Thomas C. Tsai

All Publications

• THE ROLES OF AFFECT REGULATION AND GENDER IN TELOMERE LENGTH AMONG FAMILY CAREGIVERS OF ADULTS WITH CANCER Dennis, D., Tsai, T. C., Bryan, E., Moriarty, K., Campbell, J., Doshi, S., Campbell, E., Palacios, M., Lopez, G., Cherni, O., Lin, J., Epel, E. S., Francisco, S., Spiegel, D., Kim, Y. LIPPINCOTT WILLIAMS & WILKINS. 2026

  View details for Web of Science ID 001788192100048

• DYADIC ASSOCIATIONS OF CARDIOVASCULAR SYNCHRONY WITH SLEEP HEALTH IN ADULTS WITH CANCER AND THEIR BEDPARTNER CAREGIVERS Tsai, T., Moulder, R., Zeitzer, J., Kim, Y. LIPPINCOTT WILLIAMS & WILKINS. 2026

  View details for Web of Science ID 001788192100200

• THE ROLE OF CAREGIVERS' PHYSIOLOGICAL RESILIENCE IN DYADIC SLEEP HEALTH AMONG COUPLES COPING WITH CANCER Kim, Y., Carver, C., Mendez, A., Tsai, T., Bryan, E., Zeitzer, J., Moulder, R. LIPPINCOTT WILLIAMS & WILKINS. 2026

  View details for Web of Science ID 001788192100123

• Roles of Sleep Coregulation in Longitudinal Neuroendocrine Functioning Among Patients with Colorectal Cancer and Their Spouses Kim, Y., Zeitzer, J., Moulder, R., Mendez, A., Tsai, T., Spiegel, D. OXFORD UNIV PRESS INC. 2026: A461

  View details for DOI 10.1093/sleep/zsag091.1034

  View details for Web of Science ID 001761233300013

• Self-Disclosure and Sleep Quality in Patients and Caregivers Facing Cancer Bryan, E., Tsai, T., Laurenceau, J., Zeitzer, J., Kim, Y. WILEY. 2026: 31-32

  View details for Web of Science ID 001730866000035

• Healthcare Utilization and Substance Use in Partners of Adults With Colorectal Cancer Kim, Y., Tsai, T. C., Mitchell, H., Ting, A., Spiegel, D. WILEY. 2025

  View details for Web of Science ID 001694243900075

• Dyadic Investigation of Stress Regulation and Sleep Health in Patients With Colorectal Cancer and Their Spousal Caregivers Kim, Y., Ting, A., Tsai, T. C., Zeitzer, J. WILEY. 2025

  View details for Web of Science ID 001694243900185

• The Roles of Gender and Patient versus Caregiver Status in Cardiovascular and Affective Responses to an Induced Stress. Biopsychosocial science and medicine Kim, Y., Tsai, T. C., Spiegel, D., Carver, C. S. 2025

  Abstract

  Adults with cancer and their family caregivers have displayed compromised cardiovascular functioning and elevated psychological distress, yet the independent and synergistic roles of gender and patient-versus-caregiver status in their cardiovascular and affective stress responses are yet to be elucidated.Patients newly diagnosed with colorectal cancer (n=118, 56 y old, 36% female, 62% Hispanic, 6.5 mo post-diagnosis) and their spousal caregivers (n=118, 55 y old, 70% female) underwent a stress induction task that is relevant to close relationship and health issues. Cardiovascular-Root Mean Square of the Successive Differences (RMSSD), heart rate (HR), and systolic and diastolic blood pressure (SBP and DBP)- and affective (positive and negative affect, and stress) responses were assessed for its resting, stress reactivity, and recovery patterns.Stress induction was successful noted in both cardiovascular and affective markers. General linear modeling for repeated measures revealed that the synergistic effects of gender and patient-versus-caregiver status in RMSSD, HR, DBP, and positive affect responses (4.180≤F≤8.185, P<0.043), with female caregivers showing the most heightened responses. Caregivers reported greater stress reactivity in negative affect than patients (F=28.046, P<0.001).Findings highlight the independent and synergistic effects of gender and patient-versus-caregiver roles in cardiovascular stress regulation. Findings also suggest the different ways in which gender shapes cardiovascular and affective phenotypes in stress situations, which may impact the etiology and progression of premature morbidities in this vulnerable population.

