, adherence to AET is suboptimal, and efficacious interventions are severely lacking. Barriers to adherence are well established; however, interventions, thus, far have failed to produce meaningful changes in adherence and have generally...
Chapter
This chapter discusses the promise of new longitudinal methods for collecting psychological and behavioral data to examine the extent to which post-traumatic growth is possible. These methods include weekly in-the-moment self-reports of functioning as individuals go about their everyday lives via mobile health methods, in addition to retrospective...
Article
Background: Depressed affect is observed during primary treatment for early-stage breast cancer and often persists into survivorship. Pain can influence the long-term emotions of women with breast cancer. Behavioral mechanisms explaining this relationship are less clear. Coping during primary treatment may play a role in the association between pai...
Article
Full-text available
Background Cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitor targeted therapies dramatically improve survival outcomes for metastatic breast cancer (MBC), but they are associated with significant symptom burden that can impact patients’ health-related quality of life (HRQOL) and treatment outcomes. This study is the first to describe CDK4/6 inhibi...
Article
e24124 Background: The aims of this study were to examine; the predictors of perceived stress; and the associations between perceived stress and tumor growth and development of metastases as well as the mediational role of inflammatory biomarkers. Methods: This study is prospective in design. A battery of questionnaires, including a sociodemographi...
Article
12061 Background: Despite life-saving potential, many women struggle to adhere to adjuvant endocrine therapy (AET) for their early-stage, hormone receptor-positive breast cancer. Prior research has demonstrated that emotional distress is a barrier to AET adherence. The current study aimed to test the long-term effects of two 5-week post-surgical gr...
Article
Background : Mindfulness plays a role in moderating the negative mental and physical health outcomes associated with caregiving. The aims of this study were to examine the relationship between trait mindfulness and the (1) psychological functioning, (2) health behaviors, (3) and physical health of caregivers for individuals diagnosed with cancer....
Article
Background A randomized controlled trial (RCT) of 5-week stress management interventions teaching cognitive behavioral therapy (CBT) or relaxation training (RT) techniques showed decreases in stress and serum inflammatory markers over 12 months in women undergoing treatment for breast cancer (BCa). To understand the molecular mechanisms involved, w...
Article
Background The NIH consensus statement on cancer-related symptoms concluded the most common and debilitating were depression, pain and fatigue (American Cancer Society, 2019; Qaseem et al., 2008; Meijer et al., 2013; Meijer, 2011 [1–6]). Although the comorbidity of these symptoms is well known and may have similar underlying biological mechanisms;...
Article
Objective: The experience of cancer not only elicits turmoil but also resilience in the family, which has been related to psychological adjustment and physical health of family caregivers. The biological pathways linking family cancer caregiving to health, however, remain poorly understood. This study examined the extent to which psychological ris...
Article
Objectives Compared to non‐Hispanic white (NHW) women, Hispanic women with breast cancer (BCa) are more likely to be diagnosed at later stages of disease and experience reduced quality of life (QOL) following diagnosis. We hypothesized that the demands of later‐stage disease results in a perceived inability to cope and greater distress for Hispanic...
Article
Background: This longitudinal study examined whether co-occurring stimulant use and HIV disease processes predicted greater risk for depression via dysregulated metabolism of amino acid precursors for neurotransmitters. Methods: In total, 110 sexual minority men (i.e., gay, bisexual, and other men who have sex with men) living with HIV who had b...
Article
Objective/Background Insomnia is a prevalent and interfering comorbidity of HIV infection. Nearly 70% of people living with HIV/AIDS (PLWHA) experience symptoms of insomnia and associated distress. The current study examined the mechanisms of insomnia in HIV health status and health-related quality of life and explored behavioral pathways to explai...
Article
Objectives: This study investigated a) racial/ethnic differences in past-year discrimination experiences and b) associations between discrimination and smoking abstinence. Design: Prospective, longitudinal analysis of smoking status. Perceived past-year discrimination was assessed at baseline. ANCOVAs and intent-to-treat hierarchical logistic re...
