Karen L Weihs
- Professor, Psychiatry
- Associate Professor, Family and Community Medicine
Karen Weihs, M.D. is known internationally as a clinician, scientist, educator and thought leader in the areas of PsychoOncology, Supportive Care and Psychosomatic Medicine. She is board certified in Psychiatry, Palliative Medicine and Hospice Care, as well as in Family Medicine.
Dr. Weihs’ NIH funded research investigates the biological, psychological and social mechanisms through which the stress of cancer impacts both emotional and physical health outcomes of cancer patients. Her research career was launched with a Scientist Development Award for Clinicians for studies of family process and breast cancer outcomes. This research continues with her current R01 funding from the National Cancer Institute for the project “Emotional Regulation and Depression in Breast Cancer Survivorship”.
Dr. Weihs’ mentorship for graduate students in clinical psychology, family studies, art therapy has contributed to the next generation of psychosomatic medicine researchers. She is recognized for her leadership in bringing together colleagues from diverse backgrounds to study the interface of emotion science, neural systems, cancer biology and social processes as it impacts basic and applied research on PsychoOncology.
She has served on the leadership Council for the American Psychosomatic Society since 2009 and will complete her term as president in the spring of 2016. In this capacity, she contributed to the strategic plan for the organization and led the first Special Emphasis Symposium- “Toward Precision Cancer Care: Biobehavioral Contributions to the Exposome” – in the fall of 2012.
Dr. Weihs founded the multidisciplinary clinical service, Supportive Care for Healing, at the University of Arizona Cancer Center, for which the mission is to provide “Practical resources, support and healing opportunities in life transitions with cancer for patients and their close others”. In 2008 she was honored with the Award for Excellence in Clinical Care by the American PsychoOncology Society.
She is currently Professor with Tenure at the University of Arizona, Department of Psychiatry and a Comprehensive Member of the University of Arizona Cancer Center. She is a graduate of the University of Iowa, College of Medicine and completed her training in Psychiatry at the University of Wisconsin-Madison.
- The University of Iowa College of Medicine, Iowa City, Iowa, United States
- B.A. Biology & Chemistry
- University of Northern Iowa, Cedar Falls, Iowa, United States
- Professor with tenure, University of Arizona: College of Medicine- Department of Psychiatry (2013 - Ongoing)
- Associate Professor of Family and Community Medicine, 2ndary appointment, University of Arizona: College of Medicine (2009 - Ongoing)
- Associate Professor with tenure, University of Arizona: College of Medicine- Department of Psychiatry (2008 - 2013)
- Associate Professor, University of Arizona: College of Medicine- Department of Psychiatry (2005 - 2008)
- Associate Professor, The George Washington University: Department of Psychiatry & Behavioral Sciences (2002 - 2005)
- Assistant Professor, The George Washington University: Department of Psychiatry & Behavioral Sciences (1991 - 2002)
- Instructor, University of Wisconsin: Division of Child Psychiatry, Department of Psychiatry (1991)
- Clinical Instructor, University of Wisconsin; Department of Family Medicine (1988 - 1991)
- Assistant Professor, Brown University: Department of Family Medicine (1984 - 1986)
- Instructor, Brown University: Department of Family Medicine (1982 - 1984)
- Life Fellow
- Am Psychiatric Association, Spring 2016
- Best Doctors in America
- Spring 2015
- Spring 2014
- Spring 2013
- Spring 2012
- Spring 2011
Licensure & Certification
- Certification in Hospice and Palliative Medicine, American Board of Psychiatry and Neurology (2012)
- American Board of Family Practice Certification, American Board of Family Medicine (1982)
- American Board of Family Practice Certification, American Board of Family Medicine (1988)
- American Board of Family Practice Certification, American Board of Family Medicine (1995)
- American Board of Family Practice Certification, American Board of Family Medicine (2002)
- Certification in Psychiatry, American Board of Psychiatry and Neurology (1994)
- American Board of Family Practice Certification, American Board of Family Medicine (2009)
Mind Body processes as they affect patients with chronic and life threatening illnessPsychotherapeutic processes, especially related to emotion regulation
Physician patient relationshipsPsychoOncologyMentalization based Psychotherapy
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- Weihs, K. L., Alberts, D. S., & Lluria-Prevatt, M. D. (2016). Supportive Cancer Care. Cham, Switzerland: Springer International Publishing.
- Weihs, K. L., Alberts, D. S., Lluria-Prevatt, M. D., & Ka, S. (2016). Supportive Cancer Care. Cham, Switzerland: Springer International Publishing.
