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Background: Social comparisons (SCs) are common among cancer patients, but their prospective associations are not well understood. This study examined concurrent and prospective relationships of SCs with health-related quality of life (HRQOL) and depressive symptoms during the first year of breast cancer treatment., Methods: Nonmetastatic breast cancer patients (N = 240) enrolled in a larger intervention trial reported on the frequencies of SCs postsurgery (T1) and 6 months later (T2). HRQOL and depressive symptoms were assessed at T1, T2, and 12 months after T1 (T3). Path analysis via structural equation modeling was used to assess three models relating SCs to HRQOL and depressive symptoms from T1-T2, T1-T3, and T2-T3, controlling for stage of disease, intervention condition, and dispositional optimism., Results: Upward contrast SCs were associated with poorer concurrent HRQOL at T1 and T2, and with more concurrent depressive symptoms at T2. However, upward contrast SC at T1 predicted better T2 and T3 HRQOL. Upward identification SC at T1 predicted more T2 depressive symptoms, and at T2 was associated with poorer concurrent HRQOL and more concurrent depressive symptoms. Downward identification SCs at T1 were associated with poorer concurrent HRQOL. Downward identification SCs at T2 predicted poorer T3 HRQOL., Conclusions: Upward SCs were related to compromised concurrent psychosocial well-being, but prospective effects varied by the interpretation of the comparison (ie, contrast vs identification). Findings have implications for the development and deployment of group-based psychosocial interventions during the early phases of survivorship, during which opportunities for SC are prevalent., (© 2018 John Wiley & Sons, Ltd.)

Background: Breast cancer survivors experience long-term physical and psychological sequelae after their primary treatment that negatively influence their quality of life (QOL) and increase depressive symptoms. Group-based cognitive-behavioral stress management (CBSM) delivered after surgery for early-stage breast cancer was previously associated with better QOL over a 12-month follow-up and with fewer depressive symptoms up to 5 years after study enrollment. This 8- to 15-year follow-up (median, 11 years) of a previously conducted trial (NCT01422551) evaluated whether women in this cohort receiving CBSM had fewer depressive symptoms and better QOL than controls at an 8- to 15-year follow-up., Methods: Women with stage 0 to IIIb breast cancer were initially recruited 2 to 10 weeks after surgery and randomized to a 10-week CBSM intervention or a 1-day psychoeducational control group. One hundred women (51 CBSM patients and 49 controls) were recontacted 8 to 15 years after study enrollment to participate in a follow-up assessment. The Center for Epidemiologic Studies-Depression (CES-D) scale and the Functional Assessment of Cancer Therapy-Breast (FACT-B) were self-administered. Multiple regression was employed to evaluate group differences on the CES-D scale and FACT-B over and above effects of confounding variables., Results: Participants assigned to CBSM reported significantly lower depressive symptoms (d, 0.63; 95% confidence interval [CI], 0.56-0.70) and better QOL (d, 0.58; 95% CI, 0.52-0.65) above the effects of the covariates., Conclusions: Women who received CBSM after surgery for early-stage breast cancer reported lower depressive symptoms and better QOL than the control group up to 15 years later. Early implementation of cognitive-behavioral interventions may influence long-term psychosocial functioning in breast cancer survivors., (© 2015 American Cancer Society.)