Psychophysiological stress response of newly-diagnosed breast cancer patients with and without risk of metabolic syndrome

Veronica Neri-Flores, Juan Alejandro Torres-Domínguez, Alejandro Mohar-Betancourt, María Dolores Rodríguez-Ortiz, Andrea Castro-Sánchez, Carmen Lizette Gálvez-Hernández

DOI: https://doi.org/10.17711/SM.0185-3325.2019.015

Abstract


Introduction. Little is known about how metabolic comorbidity affects stress response during breast cancer (BRCa) after a recent diagnosis.

Objective. To evaluate the physiological and psychological differences between the BRCa-RSxM groups and those with BRCa alone, and the influence of psychological variables and comorbidity in terms of stress response.

Method. Comparative non-experimental causal-descriptive study. Fifty patients recently diagnosed with BRCa (25 with BRCa and 25 with BRCa-RSxM) in a convenience sample participated. Frontal muscle activity and skin conductance were recorded in response to stressful conditions. Quality of life, perceived stress, and coping strategies scales were used.

Results. The presence of comorbidity (p = .001; p = .02), perceived stress (p = .004; p = .03), and social quality of life (p = .01; p = .01) influenced muscle activation and conductance during the emotional stressor (ES). Putting the stressful situation into perspective as a cognitive coping strategy was related to a decrease in activation (p = .04). An increase in physiological activation during the cognitive stressor (CS) was influenced by comorbidity (p = .05) and quality of social life (p = .01; p = .01). In turn, a decrease was influenced by the increase in age (p = .02).

Discussion. Physiological vulnerability, coping strategies (behavioral and cognitive), and prior learning influenced the resulting reaction during the stressful situation.

Conclusion. A metabolic disease, as a prelude to an oncological, may cause physiological vulnerability to respond adequately to stressful conditions.

Keywords


Breast cancer; comorbidity; stress; psychophysiology; clinical psychology

Full Text:

HTML Pdf ePub

References


Aaronson, N. K., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A., Duez, N. J. et al. (1993). The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in Oncology. Journal of the National Cancer Institute, 85(5), 365-376. doi: 10.1093/jnci/85.5.365

Andreassi, J. L. (2007). Psychophysiology: Human behavior and physiological response. Hillsdale, New Jersey: Lawrence Erlbaum.

Arena, J. & Schwartz, M. (2003). Psychophysiological Assessment and Biofeedback Baselines. A Primer. In: Schwartz, M. & Andrasik, F. (Ed.), Biofeedback. A Practitioner’s Guide. New York: The Guilford Press. p 128-158.

Becerril, M., Camacho, N., & Canabal, M. C. (2013). Afrontamiento del estrés percibido en mujeres con diagnóstico de cáncer de mama. (Tesis de pregrado). UNAM, Ciudad de México, México.

Bower, J., Ganz, P., & Aziz, N. (2005). Altered cortisol response to psychologic stress in breast cancer survivors with persistent fatigue. Psychosomatic Medicine, 67(2), 277-280. doi: 10.1097/01.psy.0000155666.55034.c6

Cerezo, O., Oñate-Ocaña, L. F., Arrieta-Joffe, P., González-Lara, F., García-Pasquel, M. J., Bargalló-Rocha, E. et al. (2012). Validation of the Mexican-Spanish version of the EORTC QLQ-C30 and BR23 questionnaires to assess health-related quality of life in Mexican women with breast cancer. European Journal of Cancer Care, 21(5), 684-691. doi: 10.1111/j.1365-2354.2012.01336.x

Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385-396. doi: 10.2307/2136404

Compas, B. E., Orosan, P. G. & Grant, K. E. (1993). Adolescent stress and coping: implications for psychopathology during adolescence. Journal of Adolescence, 16(3), 331-349. doi: 10.1006/jado.1993.1028

Cram, J., Kasman, G., & Holtz, J. (2011). Electrode Placements. In: Criswell, E. (Ed.). Cram´s Introduction to Surface Electromyography. Massachusetts: Jones and Bartlett Publishers. p 257-383.

Dawson, M., Schell, A., & Filion D. (2007). The Electrodermal System. In: Cacioppo, J., Tassinary, L., & Berntson, G. (Ed.), Handbook of Psychophysiology. New York: Cambridge University Press. p 159-181.

De Haro-Rodríguez, M. A., Gallardo-Vidal, L. S., Martínez-Martínez, M. L., Camacho-Calderón, N., Velázquez-Tlapanco, J., & Paredes-Hernández, E. (2014). Factores relacionados con las diferentes estrategias de afrontamiento al cáncer de mama en pacientes de recién diagnóstico. Psicooncología, 11(1), 87-99. doi: 10.5209/rev_PSIC.2014.v11.n1.44919

Delgado, L. (2010). El nivel de estrés y estilo de vida de pacientes con hipertensión arterial. (Tesis de pregrado). Universidad Don Vasco A. C., Michoacán, México.

