Michael A Andrykowski

University of Louisville, Louisville, Kentucky, United States

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Publications (172)596.48 Total impact

  • Michael A Andrykowski · Rachel F Steffens · Heather M Bush · Thomas C Tucker
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    ABSTRACT: Rural cancer survivors report more distress than non-rural survivors. Little research has examined whether rural residence might also be linked to positive psychological outcomes. Rural (n = 117) and non-rural (n = 76) lung cancer survivors completed measures of posttraumatic growth, benefit-finding, and distress. Rural survivors reported more posttraumatic growth than urban survivors. There were no differences in benefit-finding. Mediation analyses indicated distress mediated the relationship between rural residence and posttraumatic growth. Findings suggest rural residence might be beneficial with regard to potential for posttraumatic growth among cancer survivors. Consistent with trauma theory, distress mediated the relationship between rural residence and posttraumatic growth.
    No preview · Article · Dec 2015 · Journal of Health Psychology
  • Martine M Goedendorp · Paul B Jacobsen · Michael A Andrykowski
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    ABSTRACT: For clinical and research purposes, efficient identification of cases of cancer-related fatigue (CRF) is important, as CRF can be persistent and interfere with usual functioning. While various fatigue-screening instruments are available, no brief screening indices have been developed using formally diagnosed CRF cases as the criterion. Breast cancer patients (n = 385) completed a fatigue diagnostic interview and self-report fatigue measures (Profile of Mood States-fatigue subscale, Fatigue Symptom Inventory, and SF-36 vitality subscale), after initial adjuvant therapy (post-treatment (post-Tx) 1 assessment), after completion of radiotherapy for women receiving chemotherapy + radiotherapy (post-Tx 2 assessment), and 6 months after completion of all adjuvant therapy (6-month post-Tx assessment). CRF cases were identified using specific diagnostic criteria. ROC analyses identified screening indices, which could accurately identify CRF cases after initial adjuvant therapy. Screening indices were cross-validated using post-Tx 2 and 6-month follow-up assessment data. A total of 104 women (27%) met CRF criteria after initial adjuvant therapy. Six two-item screening indices were identified. For all indices, area under the curve exceeded 0.80, sensitivity exceeded 0.80, and specificity exceeded 0.57. Cross-validation suggested that, except for the index based on SF-36, all the indices continued to accurately identify CRF cases at the post-Tx 2 and 6-month post-Tx assessments. Overall, a two-item composite index based on Fatigue Symptom Inventory 'most severity' and 'work interference' items performed best. Breast cancer patients and survivors meeting CRF diagnostic criteria can be accurately identified using brief screening indices derived from common self-report fatigue measures. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
    No preview · Article · Jul 2015 · Psycho-Oncology
  • Michael A. Andrykowski · Rachel F. Steffens · Heather M. Bush · Thomas C. Tucker
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    ABSTRACT: Little research has examined how lung cancer survivors whose cancer experience met the Diagnostic and Statistical Manual of Mental Disorders (DSM) traumatic stressor criterion differ with regard to posttreatment mental health status from survivors whose cancer experience did not. No research of which we are aware has examined the impact of the revised DSM-5 traumatic stressor criterion on this question. Non-small-cell (NSC) lung cancer survivors (N = 189) completed a telephone interview and questionnaire assessing distress and growth/benefit-finding. Survivors were categorized into Trauma and No Trauma groups using both the DSM-IV and DSM-5 stressor criterion. Using the DSM-IV criterion, the Trauma group (n = 70) reported poorer status than the No Trauma group (n = 119) on 10 of 10 distress indices (mean ES = 0.57 SD) and better status on all 7 growth/benefit-finding indices (mean ES = 0.30 SD). Using the DSM-5 stressor criterion, differences between the Trauma (n = 108) and No Trauma (n = 81) groups for indices of distress (mean ES = 0.26 SD) and growth/benefit-finding (mean ES = 0.17 SD) were less pronounced. Those who experience cancer as a traumatic stressor show greater distress and growth/benefit-finding, particularly when the more restrictive DSM-IV stressor criterion defines trauma exposure. Copyright © 2015 Wiley Periodicals, Inc., A Wiley Company.
