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Elaine Drysdale

Other affiliations: BC Cancer Agency
Bio: Elaine Drysdale is an academic researcher from University of British Columbia. The author has contributed to research in topics: Group psychotherapy & Randomized controlled trial. The author has an hindex of 4, co-authored 5 publications receiving 1118 citations. Previous affiliations of Elaine Drysdale include BC Cancer Agency.

Papers
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Journal ArticleDOI
TL;DR: Supportive-expressive group therapy does not prolong survival in women with metastatic breast cancer, but it improves mood and the perception of pain, particularly in women who are initially more distressed.
Abstract: Background Supportive–expressive group therapy has been reported to prolong survival among women with metastatic breast cancer. However, in recent studies, various psychosocial interventions have not prolonged survival. Methods In a multicenter trial, we randomly assigned 235 women with metastatic breast cancer who were expected to survive at least three months in a 2:1 ratio to an intervention group that participated in weekly supportive–expressive group therapy (158 women) or to a control group that received no such intervention (77 women). All the women received educational materials and any medical or psychosocial care that was deemed necessary. The primary outcome was survival; psychosocial function was assessed by self-reported questionnaires. Results Women assigned to supportive–expressive therapy had greater improvement in psychological symptoms and reported less pain (P=0.04) than women in the control group. A significant interaction of treatment-group assignment with base-line psychological scor...

833 citations

Journal ArticleDOI
TL;DR: In the largest trial to date, MBCR was superior for improving stress levels, quality of life and social support for distressed survivors of breast cancer.
Abstract: Purpose To compare the efficacy of the following two empirically supported group interventions to help distressed survivors of breast cancer cope: mindfulness-based cancer recovery (MBCR) and supportive-expressive group therapy (SET). Patients and Methods This multisite, randomized controlled trial assigned 271 distressed survivors of stage I to III breast cancer to MBCR, SET, or a 1-day stress management control condition. MBCR focused on training in mindfulness meditation and gentle yoga, whereas SET focused on emotional expression and group support. Both intervention groups included 18 hours of professional contact. Measures were collected at baseline and after intervention by assessors blind to study condition. Primary outcome measures were mood and diurnal salivary cortisol slopes. Secondary outcomes were stress symptoms, quality of life, and social support. Results Using linear mixed-effects models, in intent-to-treat analyses, cortisol slopes were maintained over time in both SET (P = .002) and MBC...

238 citations

Journal ArticleDOI
TL;DR: Mindfulness‐based cancer recovery and supportive expressive group therapy are two well‐validated psychosocial interventions but they have not been directly compared, and little is known about long-term outcomes.
Abstract: Background Mindfulness-based cancer recovery (MBCR) and supportive expressive group therapy (SET) are two well-validated psychosocial interventions, but they have not been directly compared, and little is known about long-term outcomes This comparative effectiveness study measured the effects of these two interventions immediately following the groups and for 1 year thereafter in distressed breast cancer survivors Methods Two hundred fifty-two distressed Stage I–III breast cancer survivors were randomized into either MBCR or SET Women completed questionnaires addressing mood, stress symptoms, quality of life, social support, spirituality and post-traumatic growth before and after the interventions, and 6 and 12 months later Results Immediately following the intervention, women in MBCR reported greater reduction in mood disturbance (primarily fatigue, anxiety and confusion) and stress symptoms including tension, sympathetic arousal and cognitive symptoms than those in SET They also reported increased emotional and functional quality of life, emotional, affective and positive social support, spirituality (feelings of peace and meaning in life) and post-traumatic growth (appreciation for life and ability to see new possibilities) relative to those in SET, who also improved to a lesser degree on many outcomes Effect sizes of the time × group interactions were small to medium, and most benefits were maintained over 12 months of follow-up Conclusions This study is the first and largest to demonstrate sustained benefits of MBCR in distressed breast cancer survivors relative to an active control MBCR was superior to SET for improving psychological well-being with lasting benefits over 1 year, suggesting these women gained long-lasting and efficacious tools to cope with cancer Trial Registration Registered on clinicaltrialsgov number NCT00390169, October 2006 Copyright © 2016 John Wiley & Sons, Ltd

118 citations

Journal ArticleDOI
TL;DR: Increased social support was related to more improvement in mood and stress after MBCR compared to support groups, whereas changes in mindfulness were not, which suggests a more important role for social support in enhancing outcomes in MBCr than previously thought.
Abstract: Despite growing evidence in support of mindfulness as an underlying mechanism of mindfulness-based interventions (MBIs), it has been suggested that nonspecific therapeutic factors, such as the experience of social support, may contribute to the positive effects of MBIs. In the present study, we examined whether change in mindfulness and/or social support mediated the effect of Mindfulness-Based Cancer Recovery (MBCR) compared to another active intervention (i.e. Supportive Expressive Group Therapy (SET)), on change in mood disturbance, stress symptoms and quality of life. A secondary analysis was conducted of a multi-site randomized clinical trial investigating the impacts of MBCR and SET on distressed breast cancer survivors (MINDSET). We applied the causal steps approach with bootstrapping to test mediation, using pre- and post-intervention questionnaire data of the participants who were randomised to MBCR (n = 69) or SET (n = 70). MBCR participants improved significantly more on mood disturbance, stress symptoms and social support, but not on quality of life or mindfulness, compared to SET participants. Increased social support partially mediated the impact of MBCR versus SET on mood disturbance and stress symptoms. Because no group differences on mindfulness and quality of life were observed, no mediation analyses were performed on these variables. Findings showed that increased social support was related to more improvement in mood and stress after MBCR compared to support groups, whereas changes in mindfulness were not. This suggests a more important role for social support in enhancing outcomes in MBCR than previously thought.

