Effects of Dance Movement Therapy on subjective stress and cortisol slope among breast cancer patients undergoing radiotherapy

Abstract

Background: Breast cancer patients are at risk for psychosocial distress, which may lead to neuroendocrine dysfunction. Dance Movement Therapy (DMT) is a movement-based psychosocial intervention that incorporates exercise, artistic, and recreational components. This study aimed to examine the effectiveness of DMT on perceived stress and diurnal cortisol slope. Methods: This clinical trial randomized 121 Chinese breast cancer patients undergoing radiotherapy treatment into the DMT (n = 63) or control group (n = 58). The intervention comprised six 1.5-hour group sessions held twice a week over the course of radiotherapy. The participants completed self-report measures on perceived stress, health and sleep characteristics at baseline. Salivary cortisol samples were collected at five time points and perceived stress at the end of the intervention. Moderated mediation analysis was used to evaluate the DMT effect on the diurnal cortisol slope. Results: Overall, DMT showed a marginal beneficial effect on diurnal cortisol slope (B = –0.66, 95% CI = –1.36 to 0.06, β = –0.17). Baseline perceived stress significantly and negatively moderated the effect of DMT on diurnal cortisol slope (B = –0.21, 95% CI = –0.36 to –0.05, β = –0.35). At one SD above the pss1 mean, the cortisol slope of the DMT group (M = -6.93) was significantly steeper than the control group (M = -5.35) with 95% CI for the difference of -1.58 = -2.59 to -0.61. The indirect effect of DMT on cortisol slope via Time 2 perceived stress was not statistically significant. Discussions: The DMT program had a modest overall effect on diurnal cortisol slope in breast cancer patients but appeared to be effective in modulating the neuroendocrine response of those who were distressed. The present findings suggest that perceived stress may play a moderator but not mediator role in the DMT effect on diurnal cortisol slope.