    No preview · Article · May 2015 · Journal of Traumatic Stress
  • Fawwaz Alaloul · Judith Schrieber · Michael A Andrykowski
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    ABSTRACT: Background: A cancer diagnosis and treatment can be a stressful, life-altering experience that can pose a threat to life and raise existential challenges. Spirituality may influence the process of coping with the stress of the cancer experience. Studies of the role of spirituality for Muslim cancer patients and survivors are limited. Objective: The aim of this study was to understand the role of spirituality in the cancer experience among Arab Muslim hematopoietic stem cell transplant (HSCT) survivors. Methods: In this qualitative, descriptive study, 63 HSCT survivors (mean, 20.2 months) responded to 2 open-ended, self-report questions on the role of spirituality in their HSCT experience. Thematic analysis was used to identify themes related to spirituality. Results: Three dimensions that helped patients cope with their experiences were identified: sickness viewed in light of belief in God, use of religious/spiritual resources, and support from family and community. Two general themes described changes in their faith as a result of having the HSCT procedure: strengthening of faith in God and greater reliance on religious/spiritual activities. Conclusion: Spirituality was important to the Arab Muslim survivors in coping with cancer and HSCT treatment. Muslim cancer survivors are often deeply connected to their religion. Implications for practice: Healthcare providers in the United States and other Western countries need to be aware of the unique religious and spiritual needs of Muslim cancer survivors in order to provide them with culturally sensitive care. More research on the spiritual needs of Muslim cancer patients and survivors residing in Western countries is needed.
    No preview · Conference Paper · Apr 2015
  • John M. Salsman · Benjamin D. Schalet · Michael A. Andrykowski · David Cella
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    ABSTRACT: Objective The Impact of Events Scale (IES) is one of the most widely used measures of event-specific distress. The IES assesses the frequency with which respondents experience intrusive thoughts and avoidant behaviors over the past week. Our aim is to demonstrate the benefit of a severity-based measurement approach of the IES compared with a frequency-based measurement approach.MethodsA mixed group of post-treatment cancer survivors (N = 325; M = 31.8 years old) completed measures assessing quality of life (Functional Assessment of Cancer Therapy–General), psychological adjustment (Mental Health Inventory), and cancer-related distress (IES). The IES was keyed to the cancer experience and administered with standard (frequency) and modified (severity) response options.ResultsClassical reliability analyses and bifactor modeling were conducted on both versions of the IES. Reliability estimates suggest that the IES severity items were more highly intercorrelated than the IES frequency items. Both versions of the IES were highly correlated (r = 0.82), showing the presence of a dominant general factor. Bifactor modeling suggested that the severity items generally provided higher levels of discrimination than the frequency items. Validity correlations with the Functional Assessment of Cancer Therapy–General and Mental Health Inventory demonstrated that the IES severity performed as good as or better than the IES frequency.Conclusions Given the high correlations and similarity in content, the IES severity items largely assess the same construct as the IES frequency items. However, IES severity items generally showed improved psychometric properties and similar or higher correlations with quality of life and psychological adjustment. The IES severity approach appears to be a more informative method for assessing cancer-specific distress. Copyright © 2015 John Wiley & Sons, Ltd.
