The focus of this research database is on how stress affects women's health,

and options for treatment using mind-body therapies. 

If you are not a health care professional, see new "Medical Glossary" below.  

To obtain full summaries of the articles, see "How to Get Abstracts" below. 

10435912 R,T

The decision for genetic testing takes into account concerns about insurance liability, family dynamics, and an individual's psychological needs. Limited research suggests it is more beneficial to know than not know one's genetic status.

1999 Int J Fertil Womens Med 44;3:139-45

Frank, T. S. and Braverman, A. M

11536413 JA

In a clinic population of women at increased risk of breast or ovarian cancer, two-thirds of women indicated that perceived worries about cancer interfered with their functioning across a variety of areas in their lives.

2001 Psychooncology 10;5:349-60

Trask, P. C., Paterson, A. G., Wang, C., Hayasaka, S., Milliron, K. J., Blumberg, L. R., Gonzalez, R., Murray, S., and Merajver, S. D.

10805955 JA

Discusses methods to help women make appropriate decisions about cancer genetic testing. Anxiety can interfere with decision-making, and those declining testing can become more depressed than those who are found to be carriers.

2000 Semin Surg Oncol 18;4:333-8

Kash, K. M., Ortega-Verdejo, K., Dabney, M. K., Holland, J. C., Miller, D. G., and Osborne, M. P.

11857010 JA

In women without cancer but at some risk, genetic counseling significantly reduced worry. However, in women who had already had cancer, genetic counseling raised their perception of risk and level of concern; these women need very sensitive counseling.

2002 Br J Cancer 86;1:43-50

Bish, A., Sutton, S., Jacobs, C., Levene, S., Ramirez, A., and Hodgson, S.

11657060 JA

"The risk of psychological distress, family disruption, and non-adherence to surveillance guidelines are likely to be greater when testing is offered in clinical settings that do not provide adequate patient education, genetic counseling, informed consent, and follow-up." One very important possibly overlooked aspect of distress is the implications for parents, siblings and offspring.

1997 Cancer 80;3 Suppl:569-75

Croyle, R. T., Achilles, J. S., and Lerman, C.

11700677 JA

"Gendered patterns of socialization will make women feel that they should take primary responsibility for disclosing genetic information to others." Article raises questions of "who owns genetic information?" and what is the moral duty to disclose information to other family members.

2001 Bioethics 15;3:231-47

d'Agincourt-Canning, L.

10982476 JA

Of French women identified as having positive genetic markers for breast/ovarian cancer, 8.6% would not inform family members, 33.2% would inform at least one of them, and 58.2% would inform all. The sibship would be the most frequently informed blood relatives.

2000 Am J Med Genet 94;1:13-8

Julian-Reynier, C., Eisinger, F., Chabal, F., Lasset, C., Nogues, C., Stoppa-Lyonnet, D., Vennin, P., and Sobol, H.

10794482 JA

Among women who perceived themselves to be at low risk of breast cancer, those with higher levels of spiritual faith were significantly less likely to be genetically tested. If cancer risk perception was high, test use was high regardless of level of faith.

2000 Cancer Epidemiol Biomarkers Prev 9;4:381-5

Schwartz, M. D., Hughes, C., Roth, J., Main, D., Peshkin, B. N., Isaacs, C., Kavanagh, C., and Lerman, C.

10207642 JA

Four groups of women--Caucasian, African-American, lesbian/bisexual and Ashkenazi Jewish all felt similarly in their attitudes toward genetic testing. They would use the results to increase frequency of screening methods, but >80% in all groups rejected the concept of prophylactic surgery.

1999 Cancer Epidemiol Biomarkers Prev 8;4 Pt 2:369-75

Durfy, S. J., Bowen, D. J., McTiernan, A., Sporleder, J., and Burke, W.

11925113 JA

In a survey of over 3,000 women, most women overestimate their risk for ovarian cancer. Some average risk women get unrecommended screening, while a significant percentage of high risk women fail to get screened.

2002 Gynecol Oncol 85;1:3-8

Andersen, M. R., Peacock, S., Nelson, J., Wilson, S., McIntosh, M., Drescher, C., and Urban, N.

