Abstract B30: Coping and traumatic stress symptoms in African American prostate cancer patients compared to whites

Background: African American (AA) men are twice as likely as white (W) men to be diagnosed with prostate cancer, making it important to monitor their response to disease and subsequent treatment. This study compared AA and W ratings of psychological functioning for 318 patients who participated in a group therapy intervention.

Method: Independent groups t-tests were used to determine whether there were significant differences in mean scores for each group on the Mini-MAC and the Impact of Events (IES) scale at baseline.

Results: Significant differences were observed on Mini-MAC subscale scores assessing Cognitive Avoidance (AA mean = 10.13 vs. W mean = 7.72; t = −4.50; p < .001), Fatalism (AA mean = 15.67 vs. W mean = 14.45; t = −2.75; p = .009) and Helplessness-Hopelessness (AA mean = 12.03 vs. W mean = 10.17; t = −2.56; p = .015), with a trend towards significance on Anxious Preoccupation (AA mean = 16.00 vs. W mean = 14.50; t = −1.75; p = .089). There was no significant difference on the Fighting Spirit subscale. There were also significant differences on the IES total scale (AA mean = 28.17 vs. W mean = 23.95; t = −2.32; p = .027) and the Instrusion (AA mean = 12.66 vs. W mean = 10.86; t = −2.09; p = .045) and Avoidance (AA mean = 15.33 vs. W mean = 13.05; t = −2.15; p = .039) subscales. Nearly a quarter (24.0%) of AAs in the sample met clinical criteria (> 35 on IES total scale) for Posttraumatic Stress Disorder (PTSD), while only 11.3% of Ws did.

Conclusions: Results suggest that, compared to W men, AA men experience more difficulty coping with cancer and report higher levels of traumatic stress symptoms. These findings may be an underestimate, as AA men tend to underreport their psychological distress. Stressful life events in addition to cancer may also put AA men with prostate cancer at higher risk for mood and anxiety disorders such as depression and PTSD. Targeted efforts may be required to screen for and address the particular needs of AA prostate cancer patients, who are at higher risk for psychological distress in addition to carrying a disproportionate burden of the disease.