    No preview · Article · Mar 2015 · Psycho-Oncology
  • Paul B Jacobsen · Michael A Andrykowski
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    ABSTRACT: Tertiary prevention refers to care aimed at reducing morbidity and disability in people diagnosed with, and being treated for, disease. This article focuses on psychological aspects of tertiary prevention during the active phase of cancer treatment. Research in this area gained momentum in the 1970s, a time that coincides with changing public attitudes about discussing cancer and the origins of health psychology and behavioral medicine as fields of study. Over the past 40 years, much has been learned about the psychological impact of cancer and the beneficial effects of psychological interventions on patients' mental and physical well-being. The amount of research in this area necessitates a selective, rather than comprehensive, review approach. The focus here is on issues that affect a large proportion of people with cancer and for which research has generated an in-depth understanding. Accordingly, the article summarizes findings regarding the prevalence, etiology, and contributing factors, and the clinical management of, two of the most common psychological reactions to cancer diagnosis and treatment (i.e., depression and anxiety) and two of the most common physical symptoms related to cancer and its treatment (i.e., fatigue and pain). The review also summarizes emerging lines of research on psychological reactions to recurrent and second cancers, and on cancer diagnosis and treatment as a "teachable moment" for promoting health behavior change. Finally, important future directions are identified, including the need to adopt a team science approach to tertiary care and to better translate findings from intervention research into clinical practice. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
    No preview · Article · Feb 2015 · American Psychologist
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    ABSTRACT: The aims of this study were to determine if quality of life (QOL) among Arab Muslim hematopoietic stem cell transplantation (HSCT) survivors differs from that of a healthy matched comparison group and to examine the relationships of demographic and medical variables and perceived social support with post-HSCT QOL. HSCT survivors (n = 63) were recruited from the King Hussein Cancer Center outpatient clinic. A matched (age, gender, education), healthy comparison group (n = 63) was recruited through public advertisements. Participants completed the EORTC-30 QOL scale and the Medical Outcomes Study Social Support Survey. Differences were found between the Arab Muslim HSCT survivor and healthy comparison groups for physical functioning (p < .0001), role functioning (p < .01), social functioning (p < .0001) QOL domains, and an overall symptom score (p = .003) with the HSCT group reporting poorer status than the healthy comparison group. Effect sizes for the three QOL domains ranged from .50 (role functioning) to 1.20 (social functioning). No significant difference was noted between the Arab Muslim HSCT and comparison groups in emotional and cognitive QOL domains. Higher overall symptom scores were significantly associated with poorer QOL across all QOL domains. Similar to prior research with HSCT survivors, results suggest that HSCT has a significant negative impact on QOL. However, despite this general similarity, results suggest that the needs and experience of Muslim Arab HSCT survivors might differ from those of Western HSCT survivors in the social and emotional QOL domains. Given growing numbers of Arab and Muslim cancer survivors in the USA and other Western countries, future research is warranted.
    No preview · Article · Jan 2015 · Supportive Care Cancer
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    ABSTRACT: Women with hereditary breast-ovarian cancer face decisions about screening (transvaginal ultrasound, CA125, mammography, breast exams) and proactive (before cancer) or reactive (after cancer) surgery (oophorectomy, mastectomy). The content of genetic counseling and its relation to these key health behaviors is largely unexamined. Ashkenazi Jewish women (n = 78) were surveyed through the process of genetic testing and had audiorecorded counseling sessions available for Linguistic Inquiry and Word Count analysis. Proportions for participant and counselor cognitive and affective content during sessions were used as primary predictor variables in linear mixed models for change in intentions for screening and treatment and in self-reported screening. Cognitive and affective content were important predictors of behavior. Counselor cognitive content was associated with ovarian screening. An interaction effect also emerged for CA-125, such that counselor cognitive content plus participant cognitive content or counselor affective content were associated with more screening. Teasing out the factors in risk communication that impact decision-making are critical, and affect from a risk communicator can spur action, such as cancer screening.
    No preview · Article · Dec 2014 · Journal of Behavioral Medicine
  • Michael Andrykowski
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    ABSTRACT: Commentary on: Hsieh CC, Chen CA, Hsiao FH, et al. The correlations of sexual activity, sleep problems, emotional distress, attachment styles with quality of life: comparison between gynaecological cancer survivors and noncancer women. J Clin Nurs 2014;23:985-94. Implications for practice and research Quality of life (QOL) in long-term survivors of gynaecological cancer is similar to that of women without a cancer history. Demographical and clinical variables do not predict QOL in gynaecological cancer survivors. Physical and mental QOL in gynaecological cancer survivors is most strongly related to psychosocial factors, such as insecure attachment style and current state of anxiety. Further research is needed on how attachment style may affect coping with cancer and ultimately, QOL.
