PMID- 29688834 OWN - NLM STAT- MEDLINE DCOM- 20190812 LR - 20190812 IS - 1527-7755 (Electronic) IS - 0732-183X (Linking) VI - 36 IP - 19 DP - 2018 Jul 1 TI - 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. PG - 1930-1940 LID - 10.1200/JCO.2017.76.3318 [doi] 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. FAU - Sherman, Kerry A AU - Sherman KA AD - Kerry A. Sherman, Astrid Przezdziecki, Jessica Alcorso, and Christopher Jon Kilby, Center for Emotional Health, Macquarie University; Kerry A. Sherman and Elisabeth Elder, Westmead Breast Cancer Institute, Westmead Hospital; Astrid Przezdziecki, Liverpool Cancer Therapy Centre, Liverpool Hospital, and South Western Sydney Clinical School, University of New South Wales; John Boyages and Louise Koelmeyer, Australian Lymphedema Education, Research, and Treatment Center, Macquarie University; and Helen Mackie, Mt Wilga Lymphedema Center, Mt Wilga Private Hospital, Sydney, New South Wales, Australia. FAU - Przezdziecki, Astrid AU - Przezdziecki A AD - Kerry A. Sherman, Astrid Przezdziecki, Jessica Alcorso, and Christopher Jon Kilby, Center for Emotional Health, Macquarie University; Kerry A. Sherman and Elisabeth Elder, Westmead Breast Cancer Institute, Westmead Hospital; Astrid Przezdziecki, Liverpool Cancer Therapy Centre, Liverpool Hospital, and South Western Sydney Clinical School, University of New South Wales; John Boyages and Louise Koelmeyer, Australian Lymphedema Education, Research, and Treatment Center, Macquarie University; and Helen Mackie, Mt Wilga Lymphedema Center, Mt Wilga Private Hospital, Sydney, New South Wales, Australia. FAU - Alcorso, Jessica AU - Alcorso J AD - Kerry A. Sherman, Astrid Przezdziecki, Jessica Alcorso, and Christopher Jon Kilby, Center for Emotional Health, Macquarie University; Kerry A. Sherman and Elisabeth Elder, Westmead Breast Cancer Institute, Westmead Hospital; Astrid Przezdziecki, Liverpool Cancer Therapy Centre, Liverpool Hospital, and South Western Sydney Clinical School, University of New South Wales; John Boyages and Louise Koelmeyer, Australian Lymphedema Education, Research, and Treatment Center, Macquarie University; and Helen Mackie, Mt Wilga Lymphedema Center, Mt Wilga Private Hospital, Sydney, New South Wales, Australia. FAU - Kilby, Christopher Jon AU - Kilby CJ AD - Kerry A. Sherman, Astrid Przezdziecki, Jessica Alcorso, and Christopher Jon Kilby, Center for Emotional Health, Macquarie University; Kerry A. Sherman and Elisabeth Elder, Westmead Breast Cancer Institute, Westmead Hospital; Astrid Przezdziecki, Liverpool Cancer Therapy Centre, Liverpool Hospital, and South Western Sydney Clinical School, University of New South Wales; John Boyages and Louise Koelmeyer, Australian Lymphedema Education, Research, and Treatment Center, Macquarie University; and Helen Mackie, Mt Wilga Lymphedema Center, Mt Wilga Private Hospital, Sydney, New South Wales, Australia. FAU - Elder, Elisabeth AU - Elder E AD - Kerry A. Sherman, Astrid Przezdziecki, Jessica Alcorso, and Christopher Jon Kilby, Center for Emotional Health, Macquarie University; Kerry A. Sherman and Elisabeth Elder, Westmead Breast Cancer Institute, Westmead Hospital; Astrid Przezdziecki, Liverpool Cancer Therapy Centre, Liverpool Hospital, and South Western Sydney Clinical School, University of New South Wales; John Boyages and Louise Koelmeyer, Australian Lymphedema Education, Research, and Treatment Center, Macquarie University; and Helen Mackie, Mt Wilga Lymphedema Center, Mt Wilga Private Hospital, Sydney, New South Wales, Australia. FAU - Boyages, John AU - Boyages J AD - Kerry A. Sherman, Astrid Przezdziecki, Jessica Alcorso, and Christopher Jon Kilby, Center for Emotional Health, Macquarie University; Kerry A. Sherman and Elisabeth Elder, Westmead Breast Cancer Institute, Westmead Hospital; Astrid Przezdziecki, Liverpool Cancer Therapy Centre, Liverpool Hospital, and South Western Sydney Clinical School, University of New South Wales; John Boyages and Louise Koelmeyer, Australian Lymphedema Education, Research, and Treatment Center, Macquarie University; and Helen Mackie, Mt Wilga Lymphedema Center, Mt Wilga Private Hospital, Sydney, New South Wales, Australia. FAU - Koelmeyer, Louise AU - Koelmeyer L AD - Kerry A. Sherman, Astrid Przezdziecki, Jessica Alcorso, and Christopher Jon Kilby, Center for Emotional Health, Macquarie University; Kerry A. Sherman and Elisabeth Elder, Westmead Breast Cancer Institute, Westmead Hospital; Astrid Przezdziecki, Liverpool Cancer Therapy Centre, Liverpool Hospital, and South Western Sydney Clinical School, University of New South Wales; John Boyages and Louise Koelmeyer, Australian Lymphedema Education, Research, and Treatment Center, Macquarie University; and Helen Mackie, Mt Wilga Lymphedema Center, Mt Wilga Private Hospital, Sydney, New South Wales, Australia. FAU - Mackie, Helen AU - Mackie H AD - Kerry A. Sherman, Astrid Przezdziecki, Jessica Alcorso, and Christopher Jon Kilby, Center for Emotional Health, Macquarie University; Kerry A. Sherman and Elisabeth Elder, Westmead Breast Cancer Institute, Westmead Hospital; Astrid Przezdziecki, Liverpool Cancer Therapy Centre, Liverpool Hospital, and South Western Sydney Clinical School, University of New South Wales; John Boyages and Louise Koelmeyer, Australian Lymphedema Education, Research, and Treatment Center, Macquarie University; and Helen Mackie, Mt Wilga Lymphedema Center, Mt Wilga Private Hospital, Sydney, New South Wales, Australia. LA - eng SI - ANZCTR/ACTRN12615001381572 PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20180424 PL - United States TA - J Clin Oncol JT - Journal of clinical oncology : official journal of the American Society of Clinical Oncology JID - 8309333 MH - Body Dysmorphic Disorders/etiology/psychology/*therapy MH - Body Image/psychology MH - Breast Neoplasms/pathology/*psychology/*therapy MH - Female MH - Humans MH - Internet MH - Middle Aged MH - Neoplasm Staging MH - Psychotherapy/*methods MH - Treatment Outcome MH - Writing EDAT- 2018/04/25 06:00 MHDA- 2019/08/14 06:00 CRDT- 2018/04/25 06:00 PHST- 2018/04/25 06:00 [pubmed] PHST- 2019/08/14 06:00 [medline] PHST- 2018/04/25 06:00 [entrez] AID - 10.1200/JCO.2017.76.3318 [doi] PST - ppublish SO - J Clin Oncol. 2018 Jul 1;36(19):1930-1940. doi: 10.1200/JCO.2017.76.3318. Epub 2018 Apr 24.