Dubovsky, S. (1985). The Psychophysiology of Health, Illness, and Stress. In: Simons, R. (Ed.), Understanding Human Behavior in Health and Illness. Baltimore: Williams & Wilkins. p 90-100.

Engineering, J & J. (2004). I-330-C2+ Hardware and Software Guide. Washingtong, USA: J+J Engineering Incorporated.

Esler, M., Rumantir, M., Kaye, D., Jennings, G., Hastings, J., Socratous, F. et al. (2001). Sympathetic nerve biology in essential hypertension. Clinical and Experimental Pharmacology and Physiology, 28(12), 986-989. doi: 10.1046/j.1440-1681.2001.03566.x

Fayers, P. M., Aaronson, N. K., Bjordal, K., Groenvold, M., Curran, D., Bottomley, A et al. (2001). The EORTC QLQ-C30 Scoring Manual. Third edition. Brussels: European Organization for Research and Treatment of Cancer.

Fredrikson, M., Dimberg, U., Frisk-Holmberg, M., & Ström, G. (1982). Haemodynamic and electrodermal correlates of psychogenic stimuli in hypertensive and normotensive subjects. Biological Psychology, 15(1-2), 63-73. doi: 10.1016/0301-0511(82)90031-X

Gálvez Hernández, C. L., Rivera-Fong, L., Linares-Buitrón, A. V., Zapata-Barrera, S., Mohar-Betancourt, A., Calleja-Bello, N. et al. (2018). Validación del Cuestionario de Regulación Emocional Cognitiva (CERQ) en pacientes mexicanas con cáncer de mama. Salud Pública de México, 60(5), 488-489. doi: 10.21149/9191

Garafova, A., Penesova, A., Cizmarova, E., Marko, A., Vlcek, M., & Jezova, D. (2014). Cardiovascular and sympathetic responses to a mental stress task in young patients with hypertension and/or obesity. Physiological Research, 63(Supl 4), S459-467.

Garnefski, N., Kraaij, V., & Spinhoven, P. (2002). Manual for the use of the Cognitive Emotion Regulation Questionnaire. Leiderdorp, Netherlands: DATEC.

Giese-Davis, J., Conrad, A., Nouriani, B., & Spiegel, D. (2008). Exploring emotion-regulation and autonomic physiology in metastatic breast cancer patients: Repression, suppression, and restraint of hostility. Personality and Individual Differences, 44(1), 226-237. doi: 10.1016/j.paid.2007.08.002

GLOBOCAN. (2012). Breast–Estimated mortality, all ages. Retrieved from: http://globocan.iarc.fr/old/summary_table_site-html.asp?selection=3152&title=Breast&sex=2&type=1&window=1&america=2&sort=0&submit=%C2%A0Execute%C2%A0

González Ramírez, M. T. & Landero Hernández, R. (2007). Factor structure of the Perceived Stress Scale (SSP) in a sample from México. The Spanish Journal of Psychology, 10(1), 199-206.

Hernández Moreno, F. (2012). Estudio comparativo de variables psicosociales relacionadas con la calidad de vida en mujeres con cáncer de mama. (Tesis de maestría). Ciudad de México, México: UNAM. http://cdigital.dgb.uanl.mx/te/1080224777.PDF

Karvinen, K., Murray, N., Arastu, H., & Allison, R. (2013). Stress reactivity, health behaviors, and compliance to medical care in breast cancer survivors. Oncology Nursing Forum, 40(2), 149-156. doi: 10.1188/13.ONF.149-156

Kaushik, R. M., Mahajan, S. K., Rajesh, V. & Kaushik, R. (2004). Stress profile in essential hypertension. Hypertension Research, 27(9), 619-624.

Khazan, I. (2013). The Clinical Handbook of Biofeedback. A Step-by-Step Guide for Training and Practice with Mindfulness. First edition. Oxford, Reino Unido: Wiley-BlackWell.

Kirk, S. F., Price, S. L., Penney, T. L., Rehman, L., Lyons, R. F., Piccinini-Vallis, H. et al. (2014). Blame, shame, and lack of support: A multilevel study on obesity management. Qualitative Health Research, 24(6), 790-800. doi: 10.1177/1049732314529667

Knaul, F. M., López-Carrillo, L., Lazcano-Ponce, E., Gómez-Dantés H, Romieu I, Torres G. (2009). Cáncer de mama: un reto para la sociedad y los sistemas de salud. Salud Pública de México, 51(2), 138-140.