Article
Full-text available
Objective: People living with HIV/AIDS (PLWHA) are disproportionally exposed to a host of structural, community, and individual-level physical and psychosocial stressors also termed ‘syndemic conditions.’ The current study aimed to examine the association between experiencing syndemic conditions and physiological stress response and be associated w...
Article
Purpose: The objective of the study is to investigate trajectories of stress and depressive symptoms of spousal and intimate partner caregivers in the context of cancer. We also examined the patient-related predictors of caregiver stress and depression. Design: This is a longitudinal cohort study. Participants: Patients diagnosed with cancers affec...
Article
Background: Cancer and its treatment represent major stressors requiring that patients make multiple adaptations. Despite evidence that poor adaptation to stressors is associated with more distress and negative affect (NA), neuroimmune dysregulation and poorer health outcomes, current understanding is very limited of how NA covaries with central n...
Article
Purpose Adverse childhood experiences (ACEs) have been shown to be associated with increased risk of mortality. The biobehavioral mechanisms linking adverse events and survival in cancer patients remain unclear. The aims of the study were to: (1) examine the rates and types of early adverse events in patients diagnosed with cancer; (2) investigate...
Article
Objective: Post-exertional malaise (PEM) is often considered a cardinal symptom of Chronic Fatigue Syndrome (CFS). There is no gold standard diagnostic method for CFS, however, and the Centers for Disease Control (CDC) Fukuda case definition does not require PEM. Research has identified differences in symptom burden between patients according to P...
Article
Background Post-traumatic stress disorder (PTSD) and stimulant use disorders are highly prevalent, commonly co-occur, and predict faster clinical HIV progression. However, scant research has examined if PTSD and cocaine use are associated with the HIV reservoir that persists in immune cells, lymphoid tissue, and organs of people living with HIV tha...
Article
Full-text available
Rationale: Relationship dissatisfaction has been linked with worse health outcomes in many patient populations, though the mechanism(s) underlying this effect are unclear. Among patients with chronic fatigue syndrome (CFS) and their partners, there is evidence for a bi-directional association between poorer relationship satisfaction and the severi...
Article
Background: Cancer caregivers are at increased risk for cardiovascular disease (CVD) and mortality. The aims of this study were to examine psychosocial and behavioral predictors of metabolic syndrome. Methods: Cancer caregivers were administered a battery of questionnaires assessing sociodemographic characteristics, depressive symptoms, perceive...
Presentation
e18348 Background: The aims of this study were to test the efficacy of a stepped collaborative care intervention for comorbid cancer and depression on outcomes including complication rates, health care utilization and costs. Methods: Patients diagnosed with cancer were enrolled in a randomized controlled trial testing the efficacy of a stepped coll...
Presentation
e23128 Background: The aims of this study were to examine the associations between depression and complications, health care utilization and costs in patients with cancer. Methods: Patients diagnosed with cancer were administered a battery of questionnaires, including the Center for Epidemiological Studies-Depression (CES-D) Scale. Health care util...
Article
11599 Background: There is an urgent need for evidence-based and scalable interventions to reduce depression, pain, and fatigue and improve quality of life in patients diagnosed with cancer. The aims of this study were to share the interim analyses of testing the efficacy of a stepped collaborative care intervention for patients diagnosed with canc...
Article
Objective According to the Common‐Sense Model of Self‐Regulation, when faced with a health threat, we make cognitive and emotional assumptions about the illness. The aims of this study were to: (1) examine the role of sociodemographic and disease‐specific factors on illness perception and perceived stress; and (2) test the association between perce...
Article
Context: The Hospital Anxiety and Depression Scale (HADS) is a brief self-report measure commonly used to screen for symptoms of anxiety and depression in cancer patients. The HADS has demonstrated validity in over 100 languages, including Spanish. However, validation studies have largely used European Spanish-speaking samples with a variety of me...
Article
Despite emerging evidence that distress and adversity can contribute to negative health outcomes in cancer, little is known about the brain networks, regions, or circuits that can contribute to individual differences in affect/distress states and health outcomes in treated cancer patients. To understand the state-of-the-science in this regard, we r...