  View details for DOI 10.1097/PSY.0000000000001408

  View details for PubMedID 40511970

• INDIVIDUAL AND DYADIC ASSOCIATIONS OF SELF-REGULATION WITH SLEEP HEALTH IN PATIENTS WITH CANCER AND THEIR SLEEP-PARTNER CAREGIVERS Tsai, T. C., Zeitzer, J., Kim, Y. OXFORD UNIV PRESS INC. 2025: S647

  View details for Web of Science ID 001691132305079

• SLEEP DISTURBANCE IN ADULTS WITH CANCER: INVESTIGATION OF HISPANIC ETHNICITY AND US-BORN STATUS Kim, Y., Tsai, T., Ting, A., Ramos, A., Zeitzer, J., Spiegel, D. LIPPINCOTT WILLIAMS & WILKINS. 2025: A98

  View details for Web of Science ID 001595171200213

• A dyadic stress induction tool for experimental investigation of adult patients with cancer and their family caregivers. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine Kim, Y., Carver, C. S., Tsai, T. C., Ting, A., Spiegel, D. 2025; 59 (1)

  Abstract

  Medical illnesses are major stressors not only for the patients but also for their family caregivers, yet existing tools are inadequate to assess mechanistic response patterns to such stressors.We sought to validate a stress induction task that pertains to close relationships and health-related concerns with adult patients with cancer and their family caregivers.Patients newly diagnosed with colorectal cancer (n = 123, 56 years old, 34% female, 60% Hispanic, 6.5 months post-diagnosis) and their family caregivers (55 years old, 66% female, 59% Hispanic) underwent an experimental session during which both individuals imagined a scenario where one person is hit by a car (patient) and the partner (caregiver) has no means to provide or seek out help for the victim. The session consisted of 6 phases: baseline, scenario provision, speech preparation, speech by caregiver, speech by patient, and recovery.Results of general linear modeling with repeated measures revealed that the task induced significant affective, stress, and cardiovascular responses in both patients and caregivers. Stress reactivity and recovery patterns, however, varied by patients versus caregivers, stress induction phases, and the types of assessment.Findings suggest the newly developed stress task as an acceptable tool for studying stress regulation in medical and family contexts. With further validation, this tool may help identify psychological and physiological pathways to improve the stress coping outcomes of adult patients with cancer and their family caregivers.

  View details for DOI 10.1093/abm/kaaf005

  View details for PubMedID 39921341

  View details for PubMedCentralID PMC11805928

• Sleep Composition of Patients With Colorectal Cancer and Their Sleep-Partner Caregivers: Physical Health Correlates of Sleep Diary and Actigraphy Measurements. Psycho-oncology Ting, A., Tsai, T. C., Zeitzer, J. M., Mendez, A., Kim, Y. 2024; 33 (8): e9302

  Abstract

  Disturbed sleep is frequently identified in adult patients with cancer and their caregivers, with detrimental impact on physical health. Less known is the extent to which self-reported and actigraph-measured sleep patterns are similar between patients and their sleep-partner caregivers, and how these different modes of sleep measurements are related to physical health.Patients diagnosed with colorectal cancer and their sleep-partner caregivers (81 dyads) completed a questionnaire for physical functioning and collected saliva samples for seven consecutive days, from which cortisol slope was quantified. Additionally, participants completed a daily sleep diary and wore actigraph for 14 consecutive days, from which sleep duration, sleep onset latency (SOL), and duration of wake after sleep onset (WASO) were calculated.Participants reported sleep patterns that fell within or close to the optimal range, which were similar between patients and their caregivers. Self-reported and actigraph-measured sleep duration had moderate levels of agreement (ICC = 0.604), whereas SOL and WASO had poor agreement (ICC = 0.269). Among patients, longer self-reported WASO was associated with poorer physical health and flatter cortisol slope (p ≤ 0.013). Among caregivers, longer self-reported SOL was associated with poorer physical functioning, actigraph-measured WASO was associated with steeper cortisol slope, and longer self-reported sleep markers studied than actigraph-measured were associated with poorer physical functioning (p ≤ 0.042).Findings suggest that employing multiple assessment modes for sleep and physical health is vital for comprehensive understanding of sleep health. Furthermore, when addressing patients' sleep health, it may be beneficial to include their sleep-partner caregivers who may experience similar disturbed sleep.

