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Psychosomatic Medicine 62:337-345 (2000)
© 2000 American Psychosomatic Society


ORIGINAL ARTICLES

Social Support and Salivary Cortisol in Women With Metastatic Breast Cancer

Julie M. Turner-Cobb, PhD, Sandra E. Sephton, PhD, Cheryl Koopman, PhD, Jane Blake-Mortimer, PhD and David Spiegel, MD

From the Department of Psychiatry and Behavioral Sciences (J.M.T.-C., S.E.S., C.K., J.B.-M., D.S.), Stanford University School of Medicine, Stanford, CA; and Department of Psychology (J.B.-M.), University of Adelaide, Adelaide, South Australia, Australia. Current affiliations: Centre for Research in Health Behaviour (J.M.T.-C.), Department of Psychology, University of Kent at Canterbury, Canterbury, Kent, United Kingdom; and Department of Psychiatry (S.E.S.), University of Louisville School of Medicine, Louisville, KY.

Address reprint requests to: Julie M. Turner-Cobb, Centre for Research in Health Behaviour, Department of Psychology, University of Kent at Canterbury, Canterbury, Kent CT2 7LZ, United Kingdom. Email: J.M.Turner-Cobb{at}ukc.ac.uk

OBJECTIVE: This study used a cross-sectional design to examine the relationships between social support, both quantity (number of people) and quality (appraisal, belonging, tangible, and self-esteem), and neuroendocrine function (mean and slope of diurnal salivary cortisol) among women with metastatic breast cancer.

METHODS: Participants (

N = 103) were drawn from a study (N = 125) of the effects of group therapy on emotional adjustment and health in women with metastatic breast cancer. They completed the Interpersonal Support Evaluation List and the Yale Social Support Index and provided saliva samples for assessment of diurnal cortisol levels on each of 3 consecutive days. Diurnal mean levels were calculated using log-transformed cortisol concentrations, and the slope of diurnal cortisol variation was calculated by regression of log-transformed cortisol concentrations on sample collection time.

RESULTS: Mean salivary cortisol was negatively related to the Interpersonal Support Evaluation List subscales of appraisal, belonging, and tangible social support. No association was found between quantitative support or the esteem subscale of the Interpersonal Support Evaluation List and mean salivary cortisol. Measures of qualitative and quantitative social support were not associated with the diurnal cortisol slope.

CONCLUSIONS: Results show that greater quality of social support is associated with lower cortisol concentrations in women with metastatic breast cancer, which is indicative of healthier neuroendocrine functioning. These results may have clinical implications in the treatment of breast cancer.

Key Words: social support • cortisol • breast cancer

Abbreviations: HPA = hypothalamic-pituitary-adrenal (axis); ISEL =Interpersonal Support Evaluation List.




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