    No preview · Article · Aug 2014 · Evidence-Based Nursing
  • Michael A Andrykowski · Rachel F Steffens · Heather M Bush · Thomas C Tucker
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    ABSTRACT: Healthy People 2020 identifies elimination of health disparities as a key aim. Rural residence is associated with disparities in cancer screening, physical morbidity, and survival. The present study aimed to identify potential disparities in mental health (MH) outcomes (e.g., anxiety and depression symptoms, distress) in lung cancer (LC) survivors associated with ruralness of residence. Lung cancer survivors (LC group; n = 193; mean age = 63.1 years; mean time since diagnosis = 15.6 months) were recruited from the population-based SEER Kentucky Cancer Registry. LC survivors completed a telephone interview and questionnaire assessing MH outcomes. U.S. Department of Agriculture Rural-Urban Continuum Codes were used to identify Rural (n = 117) and Urban (n = 76) LC survivors. A healthy comparison (HC) group was recruited (n = 152) and completed a questionnaire assessing MH outcomes. Across six MH indices, Rural LC survivors reported poorer MH relative to Urban LC survivors with a mean effect size (ES) of 0.43 SD in unadjusted analyses and 0.29 SD in analyses adjusted for education and physical comorbidity. Comparison of the LC and HC groups revealed significant Ruralness × Group interactions for five of six MH indices. The Rural LC group reported poorer MH than the Rural HC group with a mean ES of 0.51 SD. The MH of Urban LC and HC groups did not differ (mean ES = 0.00 SD). Rural residence is a risk factor for poorer MH outcomes for LC survivors. The MH of Rural LC survivors may be more negatively impacted by cancer diagnosis and treatment than the MH of Urban LC survivors. Copyright © 2013 John Wiley & Sons, Ltd.
    No preview · Article · Apr 2014 · Psycho-Oncology
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    ABSTRACT: Few studies have linked actual genetic counseling content to short-term outcomes. Using the Self-regulation Model, the impact of cognitive and affective content in genetic counseling on short-term outcomes was studied in individuals at elevated risk of familial breast-ovarian cancer. Surveys assessed dependent variables: distress, perceived risk, and 6 knowledge measures (Meaning of Positive Test; Meaning of Negative Test; Personal Behavior; Practitioner Knowledge; Mechanisms of Cancer Inheritance; Frequency of Inherited Cancer) measured at pre- and post-counseling. Proportion of participant cognitive and affective and counselor cognitive and affective content during sessions (using LIWC software) were predictors in regressions. Knowledge increased for 5 measures and decreased for Personal Behavior, Distress and Perceived Risk. Controlling for age and education, results were significant/marginally significant for three measures. More counselor content was associated with decreases in knowledge of Personal Behavior. More participant and less counselor affective content was associated with gains in Practitioner Knowledge. More counselor cognitive, and interaction of counselor cognitive and affective content, were associated with higher perceived risk. Genetic counselors dominate the content of counseling sessions. Therefore, their content is tied more closely to short term outcomes than participant content. A lack of patient communication in sessions may pose problems for understanding of complex concepts.
    No preview · Article · Mar 2014 · Journal of Genetic Counseling
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    ABSTRACT: Objective: The goal of this study is to examine the relationship between socioeconomic status (SES) and both positive and negative mental health (MH) outcomes in a population-based sample of colorectal cancer survivors. On the basis of theoretical conceptualizations of trauma and posttraumatic growth, low SES was hypothesized to be positively associated with both greater negative MH outcomes (e.g., distress) and greater positive MH outcomes (e.g., growth). Methods: Colorectal cancer survivors (n = 1300; 57% male; mean age 69.4 and 4.0 years post-diagnosis) were recruited using a regional, population-based cancer registry in the Netherlands and completed a questionnaire assessing current negative and positive MH outcomes. Low, medium, and high SES respondents were identified using an area-level indicator of SES based on aggregated individual fiscal data on monetary home value and household income. Results: Analysis of covariance and logistic regression analyses indicated that low SES was a risk factor for greater negative MH outcomes. Relative to high SES survivors, low SES survivors reported poorer status on nine indices of MH, and high SES survivors were about 50% less likely to report clinically important levels of anxiety and depression. Results provided partial support for the hypothesis low SES was a 'risk' factor for greater positive MH outcomes. Relative to high SES survivors, low SES survivors reported greater positive MH outcomes on 2 of 5 positive MH indices examined (Positive Self-Evaluation, Meaning of Cancer). Conclusions: Study findings are the first to suggest that low SES might increase the likelihood of both greater negative as well as positive MH outcomes in cancer survivors.
