Reducing body image-related distress in women with breast cancer using a structured online writing exercise: results from the my changed body randomized controlled trial

Kerry A. Sherman, Astrid Przezdziecki, Jessica Alcorso, Christopher Jon Kilby, Elisabeth Elder, John Boyages, Louise Koelmeyer, Helen Mackie

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Purpose Breast cancer treatment adverse effects result in one in three survivors experiencing body image-related distress (BID) that negatively impacts on a woman's ability to recover after cancer and into survivorship. My Changed Body (MyCB) is a Web-based psychological intervention to alleviate BID and improve body appreciation in survivors of breast cancer (BCSs) through a single-session, self-compassion focused writing activity. This randomized controlled trial evaluated the impact of MyCB on BID and body appreciation in BCSs. The moderating effect of lymphedema status (affected or unaffected) and appearance investment (self-importance placed on personal appearance) and the mediating effect of self-compassion were evaluated. Patients and Methods Women (disease-free stage I to III BCSs who had experienced at least one negative event related to bodily changes after breast cancer) were randomly assigned to MyCB (n = 149) or an expressive writing control arm (n = 155). Primary outcomes were reduction in BID and improvement in body appreciation 1 week after intervention. Secondary outcomes included psychological distress (depression and anxiety) and self-compassion. Follow-up assessments occurred 1 week, 1 month, and 3 months after writing. Results Compliance with the MyCB intervention was 88%, and attrition was 9.2%. Intent-to-treat linear mixed models indicated that participants who received MyCB reported significantly less BID (P = .035) and greater body appreciation (P = .004) and self-compassion (P , .001) than expressive writing participants. Intervention effects on BID were moderated by lymphedema status (P = .007) and appearance investment (P = .042). Self-compassion mediated effects on both primary outcomes. Therapeutic effects were maintained at 1 month (BID and body appreciation) and 3 months (body appreciation) after intervention. Significant reductions in psychological distress (1-month depression, P = .001; 1-week and 1-month anxiety, P = .007) were evident for MyCB participants with lymphedema. Conclusion This study supports the efficacy of MyCB for reducing BID and enhancing body appreciation among BCSs.

LanguageEnglish
Pages1930-1940
Number of pages11
JournalJournal of Clinical Oncology
Volume36
Issue number19
DOIs
Publication statusPublished - 1 Jul 2018

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Body Image
Randomized Controlled Trials
Exercise
Breast Neoplasms
Lymphedema
Psychology
Survivors
Anxiety
Depression
Aptitude
Therapeutic Uses
Linear Models
Survival Rate

Bibliographical note

© 2018 by American Society of Clinical Oncology. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Cite this

@article{6137c78118054c24b67eab19e8f6287d,
title = "Reducing body image-related distress in women with breast cancer using a structured online writing exercise: results from the my changed body randomized controlled trial",
abstract = "Purpose Breast cancer treatment adverse effects result in one in three survivors experiencing body image-related distress (BID) that negatively impacts on a woman's ability to recover after cancer and into survivorship. My Changed Body (MyCB) is a Web-based psychological intervention to alleviate BID and improve body appreciation in survivors of breast cancer (BCSs) through a single-session, self-compassion focused writing activity. This randomized controlled trial evaluated the impact of MyCB on BID and body appreciation in BCSs. The moderating effect of lymphedema status (affected or unaffected) and appearance investment (self-importance placed on personal appearance) and the mediating effect of self-compassion were evaluated. Patients and Methods Women (disease-free stage I to III BCSs who had experienced at least one negative event related to bodily changes after breast cancer) were randomly assigned to MyCB (n = 149) or an expressive writing control arm (n = 155). Primary outcomes were reduction in BID and improvement in body appreciation 1 week after intervention. Secondary outcomes included psychological distress (depression and anxiety) and self-compassion. Follow-up assessments occurred 1 week, 1 month, and 3 months after writing. Results Compliance with the MyCB intervention was 88{\%}, and attrition was 9.2{\%}. Intent-to-treat linear mixed models indicated that participants who received MyCB reported significantly less BID (P = .035) and greater body appreciation (P = .004) and self-compassion (P , .001) than expressive writing participants. Intervention effects on BID were moderated by lymphedema status (P = .007) and appearance investment (P = .042). Self-compassion mediated effects on both primary outcomes. Therapeutic effects were maintained at 1 month (BID and body appreciation) and 3 months (body appreciation) after intervention. Significant reductions in psychological distress (1-month depression, P = .001; 1-week and 1-month anxiety, P = .007) were evident for MyCB participants with lymphedema. Conclusion This study supports the efficacy of MyCB for reducing BID and enhancing body appreciation among BCSs.",
author = "Sherman, {Kerry A.} and Astrid Przezdziecki and Jessica Alcorso and {Jon Kilby}, Christopher and Elisabeth Elder and John Boyages and Louise Koelmeyer and Helen Mackie",
note = "{\circledC} 2018 by American Society of Clinical Oncology. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.",
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Reducing body image-related distress in women with breast cancer using a structured online writing exercise : results from the my changed body randomized controlled trial. / Sherman, Kerry A.; Przezdziecki, Astrid; Alcorso, Jessica; Jon Kilby, Christopher; Elder, Elisabeth; Boyages, John; Koelmeyer, Louise; Mackie, Helen.