  View details for DOI 10.1002/pon.9302

  View details for PubMedID 39123341

• The associations of spirituality and Hispanic ethnicity with neuroendocrine biomarkers among patients with colorectal cancer. Journal of psychosomatic research Cruz, E., Mendez, A., Ting, A., Spiegel, D., Tsai, T. C., Carver, C. S., Kim, Y. 2024; 185: 111865

  Abstract

  Dealing with cancer evokes not only physical and emotional distress, but may also promote resilience through spirituality. Patients with cancer are vulnerable to neuroendocrine dysregulation. This longitudinal observational study examined the degree to which spirituality was associated with neuroendocrine biomarkers and the moderating role of Hispanic ethnicity.Participants were adults who were recently diagnosed with colorectal cancer (n = 81, 55 years old, 66% male, 63% Hispanic, 72% advanced cancer, 7 months post-diagnosis). The domains of spirituality (faith, meaning, and peace) and ethnicity (Hispanic vs. non-Hispanic) were self-reported. Cortisol and alpha amylase (sAA) were assayed from saliva samples collected at waking and bedtime on seven consecutive days. Mean levels at waking and bedtime, and diurnal slopes over seven days were calculated. Age and cancer stage were covariates.Overall, patients reported moderate to high levels of spirituality. General linear modeling revealed that greater faith was associated with higher levels of sAA at waking and bedtime as well as more blunted diurnal pattern of sAA only among Hispanic patients (p ≤ .045). Greater peace was associated with steeper diurnal pattern of sAA, regardless of ethnicity (B = 0.021, p = .005). Meaning and cortisol were not significantly associated with study variables.Findings indicate that presence of peace facing a cancer diagnosis associated with neuroendocrine regulation, whereas drawing on one's faith, particularly among Hispanic patients, associated with neuroendocrine dysregulation during the first months after the diagnosis. Further investigations of psychobiobehavioral moderators and mediators for healthy neuroendocrine functioning among patients with cancer are warranted.

  View details for DOI 10.1016/j.jpsychores.2024.111865

  View details for PubMedID 39116686

• DYADIC INVESTIGATION OF POST-TRAUMATIC STRESS SYMPTOMS AND DAILY SLEEP HEALTH IN PATIENTS WITH CANCER AND THEIR CAREGIVERS Tsai, T., Mitchell, H., Zeitzer, J., Ting, A., Laurenceau, J., Spiegel, D., Kim, Y. LIPPINCOTT WILLIAMS & WILKINS. 2024: A182

  View details for Web of Science ID 001290655500443

• THE EFFECTS OF DYADIC STRESS REGULATION ON DAILY SLEEP HEALTH AMONG ADULT PATIENTS WITH CANCER AND THEIR SLEEP-PARTNER CAREGIVERS Kim, Y., Tsai, T., Moulder, R., Ting, A., Gonzalez, A., Spiegel, D. LIPPINCOTT WILLIAMS & WILKINS. 2024: A153

  View details for Web of Science ID 001290655500374

• DYADIC ASSOCIATIONS OF SELF-REGULATION WITH CARDIOVASCULAR STRESS RESPONSES AMONG PATIENTS WITH CANCER AND THEIR CAREGIVERS Tsai, T., Hurwitz, B., Spiegel, D., Ortega, D., Kim, Y. LIPPINCOTT WILLIAMS & WILKINS. 2024: A141

  View details for Web of Science ID 001290655500345

• PHYSICAL HEALTH CORRELATES OF SUBJECTIVE AND OBJECTIVE SLEEP MARKERS IN PATIENTS WITH CANCER AND THEIR CAREGIVERS Kim, Y., Tsai, T., Ting, A., Zeitzer, J., Ramos, A., Mendez, A. OXFORD UNIV PRESS INC. 2024

