Stress Reactivity Among African American Breast Cancer Survivors

Dysregulation of the HPA has been suggested as a mechanism through which social and
biological factors contribute to racial disparities in breast cancer outcomes.The HPA axis
plays a central role in regulating the physiological stress response;a prolonged and elevated
glucocorticoid (GC) response following a social stressor predicts tumor growth rates and the
development of mammary cancer in rats that histologically and etiologically resembles human
disease.Many African Americans experience stressful life events and circumstances, including
economic, discriminatory, and other stressors. These psychosocial factors may contribute to
an increased risk of advanced stage breast cancer among African American women, but not all
African American women who are exposed to adverse psychosocial and social stressors develop
advanced stage breast cancer and African American women who have a limited number of
stressors also develop advanced stage breast cancer, regardless of early detection. This may
be because stress reactivity, or one's physiological and psychological responses to a
stressor, is highly individualized and dependent on psychological and social determinants.
However, empirical data are not available on stress reactivity among African American breast
cancer survivors and how these reactions vary among women based on their exposure to chronic
stressors and psychological characteristics. Empirical data are also lacking on the
association between stress reactivity and cancer control behaviors among African American
breast cancer survivors even though prior studies have shown that these women are less likely
than whites to engage in health behaviors that are important to cancer control and research
is now being conducted to understand how stress affects these behaviors.This research is
testing the hypothesis that stress: (1) promotes temporal discounting; (2) has an adverse
effect on self-efficacy, and (3) reduces executive functioning (e.g., goal setting,
planning). However, stress reactivity, and the association between these responses and cancer
control behaviors (e.g., diet, physical activity, and treatment compliance), have not been
examined among African American breast cancer survivors. Prior studies have shown that
African Americans have a dysregulated stress response as a result of persistent exposure to
chronic and acute and stressors; this may alter stress responses and lead to high levels of
allostatic load. In order to develop effective behavioral interventions for African American
breast cancer survivors, an important first step is to verify that the mechanisms (e.g.,
temporal discounting, self-efficacy) involved in health behaviors for cancer control (e.g.,
diet, physical activity, treatment compliance) are associated with stress reactivity among
these women. Therefore this study will characterize stress reactivity among African American
breast cancer survivors and validate the association between these responses and targeted
mechanisms of behavior change.

Inclusion Criteria:

- Self-identify as African American or Black women

- Histologically confirmed stage of I, II, or IIIa breast cancer.

- Between the ages of 21-75 at diagnosis

- Have been diagnosed within the last 5 years

Exclusion Criteria:

- Women who are not African American or Black

- Diagnosed with a later stage of breast cancer

- Not within the defined treatment parameters