Article
Full-text available
Objective: Survivors of breast cancer experience stress and are at risk for depressive symptoms following primary treatment. Group-based interventions such as cognitive-behavioral stress management (CBSM) delivered postsurgery for nonmetastatic breast cancer (BCa) were previously associated with fewer depressive symptoms over a 12-month follow-up;...
Article
The range of psychosocial stress factors/processes (eg, chronic stress, distress states, coping, social adversity) were reviewed as they relate to immune variables in cancer along with studies of psychosocial interventions on these stress processes and immune measures in cancer populations. The review includes molecular, cellular, and clinical rese...
Article
Full-text available
During the 40 years since the Yale conference on Behavioral Medicine and the founding of the Journal of Behavioral Medicine considerable progress has been made in understanding the role of psychosocial risk and management of physical diseases. We here describe the development of these fundamental concepts from early research on stress through studi...
Article
Introduction Breast cancer (BCa) patients revealing poorer psychological adaptation after surgery show greater inflammation and have poorer long-term outcomes. Our 10-wk group cognitive behavioral stress management (CBSM) intervention showed concomitant 12-month improvements in adaptation and downregulated leukocyte pro-inflammatory and pro-metasta...
Article
Introduction The link between anxiety and breast cancer outcomes has recently been a topic of interest in behavioral medicine, and threat-associated distress states may be associated with increased inflammation, which is relevant for breast cancer recurrence. The purpose of this study was to examine the relationship between post-surgical anxiety le...
Article
Background Psychosocial factors predict poor influenza vaccine (IV) response. Aging and negative affect (NA) may dampen IV response by reducing class switch recombination (CSR), a B-cell process primed by IV. We examined whether greater positive affect [PA] and less NA pre- and post-IV relates to greater antibody responses and CSR in older persons...
Article
Objective: The exclusion criteria of tobacco cessation randomized clinical trials (RCTs) may have unintended consequences on inclusion and cessation disparities. We examined racial/ethnic differences in: a) ex­clusion from a group-based cessation RCT; and b) reasons for exclusion. Design: Quasi-experimental. Inclusion criteria were self-identifica...
Article
Background Women with breast cancer (BCa) experience heightened distress, which is related to greater inflammation and poorer outcomes. The s100 protein family facilitates the inflammatory response by regulating myeloid cell function through the binding of Toll‐like receptor 4 and the receptor for advanced glycation end products (RAGE). The heterod...
Article
Objective: Cognitive-behavioral stress management (CBSM) improves adaptation to primary treatment for breast cancer (BCa), evidenced as reductions in distress and increases in positive affect. Because not all BCa patients may need psychosocial intervention, identifying those most likely to benefit is important. A secondary analysis of a previous r...
Article
Almost 2.8 million men in the U.S. are living with prostate cancer (PC), accounting for 40% of all male cancer survivors. Men diagnosed with prostate cancer may experience chronic and debilitating treatment side effects, including sexual and urinary dysfunction, pain and fatigue. Side effects can be stressful and can also lead to poor psychosocial...
Article
Background: The aims of this study were to examine the potential association between sleep problems, symptom burden, and survival in advanced cancer patients. Methods: A prospective study of 294 patients with gastrointestinal cancer were administered questionnaires assessing sleep, depression, anxiety, stress, pain, fatigue, and health-related q...
Article
Racial/ethnic disparities in tobacco cessation are such that U.S. minorities have greater difficulty quitting compared to White non-Hispanics. Group differences in distress (i.e., perceived stress and depressive symptoms) may contribute to cessation disparities. The allostasis model of health suggests that the toll of chronic stress experienced by...
Article
Objective: The burden of sleep disturbance and depressive symptomology is high for persons living with HIV and particularly so for women. While cognitive behavioral stress management (CBSM) is shown to reduce symptoms of depression and 24-hr urinary free cortisol output (CORT) in HIV+ men, less is known about the effects of CBSM on mood and concom...
Article
Background: Cancer patients often report increased stress during chemotherapy. Stress management training has been shown to reduce this adverse outcome, but few interventions exist for Spanish-speaking Hispanic and Latina women (Latinas). Methods: Following community feedback (including focus groups/in-depth interviews), we transcreated the Span...
