Exploring the effects of Acceptance and Commitment Therapy (ACT) on biomarkers of stress in breast cancer survivors

Gardner, Catherine Maree (2018) Exploring the effects of Acceptance and Commitment Therapy (ACT) on biomarkers of stress in breast cancer survivors. Honours thesis, University of Southern Queensland. (Unpublished)

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Breast cancer is the most commonly diagnosed cancer in Australian women, with advances in detection and treatment of breast cancer there is a current overall five-year survival rate of approximately 90%. For some individual breast cancer survivors, survival is associated with psychological and physiological stressors that can negatively affect well-being and quality of life as well as have a further adverse impact on long-term survival. These stressors can affect the body’s physiological stress response system, causing allostatic load (AL) and dysregulations that may be associated with symptoms such as fatigue, depression, anxiety, hypertension, and inflammation. AL is a multisystem approach to measure the cumulative negative effects that stress has on the body’s systems and overall health. Psychological and physiological stress is also associated with accelerated cellular aging and chromosome instability caused by telomere attrition. These cellular deficits can lead to an increased risk for the development of other diseases such as cardiovascular disease, diabetes and cancer recurrence.
Recent research has provided evidence that mindfulness-based psychological interventions that have been developed to meet the needs of breast cancer survivors can improve their psychological well-being and quality of life. Furthermore, other research has demonstrated that these interventions can lead to a reduction in physiological stress biomarkers. Physiological stress biomarkers indicate the activity of the stress response system, therefore a reduction subsequent to participation in a psychological intervention may indicate clinical health benefits.
The aim of this pilot study was to examine the effects of Acceptance and Commitment Therapy (ACT), a psychological treatment that incorporates acceptance and mindfulness strategies, on physiological and molecular biomarkers of stress and AL in breast cancer survivors. Breast cancer survivors, who had completed primary breast cancer treatment in the previous two years, were randomly allocated into three groups. Two groups attended ninety minutes of either a group-based ACT (Group 1) or Breast Cancer Education (BCE) program (Group 2) for six weeks; these two groups then crossed-over to the other intervention for a further six weeks. The third group (Group 3) was waitlisted for the first six weeks and then attended the ACT program for the subsequent six weeks. Physiological and molecular biomarkers of stress: heart rate, blood pressure, fasting blood glucose, telomere length, interleukin-6, cortisol and salivary alpha-amylase, were assessed before and after each intervention or wait-list, with a fourth measurement time point at six months after completion of the interventions. Six of these biomarkers were used to calculate the change in AL for each participant in response to the ACT intervention.
The study identified a significant reduction in cumulative allostatic load in Group 3 participants following the ACT intervention, but AL was increased in Groups 1 and 2. The study did not identify a statistically significant reduction in any individual biomarker from pre- to post-6 week ACT intervention for any group however, a reduction in blood pressure in Group 1 participants after 12 weeks (ACT and BCE) was evident. These results suggest that the current ACT intervention could drive improvements in AL, but the effects are highly variable. It may be that a longer intervention is required before a change in physiological and molecular biomarkers becomes measurable. Alternatively, it is plausible that the majority of participants in this study were not under substantial stress at the beginning of the trial and therefore their stress biomarkers were not elevated and had no potential to improve. A future trial could specifically recruit participants with elevated stress biomarkers.

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Item Type: Thesis (Non-Research) (Honours)
Item Status: Live Archive
Faculty/School / Institute/Centre: Historic - Faculty of Health, Engineering and Sciences - School of Health and Wellbeing (1 Jan 2015 - 31 Dec 2021)
Supervisors: Whiteside, Eliza; Kauter, Kate; King, Rachel
Qualification: Bachelor of Science (Honours)
Date Deposited: 05 Mar 2019 23:37
Last Modified: 27 Jun 2023 04:31
Uncontrolled Keywords: allostasis; allostatic load; acceptance and commitment therapy; stress biomarkers; relative telomere length; salivary cortisol; salivary alpha-amylase; cytokines; interleukin-6
Fields of Research (2008): 11 Medical and Health Sciences > 1101 Medical Biochemistry and Metabolomics > 110199 Medical Biochemistry and Metabolomics not elsewhere classified
Fields of Research (2020): 32 BIOMEDICAL AND CLINICAL SCIENCES > 3205 Medical biochemistry and metabolomics > 320599 Medical biochemistry and metabolomics not elsewhere classified
Socio-Economic Objectives (2008): E Expanding Knowledge > 97 Expanding Knowledge > 970111 Expanding Knowledge in the Medical and Health Sciences
URI: https://sear.unisq.edu.au/id/eprint/35883

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