Stress, coping, and circadian disruption among women awaiting breast cancer surgery

Eric Dedert, Elizabeth Lush, Anees Chagpar, Firdaus S. Dhabhar, Suzanne C. Segerstrom, David Spiegel, Ehab Dayyat, Meagan Daup, Kelly McMasters, Sandra E. Sephton

Research output: Contribution to journalArticlepeer-review

51 Scopus citations


Background Psychological distress and coping related to a breast cancer diagnosis can profoundly affect psychological adjustment, possibly resulting in the disruption of circadian rest/ activity and cortisol rhythms, which are prognostic for early mortality inmetastatic colorectal and breast cancers, respectively. Purpose This study aims to explore the relationships of cancer-specific distress and avoidant coping with rest/activity and cortisol rhythmdisruption in the period between diagnosis and breast cancer surgery. Methods Fifty-seven presurgical breast cancer patients provided daily self-reports of cancer-specific distress and avoidant coping as well as actigraphic and salivary cortisol data. Results Distress and avoidant coping were related to rest/ activity rhythm disruption (daytime sedentariness, inconsistent rhythms). Patients with disrupted rest/activity cycles had flattened diurnal cortisol rhythms. Conclusions Maladaptive psychological responses to breast cancer diagnosis were associated with disruption of circadian rest/activity rhythms. Given that circadian cycles regulate tumor growth, we need greater understanding of possible psychosocial effects in cancer-related circadian disruption.

Original languageEnglish
Pages (from-to)10-20
Number of pages11
JournalAnnals of Behavioral Medicine
Issue number1
StatePublished - Aug 2012

Bibliographical note

Funding Information:
Acknowledgments We would like to thank the women who participated in this research despite numerous other time demands. We also thank all of the nursing staff and research assistants who worked on recruitment and data collection and management. This study was funded by the University of Louisville Internal Research Incentive Grant for Research on Women.


  • Actigraphy
  • Breast cancer
  • Circadian rhythm
  • Cortisol
  • Rest/activity
  • Sleep

ASJC Scopus subject areas

  • General Medicine


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