Body change stress for women with breast cancer: The breast-impact of treatment scale

Georita M. Frierson1, Debora L. Thiel1 and Barbara L. Andersen2

(1) Department of Psychology, The Ohio State University, USA
(2) Department of Psychology and the Comprehensive Cancer Center, The Ohio State University, USA
(3) Department of Psychology, The Ohio State University, 1835 Neil Avenue, 43210-1222 Columbus, OH


Abstract Background: Body change stress refers to subjective psychological stress that accompanies women’s negative and distressing thoughts, emotions, and behaviors resultant from breast cancer and breast surgeries. Body change stress is manifest with traumatic stress-like symptoms.Purpose: The development of the Breast-Impact of Treatment Scale (BITS) is described. The construct is assessed with 13 items that comprise a one-factor solution.Methods and Results: Tests of convergent validity demonstrate the relationship, but not overlap, of the BITS with measures of stress, emotional distress, and sexuality. The BITS distinguishes between women receiving segmental mastectomy (lumpectomy) versus mastectomy. Incremental validity is shown with comparison to ratings of body satisfaction.Conclusions: An early psychometric foundation enables use of the BITS to assess a common and distressing quality of life outcome for women with breast cancer.
Georita Frierson is now at the Cooper Institute, Dallas, Texas. Debora Thiel is now at the Madigan Army Medical Center, Behavioral Health Department, Tacoma, Washington.
This research was supported by grants from the American Cancer Society (PBR-89), the Longaberger Company-American Cancer Society (PBR-89A), the U.S. Army Medical Research Acquisition Activity (DAMD17-94-J-4165, DAMD17-96-1-6294, and DAMD17-97-1-7062), the National Institute of Mental Health (RO1MH51487), the National Cancer Institute (RO1CA92704, KO5 CA098133), the Ohio State University Comprehensive Cancer Center (NCI: P30 CA16058), and the Clinical Research Center grant from the National Institutes of Health, Department of Health and Human Services (MO1-RR0034).
We thank the patients for their participation and continued commitment. In addition, we thank the research and professional staff of the Stress and Immunity Breast Cancer Project, William B. Farrar, M.D. and other referring surgical oncologists, and Timothy Crespin, Ph.D. and Hae-Chung Yang, Ph.D., for data analyses.