Lebel, S., Rosberger, Z., Edgar, L., & Devins, G. M. (2007). Comparison of four common stressors across the breast cancer trajectory. Journal of Psychosomatic Research, 63(3), 225-232. doi: 10.1016/j.jpsychores.2007.02.002

Li, L., Zhu, X., Yang, Y., He, J., Yi, J., Wang, Y. et al. (2015). Cognitive emotion regulation: Characteristics and effect on quality of life in women with breast cancer. Health and Quality of Life Outcomes, 13:51.

Lifshitz, G. A. (2016). Sobre la comorbilidad. Acta Médica Grupo Ángeles, 14(2), 61-62.

Mohar, A., Reynoso, N., Villareal-Garza, C., Bargalló-Rocha, J. E., Arce-Salinas, C., & Lara-Medina, F. (2015). Cáncer de mama en el Instituto Nacional de Cancerología. Experiencia del Seguro Popular 2007-2013. Revista Mexicana de Mastología, 5(1), 6-11.

National Institute on Drug Abuse. (2017). La comorbilidad. Retrieved from https://www.drugabuse.gov/es/temas-relacionados/la-comorbilidad

Oñate-Ocaña, L. F., Alcántara-Pilar, A., Vilar-Compte, D., García-Hubard, G., Rojas-Castillo, E., Alvarado-Aguilar, S. et al. (2009). Validation of the Mexican Spanish version of the EORTC C30 and STO22 questionnaires for the evaluation of health-related quality of life in patients with gastric cancer. Annals of Surgical Oncology, 16(1), 88-95. doi: 10.1245/s10434-008-0175-9

Pasquali, R., Anconetani, B., Chattat, R., Biscotti, M., Spinucci, G., Casimirri, F. et al. (1996). Hypothalamic-pituitary-adrenal axis activity and its relationship to the autonomic nervous system in women with visceral and subcutaneous obesity: Effects of the corticotropin-releasing factor/arginine-vasopressin test and of stress. Metabolism, 45(3), 351-356.

Pitman, R. K., Lanes, D. M., Williston, S. K., Guillaume, J. L., Metzger, L. J., Gehr, G. M. et al. (2001). Psychophysiological assessment of posttraumatic stress disorder in breast cancer patients. Psychosomatics, 42(2), 133-140. doi: 10.1176/appi.psy.42.2.133

Ramírez, M. A. (2005). Estresores y nivel de estrés en el paciente con Hipertensión Arterial Esencial. (Tesis de posgrado). Ciudad de México, México: UNAM.

Sandín, B. (1995). El estrés. In: Belloch, A., Sandín, B., & Ramos, F. (Ed.). Manual de psicopatología. Madrid: McGraw-Hill. p 3-52.

Sat-Muñoz, D., Contreras-Hernández, I., Balderas-Peña, L. M., Hernández-Chávez, G. A., Solano-Murillo, P., Mariscal-Ramírez, I. et al. (2011). Calidad de vida en mujeres mexicanas con cáncer de mama en diferentes etapas clínicas y su asociación con características socio-demográficas, estados co-mórbidos y características del proceso de atención en el Instituto Mexicano del Seguro Social. Value in Health, 14(5 Supl), S133-S136. doi: 10.1016/j.jval.2011.05.027

Schunk, M., Reitmeir, P., Schipf, S., Völzke, H., Meisinger, C., Ladwig, K. et al. (2015). Health-related quality of life in women and men with type 2 diabetes: a comparison across treatment groups. Journal of Diabetes and its Complications, 29(2), 203-211. doi: 10.1016/j.jdiacomp.2014.11.010

Sprangers, M. A., Groenvold, M., Arraras, J. I., Franklin, J., te Velde, A., Muller, M. et al. (1996). The European Organization for Research and Treatment of Cancer breast cancer-specific quality-of-life questionnaire module: First results from a three-country field study. Journal of Clinical Oncology, 14(10), 2756-2768. doi: 10.1200/JCO.1996.14.10.2756

Stulrajter, V., Scholzova, A., Sleboda, M., Dlhos, M., & Miklanek, A. (1997). Laboratory and field heart-rate measurements as a factor of performance and training state. Studia Psychologica, 39(4), 305-307.

Vicéns, J. & Sánchez, B. (2012). Regresión cuantílica. Estimación y contrastes. Madrid, España: Instituto L. R. Klein-Centro Gauss.

Watson, M., Pettingale, K., & Greer, S. (1984). Emotional control and autonomic arousal in breast cancer patients. Journal of Psychosomatic Research, 28(6), 467-474. doi: 10.1016/0022-3999(84)90080-1