11748980 JA

Women attending a familial ovarian cancer clinic who perceived themselves to be at a high risk for ovarian cancer, were five times more likely to be nonadherent to recommended surveillance. This was regardless of what their empirical risk was as conveyed by the clinic team.

2002 Gynecol Oncol 84;1:72-80

Ritvo, P., Irvine, J., Robinson, G., Brown, L., Murphy, K. J., Matthew, A., and Rosen, B.

10593998 JA

In the 6-8 weeks in-between genetic counseling for BRCA1/2 and disclosure of results, the majority of women and their partners did not become any more distressed that the normal population, until the last week. However, about 25% of patients and 10% of their partners experienced increased distress levels throughout the time period.

1999 J Med Genet 36;12:906-13

Lodder, L. N., Frets, P. G., Trijsburg, R. W., Meijers-Heijboer, E. J., Klijn, J. G., Duivenvoorden, H. J., Tibben, A., Wagner, A., van der Meer, C. A., Devilee, P., Cornelisse, C. J., and Niermeijer, M. F.

10896846 JA

Of 216 BRCA1/2 carriers, 3% obtained prophylactic mastectomy and 13% prophylactic oophorectomy during the 1 year follow up to genetic counseling. The majority of the remainder did not adhere to surveillance recommendations.

2000 Prev Med 31;1:75-80

Lerman, C., Hughes, C., Croyle, R. T., Main, D., Durham, C., Snyder, C., Bonney, A., Lynch, J. F., Narod, S. A., and Lynch, H. T.

"Almost all respondents viewed breast cancer as a uniformly progressive disease that begins in a silent curable form (typically found by mammograms) and, unless treated early, invariably grows, spreads, and kills." They gave great prominence to minimally accurate controllable risk factors of smoking , diet, toxic exposure, and "bad attitudes", taking considerable personal responsibility for their level of breast cancer risk, which might lead to self-blame if diagnosed.

2001 Med Decis Making 21;3:231-40

Silverman, E., Woloshin, S., Schwartz, L. M., Byram, S. J., Welch, H. G., and Fischhoff, B.

8489911 JA

Women were more afraid of cancer than men, and men more afraid of heart disease than women. The fears surrounding cancer were perceived incurability and associated suffering.

1993 J Cancer Educ 8;1:53-62

Murray, M. and McMillan, C. L.

11152810 JA

Women who had an initial false positive screening mammogram and had to come back later for follow-up testing experienced significant stress as opposed to those who had the additional tests done immediately. Women who had to come back later and who were under 50 years of age with a positive first degree family history of breast cancer had the most distress.

2001 Radiology 218;1:247-53

Lindfors, K. K., O'Connor, J., and Parker, R. A.

11722693 JA

Discusses the pros and cons of older women (mean age 81) undergoing screening mammography. Some of these women had decreased functional daily living or cognitive impairment issues.

2001 J Gen Intern Med 16;11:779-84

Walter, L. C., Eng, C., and Covinsky, K. E.

10718499 JA

Cites decreased mammogram and pap smear use in women with disabilities, especially those over 65. Lists barriers to screening and resources for health professionals to implement screening programs.

2000 J Womens Health Gend Based Med 9;1:9-12

Thierry, J. M.

11879283 JA

A random survey of 332 Chinese American women living in Chinatown in Chicago showed a low level of knowledge of cancer screening tests and low use rates, especially in women with no spoken English fluency.

2001 Cancer Pract 9;2:81-91

Yu, E. S., Kim, K. K., Chen, E. H., and Brintnall, R. A.

10732525 JA

Focus group of 9 Muslim women revealed that although they understood the benefits of breast cancer screening, they chose not to participate in screening programs since they were not structured in a manner consistent with the beliefs and customs of Islam.

1999 Cancer Pract 7;6:285-90

Underwood, S. M., Shaikha, L., and Bakr, D.

11230068 JA

Only 52% of women who were told a pap smear was "normal" understood that this entailed a small residual risk of having or developing cervical cancer in the next five years. Authors suggest pap smear reports routinely add a sentence explaining this.

2001 BMJ 322;7285:526-8

Marteau, T. M., Senior, V., and Sasieni, P.

11919069 JA

Women less likely to receive pap tests were those uninsured, poor, foreign-born, of lower educational level, and "other" race/ethnicity. Article suggests educational campaigns for these groups of women, and increased support for programs to expand pap access.

