Social Support as a Moderating Factor in Improvement of Physical Symptom Distress Post Psychotherapy Among Cancer Patients

Marjorie Heule, Fordham University


Background: Social support has been found to attenuate physical distress response across clinical settings. However, few studies have examined these effects in the context of psychotherapy. While psychotherapeutic interventions have been effective in reducing cancer symptom severity, to our knowledge no studies have investigated whether social support impacts the effectiveness of psychotherapy interventions. The present study examines how social support influences the efficacy of a psychotherapeutic intervention on physical distress among cancer patients. Methods: Patients with advanced stage cancer (N =181) were assigned to eight sessions of psychotherapy. Patients were assessed before and after therapy completion and completed an initial questionnaire to determine perceived level of social support. The primary outcome measures were physical and psychological distress. A hierarchical linear model was conducted to analyze whether patients with low social support derive more benefit from psychotherapy than those with adequate social support. Results: Hierarchical linear models revealed significant main effects for social support and time, along with a significant social support x time interaction effect. Participants with suboptimal social support reported higher levels of physical symptom distress (PHYS) than those with average or optimal social support, F(2,154.52) = 4.18, p = .02. Post-hoc analyses indicated that the difference in level of physical symptom distress was only significant (p = .01) for the comparison of individuals with suboptimal social support and optimal social support; there was no difference between participants with average and optimal levels of social support. The HLM analysis also demonstrated that the sample as a whole demonstrated significant improvement in physical symptom distress over time (i.e., lower PHYS scores), F(1,134.71) = 4.08, p = .05. Finally, there was a significant interaction between level of social support and time, F (2,134.34) = 3.61, p = .03. Conclusion: These results demonstrate that psychotherapeutic interventions may be particularly beneficial for cancer patients with less social support. While the mechanisms enabling these changes still remain unclear, these results suggest that psychotherapy may fulfill more of a need among patients with less social support. Further research should investigate the physiologic mechanisms embedded in psychotherapeutic interventions underlying these improvements in physical distress among patients with low levels of social support. Acknowledgement of Funding: This study was supported by a grant from the National Cancer Institute (W. Breitbart, P.I.).

Subject Area

Health sciences|Psychobiology|Clinical psychology|Physiology

Recommended Citation

Heule, Marjorie, "Social Support as a Moderating Factor in Improvement of Physical Symptom Distress Post Psychotherapy Among Cancer Patients" (2021). ETD Collection for Fordham University. AAI28720107.