Psychosocial moderators of presurgical stress management for men undergoing radical prostatectomy

Objective: It is important to identify factors that predict who will benefit the most from psychosocial interventions in cancer populations. Methods: This study examines the moderating effect of baseline social support (social support, SS; dyadic adjustment DA), distress (Brief Symptom Inventory, BSI; Impact of Event Scale, IES), and coping style (Brief COPE) on quality of life outcomes (SF-36 Physical Component Summary scores, PCS) 1 year postsurgery derived from a presurgical cognitive- behavioral stress management (SM; n = 23) program, supportive attention (SA; n = 37), or standard care (SC; n = 29). Results: Moderation analyses indicated that men who reported low SS and were in the SM group had increased PCS 1 year after surgery as compared with men with low SS in the SC group (β = -0.39, p <.01), with SA having a nonsignificant intermediate effect. Men who reported high distress (BSI) at baseline and were in the SA group had increased PCS 1 year after surgery, as compared with those in the SC group (β = 24.80, p = .01), with SM having a nonsignificant intermediate effect. Mediation analyses suggested that neither SM nor SA improved quality of life simply by increasing social support or decreasing general distress. Conclusions: Distressed individuals may benefit more from unstructured discussion of distress, whereas those low in social support may benefit more from a structured approach to learning coping skills.