This project will involve participation of 200 men aged 50 and older who have been diagnosed and treated (radical prostatectomy, beam radiation) for localized prostate cancer. The study will use a 2x4 randomized experimental design with experimental condition (10-wk Cognitive- Behavioral Stress Management, CBSM; 1-day CBSM seminar) as the between-group factor and time point (pre-psychosocial intervention, post- psychosocial intervention, 6-month and 12-month follow-up) as the within-group factor. We intend to test the effects of the 10-wk CBSM program on quality of life (QOL), indicators (general QOL; prostate cancer specific QOL; positive growth negative affect, fatigue, sexuality) and immune system status (natural killer [NK] cell number, NK cell cytotoxicity) across the study period. We also intend to assess mediators of the 10 wk CBSM program effects on QOL by associating QOL changes with the following intervention process: (a) changes in cognitive appraisals (increased optimism, increased positive reframing); (b) increases in coping self-efficacy; (c) increases in emotional processing (increased emotional awareness and emotional expression); (d) increases in social support provisions; (e) increases in free testosterone and DHEA- S; (f) decreases in physiological arousal as induced by 24-hour output of norepinephrine, epinephrine and cortisol; and (g) decreases in neuropeptide Y. Finally, we intend to determine the mediators of CBSM on immune system status (NK cell number; NK cell cytotoxicity) by associating immune system changes with psychosocial (QOL indicators) and neurohormonal )catecholamines, cortisol, reproductive hormones, neuropeptide Y) intervention induced changes.
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