2002 Am J Public Health 92;4:666-9

Hewitt, M., Devesa, S., and Breen, N.

8997684 R,T

Review of who participates in cervical screening, who doesn't and why. Many women thought the test was only necessary if symptoms arose.

1996 J Psychosom Obstet Gynaecol 17;4:189-94

Conway, K.

11519760 JA

Reasons for Swedish non-attendees to a pap smear clinic were lack of perception of the severity of cervical cancer, and time and economic factors, rather than emotional concerns.

2001 Cancer Causes Control 12;6:519-28

Eaker, S., Adami, H. O., and Sparen, P.

8839577 RCT

Development of a culturally attuned American Indian Talking Circle project that "uses the talking circle format coupled with traditional Indian stories, which emphasize positive roles and values in Indian culture, to provide cancer education and to improve adherence to cancer screening." Discusses need of healthcare personnel to be culturally sensitive to traditional beliefs of modesty, taboos, etc.

1996 Cancer 78;7 Suppl:1592-7

Hodge, F. S., Fredericks, L., and Rodriguez, B.

11144781 JA

Norwegian female physicians were more likely to do monthly self breast exams, and less likely to get routine pap smears than an education matched population. Reasons given for not having a pap smear were low risk, no symptoms, problem finding a physician to do it, or they forgot.

2001 Soc Sci Med 52;2:249-58

Rosvold, E. O., Hjartaker, A., Bjertness, E., and Lund, E.

11694774 JA

The majority of 129 German women with a family history of breast cancer incorrectly overestimated their risk. Those who perceived themselves most personally at risk underwent screening less often than recommended. Those under intense psychological strain had above average participation in screening.

2001 Onkologie 24;5:470-5

Neise, C., Rauchfuss, M., Paepke, S., Beier, K., and Lichtenegger, W.

9691702 JA

Israeli women with a family history of breast cancer who came for a regular clinic visit and had a breast symptom had a significant level of psychological distress. Suggests establishing special clinics for women with a family history of breast cancer to also provide counseling in coping skills.

1998 Psychosomatics 39;4:329-39

Gilbar, O.

11845558 JA

Women with increased risk for breast cancer due to family history had increased distress, heart rate and immune cell changes in response to a laboratory stressor compared to normal risk women. Chronic stress associated with familial cancer risk may have negative health consequences.

2002 J Behav Med 25;1:51-65

Valdimarsdottir, H. B., Zakowski, S. G., Gerin, W., Mamakos, J., Pickering, T., and Bovbjerg, D. H.

11191170 JA

23% of breast cancer patients on tamoxifen who underwent screening ultrasound for endometrial cancer were very anxious just before the procedure. One in six felt they would not have this done again--these women were more likely to be those having difficulties coming to terms with their mastectomy, those who were anxious in general, or those with a low tolerance towards medical procedures. Suggestions made for improving compliance.

2000 J Psychosom Obstet Gynaecol 21;4:225-33

Demyttenaere, K., Gheldof, M., Enzlin, P., Timmerman, D., Deprest, J., Bourne, T., and Vergote, I.

1520350 JA

Of third year family practice residents at a teaching hospital, male physicians offered rectal exams significantly more frequently to male patients older than 70, and female residents offered mammograms, pelvic exams and pap smears significantly more frequently to women older than 50.

1992 Fam Med 24;1:58-61

Levy, S., Dowling, P., Boult, L., Monroe, A., and McQuade, W.

3452351 JA

Although residents at a tertiary care hospital considered it important to perform gyn screening with a pap smear on non-gyn patients, only 8 of 150 patients in this study received paps. A major factor inhibiting better care was lack of equipment and facilities on hospital floors to do the exam.

1987 Am J Prev Med 3;3:142-6

Ziffer, A., Song, P., and Mandelblatt, J.

7624228 JA

Prior to breast biopsy, wives experienced three times the anxiety, two times the depression, and two times the trouble concentrating and making decisions than the regular population. Husbands had only slightly more distress than the average population, thought to possibly be due to strong denial mechanisms so that they could "maintain a strong protective stance around their wives." Women sought social support, while men tended not to discuss it outside the family.