- Weihs, K. L., Alberts, D., Lluria-Prevatt, M., & Ka, S. (2015). Supportive Cancer Care. Switzerland: Springer.More infoThis textbook provides a highly coordinated, interdisciplinary model for future clinical cancer supportive care programs in National Cancer Institute (NCI)-designated Clinical and Comprehensive Cancer Centers and NCI Community Oncology Research Programs (NCORPs). At the same time, it is intended to serve as an up-to-date resource for oncologists and primary care providers that addresses the many aspects of supportive care associated with cancer survivorship. Accordingly, the book covers a wide range of areas and topics, including but not limited to psychosocial oncology, patient and familyeducation, lifestyle change counseling, palliative care, symptom management (eg. Pain control), cancer risk and genetic counseling, financial planning, and patient navigation.
- Weihs, K. L. (2015). Psychosocial Oncology. In Supportive Cancer Care. Cham, Switzerland: Springer International Publishing.More infoThis textbook provides a highly coordinated, interdisciplinary model for future clinical cancer supportive care programs in National Cancer Institute (NCI)-designated Clinical and Comprehensive Cancer Centers and NCI Community Oncology Research Programs (NCORPs). At the same time, it is intended to serve as an up-to-date resource for oncologists and primary care providers that addresses the many aspects of supportive care associated with cancer survivorship. Accordingly, the book covers a wide range of areas and topics, including but not limited to psychosocial oncology, patient and familyeducation, lifestyle change counseling, palliative care, symptom management (eg. Pain control), cancer risk and genetic counseling, financial planning, and patient navigation.
- Bauer, M. R., Wiley, J. F., Weihs, K. L., & Stanton, A. L. (2017). Stuck in the spin cycle: Avoidance and intrusions following breast cancer diagnosis. British journal of health psychology, 22(3), 609-626.More infoTheories and research regarding cognitive and emotional processing during the experience of profound stressors suggest that the presence of intrusive thoughts and feelings predicts greater use of avoidance and that the use of avoidance paradoxically predicts more intrusions. However, empirical investigations of their purported bidirectional relationship are limited.
- Harris, L. N., Bauer, M. R., Wiley, J. F., Hammen, C., Krull, J. L., Crespi, C. M., Weihs, K. L., & Stanton, A. L. (2017). Chronic and episodic stress predict physical symptom bother following breast cancer diagnosis. Journal of behavioral medicine, 40(6), 875-885.More infoBreast cancer patients often experience adverse physical side effects of medical treatments. According to the biobehavioral model of cancer stress and disease, life stress during diagnosis and treatment may negatively influence the trajectory of women's physical health-related adjustment to breast cancer. This longitudinal study examined chronic and episodic stress as predictors of bothersome physical symptoms during the year after breast cancer diagnosis. Women diagnosed with breast cancer in the previous 4 months (N = 460) completed a life stress interview for contextual assessment of chronic and episodic stress severity at study entry and 9 months later. Physical symptom bother (e.g., pain, fatigue) was measured at study entry, every 6 weeks through 6 months, and at nine and 12 months. In multilevel structural equation modeling (MSEM) analyses, both chronic stress and episodic stress occurring shortly after diagnosis predicted greater physical symptom bother over the study period. Episodic stress reported to have occurred prior to diagnosis did not predict symptom bother in MSEM analyses, and the interaction between chronic and episodic stress on symptom bother was not significant. Results suggest that ongoing chronic stress and episodic stress occurring shortly after breast cancer diagnosis are important predictors of bothersome symptoms during and after cancer treatment. Screening for chronic stress and recent stressful life events in the months following diagnosis may help to identify breast cancer patients at risk for persistent and bothersome physical symptoms. Interventions to prevent or ameliorate treatment-related physical symptoms may confer added benefit by addressing ongoing non-cancer-related stress in women's lives.
- Howe, G. W., Selzer, R., Cimporescu, M., Neiderhiser, J., Moreno, F., & Weihs, K. L. (2017). Combining stress exposure and stress generation: Does neuroticism alter the dynamic interplay of stress, depression and anxiety following job loss?. Journal of Personality, 85(4), 553-564. doi:10.1111/jopy.12260
- Weihs, K. L., Murphy, W., Abbas, R., Chiles, D., England, R. D., Ramaker, S., & Wajsbrot, D. B. (2017). Desvenlafaxine Versus Placebo in a Fluoxetine-Referenced Study of Children and Adolescents with Major Depressive Disorder. Journal of child and adolescent psychopharmacology.More infoTo evaluate the short-term efficacy and safety of desvenlafaxine (25-50 mg/d) compared with placebo in children and adolescents with major depressive disorder (MDD).
