Racial Differences in the Psychological Functioning of Prostate Cancer

Abstract

Thesis (M.S.)--University of Rochester. School of Medicine and Dentistry. Dept. of Community & Preventive Medicine, 2009.Prostate cancer is the most commonly diagnosed cancer among men in the United States, and African American men have the highest prostate cancer rates in the world. Several studies have reported poorer health-related quality of life (e.g., disease-specific physical health and functional status) for African American men who have undergone standard treatments for prostate cancer. Relatively less attention has been given to psychological adjustment in the prostate cancer literature, and very little is known about racial differences in psychological functioning. A national controlled, randomized trial was conducted by the University of Rochester Cancer Center Community Clinical Oncology Program Research Base to test a supportive-expressive group therapy intervention in prostate cancer patients. The present study is a secondary analysis whose purpose is to compare the baseline psychological functioning of African American and white prostate cancer patients and to examine the effect of supportive-expressive group therapy on psychological adjustment for African American men. Results of this study revealed racial disparities in baseline psychological adjustment to prostate cancer, with African American men reporting higher levels of traumatic stress (Impact of Events Scale), coping through cognitive avoidance (Mini-MAC Cognitive Avoidance), and hopelessness/helplessness (Mini-MAC Hopelessness/Helplessness) compared to whites. African American men in the intervention also reported higher coping through cognitive avoidance than African American controls, a result that was replicated in an additional analysis showing that cognitive avoidance in African American men in the intervention was higher than for any other group. These results suggest that African American men have poorer psychological adjustment to prostate cancer and that targeted interventions are needed to address their specific needs