FAMILY COPING AND BREAST CANCER PROGRESSION

This proposal is a request for an ADAMHA SDAC. The main
objective is to establish an extensive educational and training program
to foster the development of the Principal Investigator as an Independent
clinician/researcher In the fields of family and psychosocial process,
specifically as they are understood through their Impact on the outcome
of chronic medical and psychiatric Illness. David Reiss, M.D., Director
of the Center for Family Research and Professor In the Department of
Psychiatry at George Washington University, will serve as sponsor for the
duration of this award. The career development plan for the Principal Investigator is
aimed at the achievement of three broad objectives: 1) competency in the
knowledge and skills of scientific Inquiry 2) ability to use theory and
data to expand the field of psychosocial processes which Influence
medical and psychiatric disorders 3) experience in planning, executing
and formulating the results of a research project. These objectives will
be achieved through didactic course work, and through collaboration with
an ongoing, intensely productive group at the Center for Family Research.
Mavis Hetherington, Ph.D., Department of Psychology at the University of
Virginia.,will serve as a mentor in longitudinal studies of family
psychology. The proposed research is a study of the family processes of
women with breast cancer. It is founded on recent data suggesting that
psychosocial characteristics of the individual patient are predictive of
disease progression and that psychosocial interventions can modify the
course of metastatic breast cancer. This research will evaluate 150
women with breast cancer, 75 of whom are newly diagnosed and 75 of whom
have new recurrence of disease. Family processes will be investigated by
using self-report and observational measures which have shown promise in
predicting outcome of other chronic diseases. The psychosocial factors
of the individual patient, found to be predicitive in other research,
will be replicated along with the exploration of family processes. The
impact of both individual and family factors on disease progression will
be assessed in this prospective longitudinal investigation. In summary,
this work is intended to provide a new window for understanding coping
with illness through this study of psychosocial processes linked to
disease outcome.