- Weihs, K. L., Segrin, C. G., Swiatkowski, P., McNelis, M. J., & Badger, T. A. (2017). Why Latinas with Breast Cancer Select Specific Supportive Partners to Participate with Them in Psychosocial Interventions.. Journal of Transcultural Nursing, 28(4), 391-397.
- Weihs, K. L., Wiley, J. F., Crespi, C. M., Krull, J. L., & Stanton, A. L. (2017). Predicting future major depression and persistent depressive symptoms: Development of a prognostic screener and PHQ-4 cutoffs in breast cancer patients. Psycho-oncology.More infoCreate a brief, self-report screener for recently diagnosed breast cancer patients to identify patients at risk of future depression.
- Bauer, M. R., Harris, L. N., Wiley, J. F., Crespi, C. M., Krull, J. L., Weihs, K. L., & Stanton, A. L. (2016). Dispositional and Situational Avoidance and Approach as Predictors of Physical Symptom Bother Following Breast Cancer Diagnosis. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.More infoFew studies examine whether dispositional approach and avoidance coping and stressor-specific coping strategies differentially predict physical adjustment to cancer-related stress.
- Howe, G. W., Cimporescu, M., Seltzer, R., Neiderhiser, J., Moreno, F., & Weihs, K. (2016). Combining stress exposure and stress generation: Does neuroticism alter the dynamic interplay of stress, depression, and anxiety following job loss?. Journal of personality.More infoEmerging models of stress point to a dynamic formulation where stressors and internalizing symptoms reciprocally influence each other. This study tested whether this dynamic interplay is the result of a general internalizing process underlying both depression and anxiety, and whether it varies with neuroticism.
- Larkey, L., Huberty, J., Pedersen, M., & Weihs, K. (2016). Qigong/Tai Chi Easy for fatigue in breast cancer survivors: Rationale and design of a randomized clinical trial. Contemporary clinical trials, 50, 222-8.More infoBreast cancer survivors (BCSs) often report fatigue that persists for years following treatment. Despite a growing body of evidence for meditative movement practices to improve symptoms among BCSs, few studies have explored using Qigong/Tai Chi to reduce fatigue. Additionally, few have examined the biological mechanisms through which fatigue may be reduced using Qigong/Tai Chi.
- Dodds, S. E., Pace, T. W., Bell, M. L., Fiero, M., Negi, L. T., Raison, C. L., & Weihs, K. L. (2015). Erratum to: Feasibility of Cognitively-Based Compassion Training (CBCT) for breast cancer survivors: a randomized, wait list controlled pilot study. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 23(12), 3609-11.
- Dodds, S. E., Pace, T. W., Bell, M. L., Fiero, M., Negi, L. T., Raison, C. L., & Weihs, K. L. (2015). Feasibility of Cognitively-Based Compassion Training (CBCT) for breast cancer survivors: a randomized, wait list controlled pilot study. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 23(12), 3599-608.More infoThis study assessed the feasibility of a meditation-based program called Cognitively-Based Compassion Training (CBCT) with breast cancer survivors. Enrollment and participant satisfaction with a novel intervention, adherence to program requirements, and differences between the intervention group and wait list controls on self-report measures were also assessed. Additionally, cortisol, a stress-related endocrine biomarker, was assessed.
- Lane, R. D., Weihs, K. L., Herring, A., Hishaw, A., & Smith, R. (2015). Affective agnosia: Expansion of the alexithymia construct and a new opportunity to integrate and extend Freud's legacy. Neuroscience and biobehavioral reviews, 55, 594-611.More infoWe describe a new type of agnosia consisting of an impairment in the ability to mentally represent or know what one is feeling. Freud the neurologist coined the term "agnosia" in 1891 before creating psychoanalysis in 1895 but the term has not been previously applied to the domain of affective processing. We propose that the concept of "affective agnosia" advances the theory, measurement and treatment of what is now called "alexithymia," meaning "lack of words for emotion." We trace the origin of the alexithymia construct and discuss the strengths and limitations of extant research. We review evidence that the ability to represent and put emotions into words is a developmental achievement that strongly influences one's ability to experience, recognize, understand and use one's own emotional responses. We describe the neural substrates of emotional awareness and affective agnosia and compare and contrast these with related conditions. We then describe how this expansion of the conceptualization and measurement of affective processing deficits has important implications for basic emotion research and clinical practice.
