By Raazia Syedda

“The more you explore an area, the more questions you can see,” says Dr. Anne Moyer of Stony Brook’s Department of Psychology and Faculty Director of the Undergraduate College of Science and Society [1]. Dr. Moyer has had a long-held interest in cancer and studies the psychosocial issues that surround cancer and cancer risk, medical decision-making, gender and health, research methodology and meta-analysis, as well as the psychology of research participation.

Dr. Moyer received her B.A. & Sc. in Psychology from McMaster University in Canada, and her Ph.D. in Social/Health Psychology from Yale University. In 2013, Dr. Moyer was presented with the Faculty Partner of the Year Award from Stony Brook University’s Career Center. She is a member of the American Psychological Association, the American Psychological Society, the Society for the Psychological Study of Social Issues, and the Society of Behavioral Medicine. Here, Young Investigators’ Raazia Syedda, a junior psychology major interviews Dr. Moyer about her research career.

            After earning your Ph.D., describe the journey that led you to join the Stony Brook Community in 2001.

I did two years at the University of California, San Francisco and held a post-doctoral position in health psychology, which was a broadening experience. UCSF is a medical school and there’s a small group of psychologists among the medical professionals, which is a good way of applying social psychological research to health. From there, I went to the Stanford Center for Biomedical Ethics. I was interested in breast cancer at the time, and that was when genetic testing for susceptibility to breast cancer was just becoming more widely available. There were a lot of concerns about potential ethical, legal, and social issues surrounding it, because when you find out genetic information, it not only impacts you, but biological relatives as well. If you’re carrying a mutation, there’s a likelihood that they [relatives] might as well, and sometimes family members disagree about whether they want that knowledge. I was involved with a project where we conducted in-depth interviews by going out to homes and speaking to multiple family members of extended families about their perception of genetic testing. There is a way in which the training in health psychology is interdisciplinary; I was the only health psychologist in that interdisciplinary center. There were philosophers, theologians, and you could hear from a lot of different fields. At the time, it almost felt like a digression, but it’s the kind of information I still carry with me today. I enjoyed doing research but I wanted to be involved in a college environment with undergraduate and graduate students, and have a lab of my own. You still have the opportunity to do research and write papers, but there’s so much more to it.

            Your research focuses particularly on those with or at risk for cancer; what was your         initial inspiration for directing your focus towards cancer?

I did my dissertation on the psychological effects of being treated for breast cancer either with breast-conserving surgery or mastectomy. I’ve hand a long-standing interest in cancer. As my career moved along, I’ve been interested in various aspects of cancer such as medical decision-making, treatment decision-making, how to improve to quality of life. The more you explore an area, the more questions you can see.

Which work did you learn the most from?

It was a meta-analytic project and I was very satisfied with my mentor at the time, who led by example, and was very meticulous, thoughtful, and careful. Working closely with him was beneficial for me. I was the project director of this single project for three years, working on sort of the same question. Then I landed a position at Stony Brook. That project informed my own meta-analytic work in the area of cancer.

            Tell me more about your studies related to psychosocial interventions to improve the     quality of life of cancer patients.

All the studies came from the same data set, which was a large-scale systematic review and meta-analysis project. We summarized 25 years and then we extended it to 30. In the literature, the research studies looked at interventions to improve the quality of life of cancer patients. They’re so widespread; there’s so many things that cancer patients can use help with to improve quality of life. There are side effects, worries about family members and spouses, worries about appearance, existential worries about life and death, and more. Psychologists, social workers, and nurses have developed all kinds of interventions to improve different aspects of the quality of life, and these interventions have taken a lot of different forms. There are all kinds of interventions from things like regular psychotherapy and cognitive behavioral therapy to mindfulness-based stress reduction and hypnosis. To summarize all of that is a big job that we worked on for eight years. We had more than 900 projects that made up the data set. Our first review project was summarizing the characteristics so what we did in the first article was present the span, breadth, and depth of research that’s been done on this topic. We coded it all and looked at different aspects like what kind of cancer patients they’re studying, the kind of interventions, and how they followed people. We found that a large portion of patients were breast cancer patients, which is understandable because there’s a lot of funding and awareness for breast cancer. But other populations with rare forms of cancer haven’t been studied. Interventions to improve their quality of life have not been developed. We also saw that there was not a lot of attention given to spirituality. Psychologists don’t consider religion and spirituality as a focus, and yet if you ask patients what kinds of issues they would like support with, some of it has to do with spiritual growth and spiritual coping. Interventions don’t really cover that.

In regards to Mediators of change in psychosocial interventions for cancer patients, the question was when something is effective when you give someone an intervention, what about that intervention is actually useful? What did they learn that resulted in less distress? That was the next level of research where they began to measure what changed. Did they get better skills, communicate better, or become more mindful? By measuring intermediate outcomes before measuring the ultimate quality of life and distress, we wanted to know what we might have taught people by seeing what the “active ingredient” was. That paper summarized the research that began to look at the mechanisms of what is effective in interventions. Not a lot of them do that; they just deliver the intervention, measure the outcome, and they don’t know why it works.

What other research projects are you currently conducting aside from the cancer-related            ones?

There are a few new projects that I’m excited about. I want to give credit to my graduate students who shape these projects. There’s one related to medical decision making with people making surrogate decisions when there’s a family member who has become incapacitated. In a surrogate decision-making position, if told there’s a 90% chance that the relative will not survive, family members interpret it more positively, being closer to 80% for their particular relative, factoring in things that they know about the individual. We wanted to replicate that, and test a few other variables. If people have this positive bias, the question is if there’s a problem. Does it impact any decisions they might make about continuing care or withdrawing life support? It was hypothetical, but we found that the level of bias did predict hypothetical decisions people would make on behalf of a family member.

What would you have pursued if you were not in the field of psychology?

I would love to be a veterinarian, though I didn’t have enough practical experience with animals. One of my students is now extending the work on surrogate decisions to veterinary projects. When you’re making decisions for pets and animals, it’s a surrogate decision because you’re always making decisions on their behalf. You can’t ask if they’d like to have a vaccination or surgery, or if they would rather just go home and live out their days. In a way, my interest in veterinary medicine is being realized.

References

1. Moyer, Anne. Personal interview. 31 January 2014