1995 Nurs Res 44;4:196-201

Northouse, L. L., Jeffs, M., Cracchiolo-Caraway, A., Lampman, L., and Dorris, G.

11822499 JA

In depth interviews with 8 Irish women about every step of the process of having a breast biopsy with subsequent benign diagnosis, with extensive references to other studies on the psychology surrounding breast biopsies.

2001 J Clin Nurs 10;4:512-20

O'Mahony, M.

11259082 JA

Women were assessed when they were told they needed a breast biopsy (5-7 days prior) and then 7-10 days after diagnosis. Initial results showed significant anxiety and mood disturbance as well as decreased immune function. Post results showed reduction in anxiety and return of immune function.

2001 Brain Behav Immun 15;1:78-84

Nagabhushan, M., Mathews, H. L., and Witek-Janusek, L.

Summary of clinical studies regarding prophylactic mastectomy, including psychological factors surrounding patient selection and quality of life outcomes.

2001 Breast J 7;5:321-30

Anderson, B. O.

11180582 JA

Interviews with 10 women who experienced prophylactic bilateral mastectomy had an overall theme of "suffering and countering multiple losses". Segments of this experience included: deciding on surgery, telling, experiencing surgery and recovering, maintaining womanliness, processing the loss, and moving on.

2000 Psychooncology 9;6:473-85

Lloyd, S. M., Watson, M., Oaker, G., Sacks, N., Querci della Rovere, U., and Gui, G.

11180581 JA

After bilateral prophylactic mastectomy, the majority of women did not have significant mental health or body image problems, but a subset who had surgical complications had more serious adjustment problems.

2000 Psychooncology 9;6:462-72

Hopwood, P., Lee, A., Shenton, A., Baildam, A., Brain, A., Lalloo, F., Evans, G., and Howell, A.

11154619 JA

In a group of women at high risk for breast cancer, those who chose prophylactic mastectomy had a significant decrease in anxiety compared to those in a screening program. Accepters were more likely to believe that breast cancer was inevitable, and decliners were more likely to believe in the protective effects of a screening program.

2001 BMJ 322;7278:76

Hatcher, M. B., Fallowfield, L., and A'Hern, R.

94 women in a program for those with familial risk for ovarian cancer received individualized risk counseling. Reduction of anxiety/uncertainty was the factor most strongly associated with current interest in prophylactic oophorectomy, independent of actual or perceived risk or cancer specific anxiety. Since anxiety can fluctuate with life events, it is suggested that women seeking prophylactic oophorectomy, particularly those with lower risk family pedigrees, be offered anxiety management as part of informed consent.

2001 J Womens Health Gend Based Med 10;2:189-99

Hurley, K. E., Miller, S. M., Costalas, J. W., Gillespie, D., and Daly, M. B.

11180583 JA

After prophylactic oophorectomy, women indicated that they wish they had known more about menopause, hormone replacement therapy, surgical procedures and convalescence. It is suggested that this information be added to genetic counseling to help women make choices.

2000 Psychooncology 9;6:486-95

Hallowell, N.

11180584 JA

Of fourteen women interviewed up to 7 years after prophylactic oophorectomy, all but one were satisfied with their choice. Premenopausal women reported unmet information needs both before and after the procedure with regards to effects of surgical menopause and HRT.

2000 Psychooncology 9;6:496-503

Meiser, B., Tiller, K., Gleeson, M. A., Andrews, L., Robertson, G., and Tucker, K. M.

11351375 JA

"Women who have undergone prophylactic oophorectomy may have more physical and emotional symptoms than women who remain in an ovarian cancer screening program, and may report equivalent levels of cancer worry. Those who are pre-menopausal at the time of the operation may be particularly vulnerable to psychological distress and take longer to recover post-operatively."

2001 Psychooncology 10;3:231-41

Fry, A., Busby-Earle, C., Rush, R., and Cull, A.

11255821 JA

Of women undergoing prophylactic oophorectomy, 7% regretted their decision, and 47% would have liked more information prior to surgery. Of women undergoing ovarian cancer surveillance, 50% expressed regret about the program, and did not recall receiving any information about prophylactic oophorectomy.

2001 J Reprod Med 46;2:87-94

Swisher, E. M., Babb, S., Whelan, A., Mutch, D. G., and Rader, J. S.