Identifying how and for whom cognitive‐behavioral stress management improves emotional well‐being among recent prostate cancer survivors

Abstract Objective The outcomes of a 10‐week cognitive‐behavioral stress management (CBSM) group intervention were evaluated in prostate cancer survivors. A model was tested in which CBSM‐related improvements in emotional well‐being were attained through changes in men's perceptions of their condition, as conceptualized by information processing explanations of self‐regulation theory. The model also tested whether life stress and treatment‐related side effects moderated intervention effects. Methods Men treated for localized prostate cancer ( n = 257) within the past 18 months were randomized to CBSM or a half‐day psycho‐educational seminar. At pre‐intervention and 12‐week follow‐up, emotional well‐being, illness perceptions, life stress, and sexual and urinary function were assessed using validated questionnaires. Results After controlling for covariates, CBSM participants showed greater improvements in emotional well‐being relative to control participants ( β = 0.13, p < 0.05). For men reporting higher stress upon study entry, CBSM‐related improvements were partially explained by changes in some, but not all, illness perceptions. Sexual and urinary dysfunction did not influence CBSM‐related gains. Conclusions Prostate cancer perceptions may be an important target for enhancing emotional well‐being, particularly for men experiencing general life stress. However, interventions that explicitly target mental representations of cancer may be needed to modify perceptions of the disease. Copyright © 2011 John Wiley & Sons, Ltd.