    No preview · Article · Nov 2013 · Psycho-Oncology
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    ABSTRACT: The course of depressive symptoms during and after breast cancer treatment is not well understood. We identified patient subgroups based on distinct trajectories of depressive symptoms and determined whether subgroups could be distinguished by personal characteristics and coping strategies. Breast cancer patients completed the Center for Epidemiologic Studies-Depression Scale on clinically meaningful occasions and during the posttreatment period. The Illness Management Questionnaire was completed prior to treatment. A three-class mixture model provided the best fit to the data. Subgroup membership was significantly (p < .05) associated with marital status, history of depression, and focusing on symptoms. In multivariate analysis, marital status and focusing on symptoms remained significant (p < .05) predictors of subgroup membership. Distinct trajectories can be identified during and after adjuvant breast cancer therapy. Predictors of these trajectories have implications for addressing depressive symptoms in this clinical population and for future research.
    Full-text · Article · Oct 2013 · Annals of Behavioral Medicine
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    ABSTRACT: Objective: The health status and psychosocial well-being of multiple primary cancer (MPC) survivors are under-researched. Methods: In total, 3615 survivors identified from the Eindhoven Cancer Registry between 2008 and 2009 were assessed. About one in six survivors had survived MPC (n = 556). All survivors completed questionnaires on health status (SF-36/European Organization of Research and Treatment of Cancer quality of life module), mental health (Hospital Anxiety and Depression Scale) and impact of cancer (Impact of Cancer). Results: Compared with single primary cancer survivors, MPC survivors reported significantly poorer scores on general health and higher symptom scores on diarrhoea and fatigue. Significantly more MPC survivors met the subclinical cut-off score of ≥ 8 points on the Hospital Anxiety and Depression Scale depression subscale (27% vs. 19%, p = 0.0001). MPC survivors also reported significantly greater negative impact of cancer (namely body changes and life interferences) and positive impact of health awareness on their lives. All results were adjusted for age at survey, time since last diagnosis, sex, comorbidity, body mass index and marital status. In secondary analyses, MPC survivors with different primary cancer combinations or time interval between primary cancer diagnoses had comparable health status and psychosocial well-being. Conclusion: Multiple primary cancer survivors reported a poorer health status and, in general, experienced a greater negative impact of cancer on their psychosocial well-being than single primary cancer survivors.
    No preview · Article · Aug 2013 · Psycho-Oncology
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    ABSTRACT: OBJECTIVE: Although many survivors continue to worry about cancer years after completing treatment, little is known about factors associated with cancer worry. This study examined associations between breast cancer worry and demographic and clinical variables, as well as fatigue, symptom burden, and risk perception in a sample of breast cancer survivors 3 years post-adjuvant treatment. We hypothesized that after controlling for demographic and treatment factors, a significant proportion of variance in cancer worry would be explained by greater fatigue severity, more symptom burden, and greater perceived risk of recurrence. METHODS: Stage 0-II breast cancer patients (N = 202) completed measures of risk perception, cancer worry (modified Lerman's Cancer Worry Scale), symptom burden (Memorial Symptom Assessment Scale), and fatigue severity (Fatigue Symptom Inventory) 3 years after completing adjuvant treatment. Multiple regression analyses were used to determine the proportion of variance in cancer worry accounted for by fatigue, symptom burden, and risk perception after controlling for demographic and clinical variables RESULTS: Age, fatigue, symptom burden, and risk perception each explained a significant proportion of variance in cancer worry (p < 0.05). Fatigue, symptom burden, and risk perception together accounted for 27% of the variance in cancer worry after controlling for demographic and clinical factors (p < 0.01) CONCLUSIONS: The hypothesis was supported that fatigue, symptom burden, and risk perception are associated with cancer worry among breast cancer survivors. It is possible that lingering fatigue and other symptoms may remind breast cancer survivors of their disease. Copyright © 2012 John Wiley & Sons, Ltd.
