This was a study conducted by doctoral students at Mercer University in Atlanta, GA. The study discusses the impact of cognitive behavioral therapy on depression and anxiety in breast cancer patients. The presentation was designed by me, Sarah McKagen. (www.sarahmckagen.com)

1. THE IMPACT OF CBT ON
DEPRESSION AND ANXIETY IN
BREAST CANCER
PATIENTS

2. BREAST CANCER
BACKGROUND INFO

3. 50%
Breast cancer patients who experience depression,
anxiety, or both within the first year of diagnosis.

4. The number of women currently living who have
had (or currently have) a diagnosis of breast cancer.
2,747,459

5. 1 in 8 women will receive a breast cancer
diagnosis during their life.

6. CBT INFO
BACKGROUND

7. COGNITIVE BEHAVIORAL THERAPY
An efficacious treatment that can be highly individualized and comes in many
different forms. Psychotherapy involves addressing maladaptive behaviors as well
as their corresponding thoughts. The focus is on the behavioral as well as the
cognitive component in order to better understand how the disease is impacting
the patient.

8. COGNITIVE BEHAVIORAL THERAPY
has been used in nearly every area of mental health as well as some medical
conditions outside of mental health.

9. RATIONALE

10. 1
Because CBT can be custom built for
an individual patient and allows room
for the therapist to use good clinical
judgment in order to treat the patient,
it seems to be an ideal treatment
option for complex diseases that may
not always have the same prognosis
for each patient.

11. 2
Breast cancer, depending on size
of the tumor, stage, current and
previous medical and psychological
conditions, age, overall health, social
support, and numerous other factors,
seems to be a prime example of
a complex medical condition.

12. 3
Evidence has been provided that
CBT alleviates distress and pain
in breast cancer patients.

13. 4
Many patients with breast cancer
develop mental health issues as a
result of their diagnosis and condition,
especially depression and anxiety.
CBT has been shown to be effective
in treating depression and anxiety.

14. QUESTIONS

15. How do other treatment options
factor in?
What specific components of CBT
make it ideal?
What about other psychological
side effects and how to deal with
those?

16. HYPOTHESIS

17. CBT will have a significant decrease
in depression and anxiety in breast
cancer patients.
The CBT group will be superior
to the care-as-usual (CAU) treatment
group in terms of decreased depression
and anxiety symptoms.

18. CAU-SPECIFIC
QUESTIONS
What does CAU typically entail?
Does CAU differ depending on setting?

19. METHOD

20. SETTING
TIME
SAMPLE
Clinic + Hospital
Baseline, 3 months, 6 months and 12 months
18-55 years old; cut off at 55 to control for any
potential cognitive decline
RECRUITMENT Through local oncologist
CBT SESSIONS
1-hour psycho-education session begins with family
members; 1-hour session twice weekly for 8 weeks

21. DESIGN

22. This will be a clinical trial as there will
be two groups – one receiving treatment
and one not receiving treatment. At the
end of the project, the two groups will
be compared for differences.

23. GROUP 1
GROUP 2
This group will consist
of breast care patients
that will be the “control”
group. They will receive
care as usual from their
oncologist and other
health care providers,
but not CBT.
This group will receive
the CBT treatment
previously outlined
as well as CAU.
CAU
CBT

24. RANDOMIZATION
Patients will be randomly divided into either group
by age and number of times receiving diagnosis
as well as prognosis/stage of cancer.

25. INCLUSION CRITERIA
A diagnosis of breast cancer within the past year; cannot
be deemed immediately terminal.

26. EXCLUSION CRITERIA
No other imminent medical or psychological conditions such
as a severe mental illness of chronic condition such as MS,
Lupus, etc. This is to control for internal validity as the other
conditions could be the driving force behind the depression
and/or anxiety.

27. OTHER
QUESTIONS

28. What about current medications, such
as SSRIs?
What about the role of support systems?
How does the role of coping strategies
impact outcome?

29. MEASURES

30. BDI (Beck Depression Inventory) to assess
for depressive symptoms.
!
BAI (Beck Anxiety Inventory) to assess
for anxiety symptoms.
!
Both easy to administer and well-validated
in clinical settings.

31. Initial unstructured interviews by a trained and
licensed psychologist will also be administered
to ensure no underlying psychopathology.
!
An initial medical exam by a physician will also
be conducted.
!
A mixed-model (2 x 3) ANOVA will be conducted.
2 groups: CBT, CAU
3 assessment points: 3, 6, 12 months

32. Q&A

33. THANK YOU.