Active and Passive Coping Strategies: Comparing Psychological Distress, Cortisol, and Proinflammatory Cytokine Levels in Breast Cancer Survivors

Abstract

Background: Breast cancer survivors can suffer psychological distress, such as anxiety and depressive symptoms, long after the treatment has ended, and the development of such negative affective states has been related to the coping strategy used by the subject. Additionally, coping strategies can affect the immune and endocrine systems, which are linked in turn to the onset of anxiety and depressive symptoms. Objectives: This pilot study aims to determine whether different coping strategies are associated with differences in psychological distress, cortisol and TNF-α in breast cancer survivors. Methods: Fifty-four breast cancer survivors completed the Stress Coping Questionnaire and the Hospital Anxiety and Depression Scale, and provided a blood sample for cortisol and proinflammatory cytokine measures. Findings: Passive coping strategy were associated with higher psychological distress, cortisol and TNF-α levels. Given that the coping style is a modifiable risk factor that influences a range of biological factors and health outcomes, it must be a target variable in preventive strategies and therapeutics.