Most women diagnosed with ovarian cancer suffer through difficult disease course that has a poor medical outcome. Our research has suggested that levels of general and cancer-specific distress are elevated after diagnosis and that cancer-specific distress remains elevated over time. Unfortunately, there have been few empirically-based psychological interventions for this population. Over the course of the past 8 years, we have tested the efficacy of two psychological interventions, a supportive counseling intervention (SC) and a coping and communication skills intervention (CCI), for this patient population. Our results have suggested that both interventions reduced depressive symptoms and have indicated that SC is more effective among women who are more expressive of positive emotions and women who experienced increasing disability. The goal of the next proposed study in our program of research is to extend our research in the following ways: 1) To evaluate the long term durability of these interventions, particularly among women who experience a disease recurrence;2) To assess unique and shared mechanisms of change by using a more appropriate methodology to assess mediation and by focusing on emotional processing and benefit finding as a unique mechanisms for SC and by assessing additional cognitive and behavioral skills that are taught in CCI as unique mechanisms for CCI;3) To examine the impact of CCI versus SC and UC on a broader range of psychosocial outcomes including worries about disease recurrence and global (e.g., social functioning) and spiritual quality of life. 401 women who are newly diagnosed with ovarian cancer will be randomly assigned to CCI, SC, or UC. Participants will complete surveys pre- intervention, 5 weeks, 9 weeks, 6, 12, and 18 months post-baseline. The primary aims are: 1) To evaluate the efficacy of CCI, SC, and Usual Care (UC) on patients'long-term general and cancer-specific psychological adaptation, concerns about recurrence, and quality of life, and to determine whether either treatment's effects are moderated by disease recurrence. 2) To evaluate the cognitive, social, emotional, and behavioral processes which mediate CCI and SC's effects on patients'long-term psychological distress, concerns about disease recurrence, and quality of life.

Public Health Relevance

Our prior research has indicated that about 25% of women diagnosed with ovarian cancer report significant depressive symptoms and nearly 70% report significant cancer- related distress. We have evaluated two interventions, a cognitive-behavioral intervention and a supportive counseling intervention and found that both interventions significantly reduced depressive symptoms. In this renewal application, we seek to extend this program of research by evaluating the long-term effects of the interventions, by assessing unique and common mechanisms of change, and by expanding our assessment to a broader range of psychosocial outcomes.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA085566-07
Application #
8134993
Study Section
Psychosocial Risk and Disease Prevention Study Section (PRDP)
Program Officer
Rowland, Julia
Project Start
2000-08-01
Project End
2015-07-31
Budget Start
2011-08-01
Budget End
2012-07-31
Support Year
7
Fiscal Year
2011
Total Cost
$519,524
Indirect Cost
Name
University of Medicine & Dentistry of NJ
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
617022384
City
Piscataway
State
NJ
Country
United States
Zip Code
08854
Manne, Sharon L; Kashy, Deborah A; Virtue, Shannon et al. (2018) Acceptance, social support, benefit-finding, and depression in women with gynecological cancer. Qual Life Res 27:2991-3002
Manne, Sharon L; Myers-Virtue, Shannon; Kissane, David et al. (2017) Group-based trajectory modeling of fear of disease recurrence among women recently diagnosed with gynecological cancers. Psychooncology 26:1799-1809
Manne, Sharon L; Myers-Virtue, Shannon; Kashy, Deborah A et al. (2017) Therapy processes, progress, and outcomes for 2 therapies for gynecological cancer patients. Psychooncology 26:2069-2078
Manne, Sharon L; Myers-Virtue, Shannon; Darabos, Katie et al. (2017) Emotional processing during psychotherapy among women newly diagnosed with a gynecological cancer. Palliat Support Care 15:405-416
Gonzalez, Brian D; Manne, Sharon L; Stapleton, Jerod et al. (2017) Quality of life trajectories after diagnosis of gynecologic cancer: a theoretically based approach. Support Care Cancer 25:589-598
Manne, Sharon L; Virtue, Shannon Myers; Ozga, Melissa et al. (2017) A comparison of two psychological interventions for newly-diagnosed gynecological cancer patients. Gynecol Oncol 144:354-362
Manne, Sharon L; Myers-Virtue, Shannon; Kashy, Deborah et al. (2015) Resilience, Positive Coping, and Quality of Life Among Women Newly Diagnosed With Gynecological Cancers. Cancer Nurs 38:375-82
Myers Virtue, Shannon; Manne, Sharon L; Darabos, Kathleen et al. (2015) Emotion episodes during psychotherapy sessions among women newly diagnosed with gynecological cancers. Psychooncology 24:1189-96
Myers Virtue, Shannon; Manne, Sharon L; Ozga, Melissa et al. (2014) Cancer-related concerns among women with a new diagnosis of gynecological cancer: an exploration of age group differences. Int J Gynecol Cancer 24:165-71
Manne, Sharon; Myers, Shannon; Ozga, Melissa et al. (2014) Holding back sharing concerns, dispositional emotional expressivity, perceived unsupportive responses and distress among women newly diagnosed with gynecological cancers. Gen Hosp Psychiatry 36:81-7

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