Biopsychosoc Sci Med. 2025 May 9. doi: 10.1097/PSY.0000000000001398. Online ahead of print.
ABSTRACT
OBJECTIVE: Diagnosis with breast cancer is a profound stressor associated with increases in depression and inflammation. However, considerable variability in these outcomes is currently unexplained. We examined risk and resilience factors that may influence depressive symptoms and inflammatory markers in recently diagnosed breast cancer patients, including lifetime stressor exposure and psychological and behavioral resources. We focused on modifiable resources – sleep, physical activity, and coping resources – that can be leveraged to enhance women’s recovery.
METHOD: Women with Stage 0-IIIA breast cancer (N=180) were assessed before radiation, chemotherapy, or endocrine therapy. The Stress and Adversity Inventory (STRAIN) measured total count and severity of lifetime stressors. Blood samples captured plasma protein markers of inflammation (TNF-α, IL-6, and CRP) combined into a composite. Self-report questionnaires evaluated depressive symptoms, sleep, physical activity, social support, self-esteem, optimism, and mastery.
RESULTS: Total stressor count (β=0.30, P<0.0001) and severity (β=0.12, P<0.0001) were associated with depressive symptoms. Total stressor count (β=0.01, P=0.04), but not severity (β=0.001, P=0.17), was associated with increased inflammation. Sleep quality, social support, optimism, and mastery buffered the effects of stressor severity on depressive symptoms; social support and optimism also buffered stressor count on depressive symptoms (ps<0.04). None of the moderators influenced the stress-inflammation relationship (all ps>0.20).
CONCLUSIONS: Lifetime stressor exposure was associated with depression and inflammation in breast cancer patients. Interventions enhancing sleep quality, social support, optimism, and mastery may prevent depression in this vulnerable group.
PMID:40359350 | DOI:10.1097/PSY.0000000000001398
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