    Full-text · Article · Apr 2013 · Psycho-Oncology
  • Michael A Andrykowski · Rachel F Steffens · Heather M Bush · Thomas C Tucker
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    ABSTRACT: Background Reports of growth' following cancer diagnosis and treatment are common and are considered evidence for the transformative potential of the cancer experience. However, reports of growth are also common in the general population. This study sought to identify the unique, value-added' with regard to the nature and magnitude of growth represented by the cancer experience. Methods Lung cancer (LC) survivors (n=190; mean 15months post-diagnosis) completed the Posttraumatic Growth Inventory (PTGI), reporting changes occurring as a result of having cancer'. Community-based, healthy controls (HC) (n=152) completed the PTGI, reporting changes occurring in the past year'. ResultsReports of growth were common in both the LC and HC groups. However, the LC group reported greater total PTGI scores (effect size (ES)=0.39 SD) and greater growth for 3 of 5 subscales (ESs 0.34-0.48 SD). The LC group was more likely to report any degree of change for 11 of 21 PTGI items (mean odds ratio (OR) across 21 items=1.92) and were more likely to report moderate' to very great' change for eight of 21 items (mean OR=1.75). The LC group was more likely to report growth in the areas of social relationships and appreciation for life. Conclusions In sum, the growth evidenced by LC survivors after diagnosis quantitatively and qualitatively differs from growth reported by the general population over a similar period. Estimates of the value-added by the cancer experience suggest a magnitude representing at least the lower range of clinical significance. Copyright (c) 2013 John Wiley & Sons, Ltd.
    No preview · Article · Mar 2013 · Psycho-Oncology
  • Celeste R Phillips-Salimi · Michael A Andrykowski
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    ABSTRACT: Purpose: Each year, nearly 21,000 adolescents and young adults (AYA) ages 15 to 29 years are diagnosed with cancer. Breast and gynecological cancers account for 25% of the cancers seen in AYA females. The purpose of this study was to compare the current physical and mental health status of female AYA cancer survivors with non-cancer female controls. Methods: Using data from the population-based 2009 National Health Interview Survey, 100 cases of female AYA survivors of breast and gynecological cancers were identified [female AYA cancer survivor (FCS) group]. FCS cases were matched with 300 female respondents without a history of cancer on age, education, marital status, and minority status [non-cancer control (NCC) group]. The FCS and NCC groups were compared on a range of physical and mental health status indices using analysis of covariance and binary logistic regression. Results: FCS group reported significantly poorer physical and mental health status than the matched controls. Relative to the NCC group, FCS survivors had significantly poorer scores on 7 of 8 mental health outcomes and were more likely to meet criteria for serious psychological distress (odds ratio = 4.23, p ≤ 0.001). FCS group also reported greater lifetime and current prevalence of various medical conditions, more health-related disabilities, and greater functional limitations than the NCC group. Conclusion: Diagnosis of breast and gynecological cancer during adolescence and young adulthood is associated with clinically important deficits in physical and mental health status. Given the young age of this cancer survivor cohort, increased attention should be devoted to minimizing these deficits.
    No preview · Article · Jan 2013 · Supportive Care in Cancer
  • Michael A Andrykowski
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    ABSTRACT: Identify the current physical and mental health status and health behaviors of male breast cancer survivors. Using data from the national, population-based, 2009 Behavioral Risk Factor Surveillance System (BRFSS) survey, 66 cases of male breast cancer were identified (mean age = 66.2 years, mean time since diagnosis = 12.0 years). Male breast cancer cases were matched with 198 male BRFSS respondents with no history of cancer (control group) on age, education, and minority status. The male breast cancer and control groups were compared on physical and mental health status and health behaviors, using t-test and logistic regression analyses. The male breast cancer group reported poorer physical and mental health than controls. Male breast cancer survivors were significantly (p < 0.05) more likely to be obese (Odds Ratio = 2.41) and reported more physical comorbidities (Effect Size = 0.45) and activity limitations (Odds Ratio = 3.17), poorer life satisfaction (Effect Size = 0.41) and general health (Effect Size = 0.40), and more days in the past month when mental health (Effect Size = 0.49), and physical health (Effect Size = 0.29) were not good. In contrast, the male breast cancer and control groups were similar with regard to current health behaviors, including tobacco and alcohol use, diet, exercise, and health care. The diagnosis and treatment of male breast cancer may be associated with clinically important and long-term deficits in physical and mental health status, deficits which may exceed those evidenced by long-term female breast cancer survivors. Copyright © 2011 John Wiley & Sons, Ltd.
