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KNOXVILLE — Clinical depression affects up to 40 percent of women diagnosed with breast cancer, but it’s a topic that scientists have not yet examined in depth.

A new grant from the Susan G. Komen Breast Cancer Foundation will allow a University of Tennessee professor to conduct a groundbreaking study into how best to treat well diagnosed depression in breast cancer patients.

“The study of how to treat depressed breast cancer patients is a critical area to examine that has thus far largely been neglected,” said Derek Hopko, an associate professor of psychology at UT and the study’s lead researcher. “It could have real benefits to a lot of people.”

Research has shown that clinical depression in cancer patients leads to a significant decline in their quality of life, as well as more rapidly progressing cancer symptoms and pain.

Hopko’s study will look at two different methods of treating depression, problem-solving therapy and brief behavior activation therapy (BATD). Hopko and a colleague from the University of Maryland designed BATD in 2001.

The study will examine the relative effectiveness of both treatments for depression in breast cancer patients and determine if BATD is more effective than the more traditional problem-solving approach.

The BATD technique helps patients to identify their unique value system as it relates to many different parts of life, such as family, peer and intimate relationships, hobbies and recreation, employment and spirituality.

Psychologists then work with patients to facilitate participation in behaviors that will move them towards their individual values and goals. The process allows for increased and more rewarding experiences and helps reduce depression symptoms, said Hopko. A psychologist also will work with patients to understand what was rewarding in the past, and help plan ways to re-engage in those activities.

Hopko likens the BATD approach to the way a train builds momentum as it begins moving.

“When a train is at a stop, it takes a lot of effort to get it moving slowly forward, but once it starts rolling, it builds momentum and is just as hard to stop,” said Hopko. “By giving patients a plan to get moving, they build momentum and eventually gain confidence, feelings of achievement and success, and less depression.”

Hopko’s approach has been effective in early, smaller trials conducted with cancer patients in recent years, showing a reduction in anxiety and depression and even pain as reported by patients. The technique also addresses the specific needs of cancer patients, especially the need to work toward processing and accepting their cancer diagnoses.

“When you are diagnosed with breast cancer, it’s a difficult experience that ultimately requires a certain level of acceptance,” said Hopko. “One way that many cancer patients choose to cope is through denial, trying to wish it away, but understanding and acceptance generally is a much healthier coping strategy.”

Hopko noted that his choice to study breast cancer specifically went beyond its role as the second most common type of cancer for women.

“Having a mother who was diagnosed and treated for breast cancer was a strong motivating factor,” said Hopko. “I’m thankful for the support I’ve gotten.”

Hopko’s grant is for $296,000 over three years.

The study will consist of 80 participants, with 40 receiving the BATD treatment and 40 receiving the more traditional problem-solving therapy. Each treatment method will include eight sessions. The University of Tennessee Medical Center’s UT Cancer Institute will be a major study site for the research, though breast cancer patients not being seen at the Cancer Institute may also be eligible.

Hopko is currently seeking participants in the Knoxville area for the study.

They should be diagnosed with breast cancer and also have significant symptoms of depression, such as a depressed mood, lack of interest in activities, changes in eating or sleeping habits, decreased concentration, or feelings of worthlessness and guilt. Participants must be 18 years of age or older.

For more information on participating in the study, please call 865-974-3368 or e-mail


Derek Hopko (865-974-3368,
Jay Mayfield (865-974-9409,