Exploring chronic stress, avoidance coping, and diurnal cortisol in head and neck cancer patients: A pilot study of best practices in diurnal cortisol sampling.

Author

Brooks R. Harbison, University of LouisvilleFollow

Date on Master's Thesis/Doctoral Dissertation

8-2024

Document Type

Doctoral Dissertation

Degree Name

Ph. D.

Department

Counseling and Human Development

Degree Program

Counseling and Personnel Services, PhD

Committee Chair

Pössel, Patrck

Committee Co-Chair (if applicable)

Cash, Elizabeth

Committee Member

Mitchell, Amanda

Committee Member

Leach, Mark

Author's Keywords

head and neck cancer; chronic stress; avoidance coping; diurnal cortisol; cortisol sampling methods; transactional model

Abstract

Cancer patients are vulnerable to the deleterious effects of chronic stress, especially those prone to avoidance coping. Research in the general population has linked these effects to aberrant diurnal cortisol. However, the current literature on cancer patients has shown inconsistent results in associations between chronic stress, avoidance coping, and diurnal cortisol, possibly due to inconsistent cortisol sampling practices. This pilot study of head and neck cancer patients aimed to address this gap in the literature by implementing best cortisol sampling practices to investigate the links among chronic stress, avoidance coping, and diurnal cortisol slope, average bedtime cortisol, and average wake cortisol. It was hypothesized that chronic stress and avoidance coping would be related in main effects and interaction to each cortisol variable. The sample of this secondary analysis included 43 patients (51.4% male; 81% White; 24% married; median age = 57 years, SD = 11.67) who provided psychological and cortisol data during the planning phase of their treatment. Multiple regression analyses showed main effects for chronic stress and diurnal cortisol (p = 0.05; R² = 0.16) and for chronic stress and average wake cortisol (p = 0.013; R² = 0.17). However, no significant effects were shown for chronic stress and average bedtime cortisol; any of the links between avoidance coping and the cortisol variables; or any of the interaction effects. Results are discussed based on design limitations. Despite limitations, this study contributes to the small body of literature on the link between chronic stress and diurnal cortisol in cancer patients.

Recommended Citation

Harbison, Brooks R., "Exploring chronic stress, avoidance coping, and diurnal cortisol in head and neck cancer patients: A pilot study of best practices in diurnal cortisol sampling." (2024). Electronic Theses and Dissertations. Paper 4422.
Retrieved from https://ir.library.louisville.edu/etd/4422