- Larkey, L. K., Roe, D. J., Weihs, K. L., Jahnke, R., Lopez, A. M., Rogers, C. E., Oh, B., & Guillen-Rodriguez, J. (2015). Randomized controlled trial of Qigong/Tai Chi Easy on cancer-related fatigue in breast cancer survivors. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine, 49(2), 165-76.More infoMany breast cancer survivors experience fatigue, mood, and sleep disturbances.
- Monfort, S. S., Howe, G. W., Nettles, C. D., & Weihs, K. L. (2015). A longitudinal examination of re-employment quality on internalizing symptoms and job-search intentions. Journal of occupational health psychology, 20(1), 50-61.More infoUnderemployed workers-those receiving less pay, working fewer hours, or using fewer skills than they would prefer-appear to experience negative mental health outcomes similar to the unemployed. Prior cross-sectional research provides mixed empirical evidence for this conclusion, however. The current study sought to clarify the impact of underemployment longitudinally, assessing mental health 5 times over 8 months after job loss. In addition to the commonly used indicators of underemployment, we designed a measure of cognitive complexity using the Occupational Information Network (O*NET), an extensive government database used to organize and categorize occupational information. Replicating past research, we found concurrent associations between all indexes of reemployment job quality and internalizing symptoms in the period immediately after reemployment. However, when controlling for quality of prior employment, all indicators except our measure for cognitive complexity became nonsignificant. As participants transitioned from unemployment to reemployment, only reductions in cognitive complexity were associated with sustained general internalizing symptoms. We also found that although changes in cognitive complexity had an immediate impact on the well-being of the recently reemployed, only the number of available weekly hours (full-time vs. part-time status) was relevant 6 to 12 weeks later. Our longitudinal model thus provides significant nuance to the current understanding of underemployment and mental health.
- Stanton, A. L., Wiley, J. F., Krull, J. L., Crespi, C. M., Hammen, C., Allen, J. J., Barrón, M. L., Jorge, A., & Weihs, K. L. (2015). Depressive episodes, symptoms, and trajectories in women recently diagnosed with breast cancer. Breast cancer research and treatment, 154(1), 105-15.More infoDepression carries serious psychosocial, physical, and economic consequences for cancer survivors. Study goals were to characterize patterns and predictors of depressive symptoms and major depressive episodes in recently diagnosed breast cancer patients. Consecutively recruited women (N = 460) completed a validated interview (CIDI) and questionnaire measure (CES-D) of depression within 4 months after invasive breast cancer diagnosis and at six additional assessments across 12 months. Outcomes were major depressive episodes, continuous symptom scores, and latent symptom trajectory classes. Across 12 months, 16.6 % of women met criteria for a major depressive episode. Unemployment predicted depressive episodes after other correlates were controlled. Distinct trajectory classes were apparent: an estimated 38 % of women had chronically elevated symptoms (High trajectory), 20 % recovered from elevated symptoms (Recovery), and 43 % had lower symptoms (Low and Very Low trajectories). Although 96 % of episodes occurred in the High or Recovery classes, 66 % of women in the High trajectory did not have an episode. Women in the Low (vs High) trajectory were more likely to be older, retired, more affluent, and have fewer comorbid diseases and briefer oncologic treatment. Women in the Recovery trajectory (vs High) were more likely to be married and more affluent and have fewer comorbid diseases. Assuming available therapeutic resources, assessment of both depressive symptoms and episodes over several months after diagnosis is important. Identification of patients at risk for persistently high depressive symptoms (e.g., younger, longer treatment course) opens targeted opportunities to prevent and promote rapid recovery from depression.
- Menzl, I., Lebeau, L., Pandey, R., Hassounah, N. B., Li, F. W., Nagle, R., Weihs, K., & McDermott, K. M. (2014). Loss of primary cilia occurs early in breast cancer development. Cilia, 3, 7.More infoPrimary cilia are microtubule-based organelles that protrude from the cell surface. Primary cilia play a critical role in development and disease through regulation of signaling pathways including the Hedgehog pathway. Recent mouse models have also linked ciliary dysfunction to cancer. However, little is known about the role of primary cilia in breast cancer development. Primary cilia expression was characterized in cancer cells as well as their surrounding stromal cells from 86 breast cancer patients by counting cilia and measuring cilia length. In addition, we examined cilia expression in normal epithelial and stromal cells from reduction mammoplasties as well as histologically normal adjacent tissue for comparison.
