Racial disparities in posttraumatic stress after diagnosis of localized breast cancer: The BQUAL study

Neomi Vin-Raviv, Grace Clarke Hillyer, Dawn L. Hershman, Sandro Galea, Nicole Leoce, Dana H. Bovbjerg, Lawrence H. Kushi, Candyce Kroenke, Lois Lamerato, Christine B. Ambrosone, Heidis Valdimorsdottir, Lina Jandorf, Jeanne S. Mandelblatt, Wei Yann Tsai, Alfred I. Neugut

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Abstract

Background Little is known about the development of posttraumatic stress disorder (PTSD) over time among women diagnosed with breast cancer. This study examines changes in PTSD symptoms in the first 6 months after diagnosis and assesses racial/ethnic differences in PTSD symptomatology over time.MethodsWe recruited women with newly diagnosed breast cancer, stages I to III, from three sites in the United States. Three telephone interviews were conducted: baseline at about 2 to 3 months after diagnosis, first follow-up at 4 months after diagnosis, and second follow-up at 6 months after diagnosis. We measured traumatic stress in each interview using the Impact of Events Scale; recorded sociodemographic, tumor, and treatment factors; and used generalized estimating equations and polytomous logistic regression modeling to examine the associations between variables of interest and PTSD.ResultsOf 1139 participants, 23% reported symptoms consistent with a diagnosis of PTSD at baseline, 16.5% at first follow-up, and 12.6% at the second follow-up. Persistent PTSD was observed among 12.1% participants, as defined by having PTSD at two consecutive interviews. Among participants without PTSD at baseline, 6.6% developed PTSD at the first follow-up interview. Younger age at diagnosis, being black (odds ratio [OR] = 1.48 vs white, 95% confidence interval [CI] =1.04 to 2.10), and being Asian (OR = 1.69 vs white, 95% CI = 1.10 to 2.59) were associated with PTSD.ConclusionsNearly one-quarter of women newly diagnosed with breast cancer reported symptoms consistent with PTSD shortly after diagnosis, with increased risk among black and Asian women. Early identification of PTSD may present an opportunity to provide interventions to manage symptoms.

Original languageEnglish (US)
Pages (from-to)563-572
Number of pages10
JournalJournal of the National Cancer Institute
Volume105
Issue number8
DOIs
StatePublished - Apr 17 2013
Externally publishedYes

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Post-Traumatic Stress Disorders
Breast Neoplasms
Interviews
Odds Ratio
Confidence Intervals
Logistic Models

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Vin-Raviv, N., Hillyer, G. C., Hershman, D. L., Galea, S., Leoce, N., Bovbjerg, D. H., ... Neugut, A. I. (2013). Racial disparities in posttraumatic stress after diagnosis of localized breast cancer: The BQUAL study. Journal of the National Cancer Institute, 105(8), 563-572. https://doi.org/10.1093/jnci/djt024

Racial disparities in posttraumatic stress after diagnosis of localized breast cancer : The BQUAL study. / Vin-Raviv, Neomi; Hillyer, Grace Clarke; Hershman, Dawn L.; Galea, Sandro; Leoce, Nicole; Bovbjerg, Dana H.; Kushi, Lawrence H.; Kroenke, Candyce; Lamerato, Lois; Ambrosone, Christine B.; Valdimorsdottir, Heidis; Jandorf, Lina; Mandelblatt, Jeanne S.; Tsai, Wei Yann; Neugut, Alfred I.

In: Journal of the National Cancer Institute, Vol. 105, No. 8, 17.04.2013, p. 563-572.

Research output: Contribution to journalArticle

Vin-Raviv, N, Hillyer, GC, Hershman, DL, Galea, S, Leoce, N, Bovbjerg, DH, Kushi, LH, Kroenke, C, Lamerato, L, Ambrosone, CB, Valdimorsdottir, H, Jandorf, L, Mandelblatt, JS, Tsai, WY & Neugut, AI 2013, 'Racial disparities in posttraumatic stress after diagnosis of localized breast cancer: The BQUAL study', Journal of the National Cancer Institute, vol. 105, no. 8, pp. 563-572. https://doi.org/10.1093/jnci/djt024
Vin-Raviv, Neomi ; Hillyer, Grace Clarke ; Hershman, Dawn L. ; Galea, Sandro ; Leoce, Nicole ; Bovbjerg, Dana H. ; Kushi, Lawrence H. ; Kroenke, Candyce ; Lamerato, Lois ; Ambrosone, Christine B. ; Valdimorsdottir, Heidis ; Jandorf, Lina ; Mandelblatt, Jeanne S. ; Tsai, Wei Yann ; Neugut, Alfred I. / Racial disparities in posttraumatic stress after diagnosis of localized breast cancer : The BQUAL study. In: Journal of the National Cancer Institute. 2013 ; Vol. 105, No. 8. pp. 563-572.
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title = "Racial disparities in posttraumatic stress after diagnosis of localized breast cancer: The BQUAL study",
abstract = "Background Little is known about the development of posttraumatic stress disorder (PTSD) over time among women diagnosed with breast cancer. This study examines changes in PTSD symptoms in the first 6 months after diagnosis and assesses racial/ethnic differences in PTSD symptomatology over time.MethodsWe recruited women with newly diagnosed breast cancer, stages I to III, from three sites in the United States. Three telephone interviews were conducted: baseline at about 2 to 3 months after diagnosis, first follow-up at 4 months after diagnosis, and second follow-up at 6 months after diagnosis. We measured traumatic stress in each interview using the Impact of Events Scale; recorded sociodemographic, tumor, and treatment factors; and used generalized estimating equations and polytomous logistic regression modeling to examine the associations between variables of interest and PTSD.ResultsOf 1139 participants, 23{\%} reported symptoms consistent with a diagnosis of PTSD at baseline, 16.5{\%} at first follow-up, and 12.6{\%} at the second follow-up. Persistent PTSD was observed among 12.1{\%} participants, as defined by having PTSD at two consecutive interviews. Among participants without PTSD at baseline, 6.6{\%} developed PTSD at the first follow-up interview. Younger age at diagnosis, being black (odds ratio [OR] = 1.48 vs white, 95{\%} confidence interval [CI] =1.04 to 2.10), and being Asian (OR = 1.69 vs white, 95{\%} CI = 1.10 to 2.59) were associated with PTSD.ConclusionsNearly one-quarter of women newly diagnosed with breast cancer reported symptoms consistent with PTSD shortly after diagnosis, with increased risk among black and Asian women. Early identification of PTSD may present an opportunity to provide interventions to manage symptoms.",
author = "Neomi Vin-Raviv and Hillyer, {Grace Clarke} and Hershman, {Dawn L.} and Sandro Galea and Nicole Leoce and Bovbjerg, {Dana H.} and Kushi, {Lawrence H.} and Candyce Kroenke and Lois Lamerato and Ambrosone, {Christine B.} and Heidis Valdimorsdottir and Lina Jandorf and Mandelblatt, {Jeanne S.} and Tsai, {Wei Yann} and Neugut, {Alfred I.}",
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T1 - Racial disparities in posttraumatic stress after diagnosis of localized breast cancer