    No preview · Article · Sep 2012 · Psycho-Oncology
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    Celeste R Phillips-Salimi · Karen Lommel · Michael A Andrykowski
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    ABSTRACT: The growing number of childhood cancer survivors makes examination of their current physical and mental health status and health behaviors an important concern. Much of what is known about the long-term outcomes of childhood cancer survivors comes from the Childhood Cancer Cohort Study (CCSS) which uses sibling controls. Using data from the 2009 Behavioral Risk Factor Surveillance System survey, 651 childhood cancer survivors and 142,932 non-cancer peer controls were identified. The two groups were compared on a variety of physical and mental health status and health behavior variables using ANCOVA and binary logistic regression. While controlling for differences in age, sex, and minority status, survivors significantly (P ≤ 0.001) had poorer socioeconomic outcomes, more comorbid conditions, lower life satisfaction, less social and emotional support, poorer general health, and reported more days per month of poor physical and mental health than non-cancer individuals. Survivors were more likely to report being a current smoker [odds ratio (OR) = 2.33; 95% confidence interval (CI), 1.98-2.73; P < 0.001]; tested for human immunodeficiency virus (HIV) (OR = 1.79; 95% CI, 1.52-2.11; P < 0.001); and that at least one HIV situation applied to them (OR = 2.06; 95% CI, 1.55-2.74; P < 0.001). No significant differences were found between groups in regards alcohol use and diet. Results support and extend previous findings reported by the CCSS. New findings regarding survivors' increased likelihood to engage in risky behaviors proposes new directions for future research.
    Preview · Article · Jun 2012 · Pediatric Blood & Cancer
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    Jessica L Burris · Paul B Jacobsen · Loretta S Loftus · Michael A Andrykowski
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    ABSTRACT: There is a growing body of evidence suggesting breast cancer (BC) recurrence risk might be linked to behavioral factors. However, little is known about BC survivors' beliefs regarding the link between their behavior and recurrence risk. The objective of this study was to describe BC survivors' beliefs regarding performance of behaviors potentially associated with BC recurrence risk reduction, and to examine the link between these behaviors and BC recurrence risk reduction beliefs, worry, and risk perception. 200 female BC survivors (age, years: mean=57.7, standard deviation=9.2) completed a questionnaire assessing beliefs about the effectiveness of 14 potential BC recurrence risk reduction behaviors, their performance of these potential risk reduction behaviors, recurrence worry, and perception of personal lifetime BC recurrence risk. The behaviors most frequently endorsed as potentially reducing BC recurrence risk included avoiding tobacco use (84%), exercising at least three times per week (74%), eating an average of five servings a day of fruits and vegetables (72%), and limiting food intake to maintain current weight or lose weight (70%). Multivariate logistic regression analyses predicting behavioral performance showed that beliefs were consistently associated with behavior while worry and risk perception were largely unrelated to behavior. BC survivors' beliefs about the effectiveness of potential BC recurrence risk reduction behaviors are largely consistent with empirical findings and relate strongly to actual behavioral performance. Misconceptions about the effects of behavior to reduce BC recurrence risk are important targets for clinical and public health efforts.
    Preview · Article · Apr 2012 · Psycho-Oncology

Publication Stats

8k Citations
596.48 Total Impact Points


  • 2015
    • University of Louisville
      Louisville, Kentucky, United States
  • 1986-2015
    • University of Kentucky
      • • College of Medicine
      • • Department of Behavioral Science
      • • Department of Psychology
      • • Department of Pediatrics
      Lexington, Kentucky, United States
  • 2009
    • University of Washington Seattle
      Seattle, Washington, United States
  • 2007-2009
    • Lexington College
      Lexington, Kentucky, United States
    • Stanford University
      • Department of Medicine
      Palo Alto, California, United States
  • 1999-2007
    • Vanderbilt University
      • School of Nursing
      Nashville, Michigan, United States
  • 2005
    • Spalding University
      Louisville, Kentucky, United States
  • 2004
    • University of South Florida
      • Department of Psychology
      Tampa, FL, United States
  • 2003
    • VA Palo Alto Health Care System
      Palo Alto, California, United States
  • 1987-1989
    • Memorial Sloan-Kettering Cancer Center
      New York, New York, United States
  • 1983-1985
    • University of Illinois, Urbana-Champaign
      • Department of Psychology
      Urbana, Illinois, United States