- Robbins, M. L., López, A. M., Weihs, K. L., & Mehl, M. R. (2014). Cancer conversations in context: naturalistic observation of couples coping with breast cancer. Journal of family psychology : JFP : journal of the Division of Family Psychology of the American Psychological Association (Division 43), 28(3), 380-90.More infoThis study explored the feasibility and potentials of a naturalistic observation approach to studying dyadic coping in everyday life. Specifically, it examined the natural context and content of the spontaneous cancer conversations of couples coping with cancer, and how they relate to patients' and spouses' psychological adjustment. Women with breast cancer (N = 56) and their spouses wore the electronically activated recorder (EAR), an unobtrusive observation method that periodically records snippets of ambient sounds, over one weekend to observe the couples' cancer conversations in their natural context. Both patients and spouses completed self-reported measures of psychological adjustment at baseline and at a 2-month follow-up. Cancer was a topic of approximately 5% of couples' conversations. Cancer conversations occurred more often within the couple than with friends and family, and they were more often informational than emotional or supportive. Consistent with research on the social cognitive processing model (Lepore & Revenson, 2007), spouses' engagement in emotional disclosure and informational conversation with patients predicted better patient adjustment. This first naturalistic observation study of dyadic coping revealed that the EAR method can be implemented with high compliance and relatively low obtrusiveness within the sensitive context of couples coping with cancer, and having a spouse who discussed cancer in an emotional or informational way predicted better patient adjustment. As a complement to in-lab and other momentary assessment methods, a naturalistic observation approach with a method such as the EAR can contribute to a more comprehensive understanding of the role that communication processes play in coping with cancer.
- Varga, C. M., Nettles, C. D., Whitesel, A. L., Howe, G. W., & Weihs, K. L. (2014). The Interplay of Stress and Attachment in Individuals Weathering Loss of Employment. Journal of research in personality, 50, 23-32.
- Marshall, C. A., Curran, M. A., Koerner, S. S., Weihs, K. L., Hickman, A. C., & García, F. A. (2013). Information and support for co-survivors during or after cancer treatment: Consideration of Un Abrazo Para la Familia as a model for family-focused intervention in cancer rehabilitation. Work (Reading, Mass.), 46(4), 395-405.More infoThe development and evaluation of Un Abrazo Para La Familia, [A Hug for the Family] is described. Un Abrazo is discussed as an effective model of education, information-sharing, and skill-building for use with low-income co-survivors of cancer.
- Weihs, K. L. (2017, June/Summer). Preventive Intervention to Reduce Depression in the Year After Breast Cancer Diagnosis: A precision/Experimental Medicine Approach. Annual meeting of the Academy of Behavioral Medicine Research. Santa Fe, NM: Academy for Behavioral Medicine Research.More infoeihs, KL (2017, June 23) Preventive Intervention to Reduce Depression in the Year After Breast Cancer Diagnosis: A Precision/ Experimental Medicine Approach. 2017 Academy of Behavioral Medicine Research Annual Meeting, Santa Fe, New Mexico.
- Weihs, K. L., Kogan, A., Stanton, A. L., Wiley, J., & Allen, J. (2015, March). Cardiac Vagal Control and Coping Strategies as Predictors of Depression in Breast Cancer. American Psychosomatic Society 73rd Annual Scientific Meeting. Savannah, GA.
- Weihs, K. L., Lane, R. D., Landa, A., & Gundel, H. (2015, January). Symptom Formation and mechanisms of Change in Somatoform Disorders: Research findings and implications for treatment. Psychodynamic Psychoanalytic Research Society, 5th Annual Meeting. New York, NY.
- Weihs, K. L., Weihs, K. L., Raison, C. L., Raison, C. L., Pace, T. W., Pace, T. W., Dodds, S., Dodds, S., Bell, M., Bell, M., Eparvier, L., Eparvier, L., Fiero, M., & Fiero, M. (2015, July). Feasibility and Effects of Cognitively-Based Compassion Training (CBCT) on Psychological Well-Being in Breast Cancer Survivors: A Randomized, Wait List Controlled Pilot Study. 2015 World Congress of Psycho-Oncology. Washington, D.C.: American PsychoOncology Society.
- Weihs, K. L., Wiley, J. F., Crespi, C. M., Krull, J. L., Allen, J. J., & Stanton, A. L. (2015, January). Intraindividual Variability in Cancer-Related Avoidance Coping predicts Depressive Symptoms. Annual meeting of the American Psychosomatic Society.
- Weihs, K. L., Reed, R. G., Butler, E. A., Sbarra, D. A., Breen, E. C., & Irwin, M. R. (2015, March). Associations between pro-inflammatory cytokines and physical symptoms are moderated by emotional acceptance in women with breast cancer.. American Psychosomatic Society 73rd Annual Scientific Meeting. Savannah, GA.