{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T04:24:20Z","timestamp":1789705460119,"version":"4.0.1"},"reference-count":72,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"12","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2017,4,20]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> We evaluated the effect of Internet-based cognitive behavioral therapy (CBT) on sexual functioning and relationship intimacy (primary outcomes) and body image, menopausal symptoms, marital functioning, psychological distress, and health-related quality of life (secondary outcomes) in breast cancer survivors (BCSs) with a DSM-IV diagnosis of a sexual dysfunction. <\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p> We randomly assigned 169 BCSs to either Internet-based CBT or a waiting-list control group. The CBT consisted of weekly therapist-guided sessions, with a maximum duration of 24 weeks. Self-report questionnaires were completed by the intervention group at baseline (T0), midtherapy (T1), and post-therapy (T2) and at equivalent times by the control group. We used a mixed-effect modeling approach to compare the groups over time. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Compared with the control group, the intervention group showed a significant improvement over time in overall sexual functioning (effect size for T2 [ES<jats:sub>T2<\/jats:sub>] = .43; P = .031), which was reflected in an increase in sexual desire (ES<jats:sub>T1<\/jats:sub> = .48 and ES<jats:sub>T2<\/jats:sub> = .72; P &lt; .001), sexual arousal (ES<jats:sub>T2<\/jats:sub> = .50; P = .008), and vaginal lubrication (ES<jats:sub>T2<\/jats:sub> = .46; P = .013). The intervention group reported more improvement over time in sexual pleasure (ES<jats:sub>T1<\/jats:sub> = .32 and ES<jats:sub>T2<\/jats:sub> = .62; P = .001), less discomfort during sex (ES<jats:sub>T1<\/jats:sub> = .49 and ES<jats:sub>T2<\/jats:sub> = .66; P = .001), and less sexual distress (ES<jats:sub>T2<\/jats:sub> = .59; P = .002) compared with the control group. The intervention group reported greater improvement in body image (ES<jats:sub>T2<\/jats:sub> = .45; P = .009) and fewer menopausal symptoms (ES<jats:sub>T1<\/jats:sub> = .39; P = .007) than the control group. No significant effects were observed for orgasmic function, sexual satisfaction, intercourse frequency, relationship intimacy, marital functioning, psychological distress, or health-related quality of life. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> Internet-based CBT has salutary effects on sexual functioning, body image, and menopausal symptoms in BCSs with a sexual dysfunction. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.2016.69.6021","type":"journal-article","created":{"date-parts":[[2017,2,27]],"date-time":"2017-02-27T20:58:00Z","timestamp":1488229080000},"page":"1328-1340","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":147,"title":["Efficacy of Internet-Based Cognitive Behavioral Therapy in Improving Sexual Functioning of Breast Cancer Survivors: Results of a Randomized Controlled Trial"],"prefix":"10.1200","volume":"35","author":[{"given":"Susanna B.","family":"Hummel","sequence":"first","affiliation":[{"name":"Susanna B. 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