45 citations

01 Jan 2013
TL;DR: In the largest trial to date, MBCR was superior for improving stress levels, quality of life, and social support for distressed survivors of breast cancer.
Abstract: Purpose To compare the efficacy of the following two empirically supported group interventions to help distressed survivors of breast cancer cope: mindfulness-based cancer recovery (MBCR) and supportive-expressive group therapy (SET). Patients and Methods This multisite, randomized controlled trial assigned 271 distressed survivors of stage I to III breast cancer to MBCR, SET, or a 1-day stress management control condition. MBCR focused on training in mindfulness meditation and gentle yoga, whereas SET focused on emotional expression and group support. Both intervention groups included 18 hours of professional contact. Measures were collected at baseline and after intervention by assessors blind to study condition. Primary outcome measures were mood and diurnal salivary cortisol slopes. Secondary outcomes were stress symptoms, quality of life, and social support. Results Using linear mixed-effects models, in intent-to-treat analyses, cortisol slopes were maintained over time in both SET (P .002) and MBCR (P .011) groups relative to the control group, whose cortisol slopes became flatter. Women in MBCR improved more over time on stress symptoms compared with women in both the SET (P .009) and control (P .024) groups. Per-protocol analyses showed greater improvements in the MBCR group in quality of life compared with the control group (P .005) and in social support compared with the SET group (P .012). Conclusion In the largest trial to date, MBCR was superior for improving stress levels, quality of life, and social support for distressed survivors of breast cancer. Both SET and MBCR also resulted in more normative diurnal cortisol profiles than the control condition. The clinical implications of this finding require further investigation. J Clin Oncol 31:3119-3126. © 2013 by American Society of Clinical Oncology

1 citations


Cited by
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Journal ArticleDOI
TL;DR: The author argues that all 3 variables that assess different aspects of social relationships are associated with health outcomes, that these variables each influence health through different mechanisms, and that associations between these variables and health are not spurious findings attributable to the authors' personalities.
Abstract: The author discusses 3 variables that assess different aspects of social relationships—social support, social integration, and negative interaction. The author argues that all 3 are associated with health outcomes, that these variables each influence health through different mechanisms, and that associations between these variables and health are not spurious findings attributable to our personalities. This argument suggests a broader view of how to intervene in social networks to improve health. This includes facilitating both social integration and social support by creating and nurturing both close (strong) and peripheral (weak) ties within natural social networks and reducing opportunities for negative social interaction. Finally, the author emphasizes the necessity to understand more about who benefits most and least from socialconnectedness interventions.

3,981 citations

Journal Article
TL;DR: Definition: To what extent does the study allow us to draw conclusions about a causal effect between two or more constructs?
Abstract: Definition: To what extent does the study allow us to draw conclusions about a causal effect between two or more constructs? Issues: Selection, maturation, history, mortality, testing, regression towrd the mean, selection by maturation, treatment by mortality, treatment by testing, measured treatment variables Increase: Eliminate the threats, above all do experimental manipulations, random assignment, and counterbalancing.

2,006 citations

Journal ArticleDOI
TL;DR: It is concluded that the existence of social networks means that people's health is interdependent and that health and health care can transcend the individual in ways that patients, doctors, policy makers, and researchers should care about.
Abstract: People are interconnected, and so their health is interconnected. In recognition of this social fact, there has been growing conceptual and empirical attention over the past decade to the impact of social networks on health. This article reviews prominent findings from this literature. After drawing a distinction between social network studies and social support studies, we explore current research on dyadic and supradyadic network influences on health, highlighting findings from both egocentric and sociocentric analyses. We then discuss the policy implications of this body of work, as well as future research directions. We conclude that the existence of social networks means that people's health is interdependent and that health and health care can transcend the individual in ways that patients, doctors, policy makers, and researchers should care about.

1,297 citations

Journal ArticleDOI
TL;DR: The evidence that various cellular and molecular immunological factors are compromised in chronic stress and depression is overviewed and the clinical implications of these factors in the initiation and progression of cancer are discussed.
Abstract: The links between the psychological and physiological features of cancer risk and progression have been studied through psychoneuroimmunology. The persistent activation of the hypothalamic-pituitary-adrenal (HPA) axis in the chronic stress response and in depression probably impairs the immune response and contributes to the development and progression of some types of cancer. Here, we overview the evidence that various cellular and molecular immunological factors are compromised in chronic stress and depression and discuss the clinical implications of these factors in the initiation and progression of cancer. The consecutive stages of the multistep immune reactions are either inhibited or enhanced as a result of previous or parallel stress experiences, depending on the type and intensity of the stressor and on the animal species, strain, sex, or age. In general, both stressors and depression are associated with the decreased cytotoxic T-cell and natural-killer-cell activities that affect processes such as immune surveillance of tumours, and with the events that modulate development and accumulation of somatic mutations and genomic instability. A better understanding of the bidirectional communication between the neuroendocrine and immune systems could contribute to new clinical and treatment strategies.

1,100 citations

Journal ArticleDOI
TL;DR: A growing body of evidence suggests that biological mechanisms underlie a bidirectional link between mood disorders and many medical illnesses and there is evidence to suggest that mood disorders affect the course of medical illnesses.

992 citations