Article
Introduction: Research has shown that African Americans gain more than average weight after smoking cessation. However, African Americans have been underrepresented in post-cessation weight gain research. The current study examined 1) the pattern of weight gain and 2) the association between smoking status and weight gain in a sample of African Am...
Article
Introduction: Chronic Fatigue Syndrome (CFS) is a poorly understood illness that is characterized by diverse somatic symptoms, hypothalamic pituitary adrenal (HPA) axis dysfunction and heightened inflammatory indicators. These symptoms are often exacerbated and accompanied by psychological distress states and depression. Since depression is known...
Article
Full-text available
Cardiovascular disease is a growing concern in HIV disease management and nearly 1 out of 3 persons living with the virus is hypertensive. Biobehavioral factors such as anger, hostility, and HPA axis reactivity are emperically linked to blood pressure regulation. Whether HPA axis or mood disturbance increases risk for hypertension remains unclear i...
Article
Full-text available
Purpose: Satisfaction with social resources, or "social well-being," relates to better adaptation and longer survival after breast cancer diagnosis. Biobehavioral mechanisms linking social well-being (SWB) to mental and physical health may involve inflammatory signaling. We tested whether reports of greater SWB were associated with lower levels of...
Article
Full-text available
Objective: Anxiety and depression can substantially impact the life of a cancer patient, but literature on emotional distress in the Hispanic cancer population is sparse. Additionally, the influence of psychosocial variables including age, acculturation, and spiritual wellbeing on emotional distress in this population remains unclear. The purpose...
Article
Objective Physical activity (PA) following surgery for breast cancer may improve depressive symptoms and quality of life (QoL) via reduction in fatigue-related daily interference (FRDI). Less is known about how change in PA may relate to these psychosocial factors throughout the course of treatment. In a secondary analysis of a previous psychosocia...
Article
Full-text available
We examined the feasibility and differential efficacy of cognitive-behavioral stress management (CBSM) and yoga for first-year college students to reduce stress and improve mental and physical health. Thirty-four incoming first-year female students were assigned to 8 weeks of yoga, CBSM, or a wait-list control. Assessments were made at baseline, en...
Conference Paper
The underrepresentation of racial/ethnic minorities in smoking cessation trials may contribute to disparities in quitting. The strict inclusion and exclusion criteria of randomized controlled trials (RCTs) may have unintended consequences on racial/ethnic inclusivity. The present study examined racial/ethnic differences in (a) exclusion from a grou...
Conference Paper
Multiple recruitment strategies are often required to obtain a diverse sample of treatment-seeking smokers. This study is a multisite, behavioral randomized controlled trial designed to address racial/ethnic cessation disparities, among non–Hispanic White, African American, and Hispanic smokers. We implemented an 18-month recruitment campaign utili...
Article
Objective. Chronic Fatigue Syndrome (CFS) symptoms have been shown to be exacerbated by stress and ameliorated by group-based psychosocial interventions such as cognitive behavioral stress management (CBSM). Still, patients may have difficulty attending face-to-face groups. This study compared the effects of a telephone-delivered (T-CBSM) vs a live...
Article
Objective Sleep problems have been linked to increased risk of mortality in the general population. Limited evidence suggests similar relationships among people diagnosed with cancer. The aims of the present study were to investigate the type and rates of sleep problems in advanced cancer patients and examine whether sleep problems are associated w...
Article
The need for brief, low-cost, easily disseminable, and effective interventions to promote healthy lifestyles is high. This is especially true for mental health providers. The authors developed two studies to compare the impacts of Cognitive Behavioral Stress Management (CBSM) and Yoga-Based Stress Management (YBSM) interventions for health care pro...
Article
Objective: Poor sleep quality has been linked to inflammatory processes and worse disease outcomes in the context of many chronic illnesses, but less is known in conditions such as chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). This study examines the relationships between sleep quality, pro-inflammatory cytokines, and CFS/ME symptom...
Article
Purpose: Individuals with trait alexithymia (AL) display poor cognitive assimilation of thoughts, feelings, and emotions. This may result in the persistence of stress, anxiety, and depressive disorders. The cumulative effect of this psychological distress is also linked clinical markers of human immunodeficiency virus (HIV) disease progression. Th...