T2 - The BQUAL study

AU - Vin-Raviv, Neomi

AU - Hillyer, Grace Clarke

AU - Hershman, Dawn L.

AU - Galea, Sandro

AU - Leoce, Nicole

AU - Bovbjerg, Dana H.

AU - Kushi, Lawrence H.

AU - Kroenke, Candyce

AU - Lamerato, Lois

AU - Ambrosone, Christine B.

AU - Valdimorsdottir, Heidis

AU - Jandorf, Lina

AU - Mandelblatt, Jeanne S.

AU - Tsai, Wei Yann

AU - Neugut, Alfred I.

PY - 2013/4/17

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N2 - Background Little is known about the development of posttraumatic stress disorder (PTSD) over time among women diagnosed with breast cancer. This study examines changes in PTSD symptoms in the first 6 months after diagnosis and assesses racial/ethnic differences in PTSD symptomatology over time.MethodsWe recruited women with newly diagnosed breast cancer, stages I to III, from three sites in the United States. Three telephone interviews were conducted: baseline at about 2 to 3 months after diagnosis, first follow-up at 4 months after diagnosis, and second follow-up at 6 months after diagnosis. We measured traumatic stress in each interview using the Impact of Events Scale; recorded sociodemographic, tumor, and treatment factors; and used generalized estimating equations and polytomous logistic regression modeling to examine the associations between variables of interest and PTSD.ResultsOf 1139 participants, 23% reported symptoms consistent with a diagnosis of PTSD at baseline, 16.5% at first follow-up, and 12.6% at the second follow-up. Persistent PTSD was observed among 12.1% participants, as defined by having PTSD at two consecutive interviews. Among participants without PTSD at baseline, 6.6% developed PTSD at the first follow-up interview. Younger age at diagnosis, being black (odds ratio [OR] = 1.48 vs white, 95% confidence interval [CI] =1.04 to 2.10), and being Asian (OR = 1.69 vs white, 95% CI = 1.10 to 2.59) were associated with PTSD.ConclusionsNearly one-quarter of women newly diagnosed with breast cancer reported symptoms consistent with PTSD shortly after diagnosis, with increased risk among black and Asian women. Early identification of PTSD may present an opportunity to provide interventions to manage symptoms.

AB - Background Little is known about the development of posttraumatic stress disorder (PTSD) over time among women diagnosed with breast cancer. This study examines changes in PTSD symptoms in the first 6 months after diagnosis and assesses racial/ethnic differences in PTSD symptomatology over time.MethodsWe recruited women with newly diagnosed breast cancer, stages I to III, from three sites in the United States. Three telephone interviews were conducted: baseline at about 2 to 3 months after diagnosis, first follow-up at 4 months after diagnosis, and second follow-up at 6 months after diagnosis. We measured traumatic stress in each interview using the Impact of Events Scale; recorded sociodemographic, tumor, and treatment factors; and used generalized estimating equations and polytomous logistic regression modeling to examine the associations between variables of interest and PTSD.ResultsOf 1139 participants, 23% reported symptoms consistent with a diagnosis of PTSD at baseline, 16.5% at first follow-up, and 12.6% at the second follow-up. Persistent PTSD was observed among 12.1% participants, as defined by having PTSD at two consecutive interviews. Among participants without PTSD at baseline, 6.6% developed PTSD at the first follow-up interview. Younger age at diagnosis, being black (odds ratio [OR] = 1.48 vs white, 95% confidence interval [CI] =1.04 to 2.10), and being Asian (OR = 1.69 vs white, 95% CI = 1.10 to 2.59) were associated with PTSD.ConclusionsNearly one-quarter of women newly diagnosed with breast cancer reported symptoms consistent with PTSD shortly after diagnosis, with increased risk among black and Asian women. Early identification of PTSD may present an opportunity to provide interventions to manage symptoms.

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