  View details for Web of Science ID 001262172001426

• Dyadic Investigation of Posttraumatic Stress Symptoms and Daily Sleep Health in Patients with Cancer and their Caregivers. Psychosomatic medicine Tsai, T. C., Mitchell, H. R., Zeitzer, J., Ting, A., Laurenceau, J. P., Spiegel, D., Kim, Y. 2024

  Abstract

  Cancer can be a traumatic experience affecting multidimensional aspects of sleep among patients and caregivers. This study examined the differential associations of cancer-related post-traumatic stress symptoms (PTSS) with various sleep markers in this population.Patients newly diagnosed with colorectal cancer (n = 138, mean age = 56.93 years, 31.88% female, 60.14% Hispanic, 6.53 months post-diagnosis) and their sleep-partner caregivers (n = 138, mean age = 55.32 years, 68.12% female, 57.97% Hispanic) completed questionnaires assessing the four PTSS clusters (intrusion, avoidance, alterations in arousal and reactivity, negative alterations in cognitions and mood). Participants also completed daily sleep diaries for 14 consecutive days, from which sleep onset latency (SOL), wake after sleep onset (WASO), and sleep duration were derived.Actor-partner interdependence model revealed that caregivers' greater alterations in arousal and reactivity were associated with their own longer SOL (b = 14.54, p < .001) and their patients' longer sleep duration (b = 0.47, p = .040), whereas patients' arousal and reactivity were associated with their caregivers' shorter SOL (b = -8.34, p = .047) and WASO (b = -8.12, p = .019). Patients' and caregivers' greater negative alterations in cognitions and mood were associated with patients' longer SOL (b = 8.89, p = .016) and shorter sleep duration (b = -0.40, p = .038), respectively. Caregivers' greater intrusion was related to their own shorter SOL (b = -10.92, p = .002).The four PTSS clusters, particularly arousal and reactivity and negative cognitions and mood, have distinct associations with sleep markers individually and dyadically in patients and caregivers affected by cancer. Investigations of psychosocial and biobehavioral pathways underlying these relations are warranted. Tailored trauma treatments and sleep interventions may improve the well-being of this population.

  View details for DOI 10.1097/PSY.0000000000001283

  View details for PubMedID 38345316

• ASSOCIATIONS OF SELF-DISCLOSURE WITH SLEEP IN CANCER PATIENTS AND THEIR SLEEP-PARTNER CAREGIVERS: A DYADIC INVESTIGATION Tsai, T. C., Ajmera, N., Ting, A., Laurenceau, J., Zeitzer, J., Kim, Y. LIPPINCOTT WILLIAMS & WILKINS. 2023: A105

  View details for Web of Science ID 001167041400259

• CARDIOVASCULAR COREGULATION TO A SERIES OF ACUTE INTERPERSONAL STRESSORS: INNOVATIVE METHODOLOGICAL APPROACH TO STUDYING REGULATION TO A CHRONIC ILLNESS IN THE FAMILY Moulder, R., Tsai, T. C., Hurwitz, B., Spiegel, D., Kim, Y. LIPPINCOTT WILLIAMS & WILKINS. 2022: A38

  View details for Web of Science ID 000804854700122

• EFFECT OF SELF-REGULATION ON SLEEP IN COLORECTAL CANCER PATIENTS: THE MEDIATING ROLE OF NEGATIVE AFFECT RECOVERY Tsai, T. C., Ting, A., Llabre, M., Martinez, L., Zeitzer, J., Kim, Y. LIPPINCOTT WILLIAMS & WILKINS. 2022: A82

  View details for Web of Science ID 000804854700247

• DYADIC INVESTIGATIONS OF ADULT ATTACHMENT AND SLEEP IN ADULT CANCER PATIENTS AND THEIR CAREGIVERS Ting, A., Zeitzer, J., Wohlgemuth, W., Tsai, T. C., Ajmera, N., Kim, Y. LIPPINCOTT WILLIAMS & WILKINS. 2022: A67

  View details for Web of Science ID 000804854700203