The proposed study will evaluate the efficacy of two 12-week psychosocial interventions, one emphasizing the development of specific coping skills and the other emphasizing the receipt and provision of social support, for women with newly diagnosed breast cancer (N = 280). Breast cancer patients will be randomly assigned at diagnosis either to the coping skills intervention, social support intervention, or a waiting list control. Women assigned to the waiting list condition will be randomly assigned to one of the two interventions 6 months after their diagnosis. The impact of the coping skills versus social support intervention delivered early (time of diagnosis) or delayed (6 months post-diagnosis) will be evaluated on psychological and medical variables. Psychological measures will include quality of life, affective distress, and ways of coping with the disease. Data will be obtained pre- and post-intervention and at follow-ups from 1 to 2 years post-diagnosis. Additional analyses will examine the efficacy of the interventions for women at high-risk for prolonged affective distress. High-risk status will be defined in two ways, one based on psychological risk factors (pessimism, high information seeking, high distress at diagnosis) and a second based on disease severity (Stage I, node negative versus Stage II-IV, node positive). Both the coping skills and social support interventions are hypothesized to lead to higher quality of life when compared to waiting list controls at post-intervention. The coping skills intervention is hypothesized to lead to lower affective distress than the social support intervention, with larger effects for those women at high-risk. The effects of the interventions on affective distress are hypothesized to be mediated by decreased use of avoidance coping methods, decreased levels of intrusive negative thoughts, and increased use of engagement coping.