In: Journal of Clinical Oncology, Vol. 36, No. 19, 01.07.2018, p. 1930-1940.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Reducing body image-related distress in women with breast cancer using a structured online writing exercise

T2 - Journal of Clinical Oncology

AU - Sherman, Kerry A.

AU - Przezdziecki, Astrid

AU - Alcorso, Jessica

AU - Jon Kilby, Christopher

AU - Elder, Elisabeth

AU - Boyages, John

AU - Koelmeyer, Louise

AU - Mackie, Helen

N1 - © 2018 by American Society of Clinical Oncology. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

PY - 2018/7/1

Y1 - 2018/7/1

N2 - Purpose Breast cancer treatment adverse effects result in one in three survivors experiencing body image-related distress (BID) that negatively impacts on a woman's ability to recover after cancer and into survivorship. My Changed Body (MyCB) is a Web-based psychological intervention to alleviate BID and improve body appreciation in survivors of breast cancer (BCSs) through a single-session, self-compassion focused writing activity. This randomized controlled trial evaluated the impact of MyCB on BID and body appreciation in BCSs. The moderating effect of lymphedema status (affected or unaffected) and appearance investment (self-importance placed on personal appearance) and the mediating effect of self-compassion were evaluated. Patients and Methods Women (disease-free stage I to III BCSs who had experienced at least one negative event related to bodily changes after breast cancer) were randomly assigned to MyCB (n = 149) or an expressive writing control arm (n = 155). Primary outcomes were reduction in BID and improvement in body appreciation 1 week after intervention. Secondary outcomes included psychological distress (depression and anxiety) and self-compassion. Follow-up assessments occurred 1 week, 1 month, and 3 months after writing. Results Compliance with the MyCB intervention was 88%, and attrition was 9.2%. Intent-to-treat linear mixed models indicated that participants who received MyCB reported significantly less BID (P = .035) and greater body appreciation (P = .004) and self-compassion (P , .001) than expressive writing participants. Intervention effects on BID were moderated by lymphedema status (P = .007) and appearance investment (P = .042). Self-compassion mediated effects on both primary outcomes. Therapeutic effects were maintained at 1 month (BID and body appreciation) and 3 months (body appreciation) after intervention. Significant reductions in psychological distress (1-month depression, P = .001; 1-week and 1-month anxiety, P = .007) were evident for MyCB participants with lymphedema. Conclusion This study supports the efficacy of MyCB for reducing BID and enhancing body appreciation among BCSs.

AB - Purpose Breast cancer treatment adverse effects result in one in three survivors experiencing body image-related distress (BID) that negatively impacts on a woman's ability to recover after cancer and into survivorship. My Changed Body (MyCB) is a Web-based psychological intervention to alleviate BID and improve body appreciation in survivors of breast cancer (BCSs) through a single-session, self-compassion focused writing activity. This randomized controlled trial evaluated the impact of MyCB on BID and body appreciation in BCSs. The moderating effect of lymphedema status (affected or unaffected) and appearance investment (self-importance placed on personal appearance) and the mediating effect of self-compassion were evaluated. Patients and Methods Women (disease-free stage I to III BCSs who had experienced at least one negative event related to bodily changes after breast cancer) were randomly assigned to MyCB (n = 149) or an expressive writing control arm (n = 155). Primary outcomes were reduction in BID and improvement in body appreciation 1 week after intervention. Secondary outcomes included psychological distress (depression and anxiety) and self-compassion. Follow-up assessments occurred 1 week, 1 month, and 3 months after writing. Results Compliance with the MyCB intervention was 88%, and attrition was 9.2%. Intent-to-treat linear mixed models indicated that participants who received MyCB reported significantly less BID (P = .035) and greater body appreciation (P = .004) and self-compassion (P , .001) than expressive writing participants. Intervention effects on BID were moderated by lymphedema status (P = .007) and appearance investment (P = .042). Self-compassion mediated effects on both primary outcomes. Therapeutic effects were maintained at 1 month (BID and body appreciation) and 3 months (body appreciation) after intervention. Significant reductions in psychological distress (1-month depression, P = .001; 1-week and 1-month anxiety, P = .007) were evident for MyCB participants with lymphedema. Conclusion This study supports the efficacy of MyCB for reducing BID and enhancing body appreciation among BCSs.

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