About

Dr. Shelby Langer is a personality and social psychologist with post-doctoral training in behavioral medicine and cancer control. She is an Associate Professor with tenure in the Edson College of Nursing and Health Innovation at Arizona State University and serves as an affiliate investigator at Mayo Clinic Arizona. Her scholarship primarily focuses on family processes within the context of chronic illness, with research spanning both adult and pediatric illness populations. Her primary line of investigation examines communication and emotion regulation among couples coping with advanced cancer, aiming to understand the intra- and inter-personal consequences of patient and partner communicative behaviors and motivations on psychological, relational, and physical health outcomes. Dr. Langer employs multiple methods in her research, including technology-based assessment, behavioral observation, and biological sampling, to inform the development and testing of behavioral interventions designed to optimize patient and partner well-being. Her work has been funded by awards from the National Institutes of Health, the American Cancer Society, the National Endowment for the Arts, and the Mayo Clinic - ASU Alliance. In addition to her research, she is an educator, a fellow of the Society of Behavioral Medicine, and has served as the Immediate Past Chair of the society’s Cancer Special Interest Group. She is also a member of the editorial boards of Annals of Behavioral Medicine and Contemporary Clinical Trials, and participates in the professional advisory board of Cancer Support Community Arizona.

Research topics

• Medicine
• Gerontology
• Psychology
• Demography
• Sociology
• Computer Science
• Applied psychology
• Environmental health
• Business
• Clinical psychology
• Internal medicine
• Medical education
• Physical therapy
• Marketing
• Psychiatry

Selected publications

• Beliefs and Behaviors Related to Physical Activity in Black Girls With Asthma

  Pediatric Pulmonology · 2026-02-01

  articleOpen access

  INTRODUCTION AND OBJECTIVE: Physical activity (PA) is associated with improved asthma outcomes. Black girls face higher rates of asthma morbidity and are less likely to meet recommended PA than their White and Black male peers. To address these health disparities, it is essential to understand beliefs and behaviors related to PA among Black girls with asthma. METHODS: For this qualitative study, Black girls with asthma and their mothers or female caregivers were recruited through flyers and direct outreach to patients at one academic medical center. Semi-structured interviews focused on knowledge of PA recommendations, perceived risks and benefits of PA, barriers and facilitators to PA, and maternal influences on PA. Transcripts were coded iteratively through deductive thematic analysis. FINDINGS: Twenty girls (age: mean = 9.9 years, SD = 1.33, range = 8-12) and their caregivers participated. Most viewed asthma as a limitation to PA and could not identify a beneficial relationship between PA and asthma. Nonetheless, girls were enthusiastic about PA and shared strategies for managing asthma symptoms while exercising. Facilitators included outdoor access and social support, while barriers included program costs and safety concerns. Many girls said they would be more active with their mother/caregiver. CONCLUSIONS: Despite personal and structural barriers to PA, Black girls with asthma view PA as important for physical and social wellbeing. Mothers/female caregivers play a major role in motivating and creating opportunities for PA. Our findings inform efforts to promote PA in a vulnerable yet understudied population, including expanding asthma management education and leveraging mother-daughter relationships to facilitate engagement in PA.

  PublisherOA PDFDOI

• Associations Between Parent–Child Attachment and Psychosocial- and Health-Related Symptoms in Children with Functional Abdominal Pain Disorders

  UNC Libraries · 2025-10-23

  articleOpen access1st authorCorresponding

  Background and Objectives: The attachment-diathesis model of chronic pain, which associates insecure attachment with pain catastrophizing and worse pain-related outcomes, is well-supported in adults. Although Functional Abdominal Pain Disorders (FAPDs) are common in youth, with symptoms influenced by the parent–child dynamic, an attachment-diathesis model of FAPDs is unexplored. The aim of this study was to investigate if insecure parental attachment is associated with pain catastrophizing and pain-related variables in youth with FAPDs. Methods: Baseline questionnaire data from an RCT of cognitive behavioral therapy for children with FAPDs (n = 200, 73% girls, 93% White, and a mean age of 11.2 years old) were used to examine relationships between parental attachment (subscales include Alienation, Trust, and Communication), catastrophizing, and pain-related variables (depression, disability, and gastrointestinal (GI) symptom severity). Results: Alienation was significantly correlated with depression (r = 0.39), GI symptom severity (r = 0.30), and disability (r = 0.22; ps < 0.05). Trust was also correlated with depression (r = −0.39), GI symptom severity (r = −0.19), and disability (r = −0.19; ps < 0.05). Communication was associated with depression (r = −0.30, p < 0.01). Catastrophizing mediated these associations, accounting for 22–89% of the relationship between attachment and pain-related variables. Conclusions: Children who report a less secure attachment to their parents report more physical and psychological symptomatology than children who describe their attachment as more secure. This association is partly explained by child catastrophizing. Results suggest that parent–child attachment and catastrophizing may be important treatment targets in children with FAPDs.

  PublisherDOI

• Associations Between Sexual Script Flexibility and Sexual Outcomes: An Investigation Among Breast Cancer Survivor Couples

  Psycho-Oncology · 2025-04-01 · 2 citations

  articleOpen access

  OBJECTIVES: Breast cancer (BC) survivors often experience sexual concerns affecting their intimate relationships. Sexual script flexibility (SSF) refers to the ability to adapt one's sexual scripts in response to sexual problems and may have implications for sexual adjustment. We studied SSF and its links to sexual self-efficacy and sexual satisfaction in BC survivor couples. METHODS: One hundred-twenty female post-treatment BC survivors reporting sexual concerns and their spouses (98% male) participating in a couples' sexual health intervention trial completed baseline surveys assessing SSF, sexual self-efficacy, and sexual satisfaction. Analyses included paired t-tests comparing survivors and spouses on SSF, ANOVA's to assess effects of couple-level SSF on sexual self-efficacy and satisfaction, and Actor-Partner Interdependence (APIM) models using multilevel modeling with generalized least squares analysis to assess effects of survivors' and spouses' SSF on their own and their spouses' sexual self-efficacy and satisfaction. RESULTS: Survivors reported lower SSF and sexual self-efficacy than spouses (p's ≤ 0.001). Couples where both members reported above median SSF (23% of couples) were distinguished by greater sexual self-efficacy and sexual satisfaction. APIM results indicated that (1) the greater survivors' and spouses' own SSF, the greater their own sexual self-efficacy (p < 0.01); (2) the greater survivors' SSF, the greater their own sexual satisfaction (p < 0.001); and (3) the greater survivors' SSF, the greater their partners' sexual satisfaction (p < 0.05). CONCLUSIONS: Greater sexual script flexibility may benefit BC survivor couples coping with sexual concerns. Future studies should examine whether intervention-related changes in SSF lead to better sexual outcomes, with survivors' flexibility an especially promising target.

  PublisherOA PDFDOI

• Associations Between Parent–Child Attachment and Psychosocial- and Health-Related Symptoms in Children with Functional Abdominal Pain Disorders

  Children · 2025-10-11

  articleOpen access

  Background and Objectives: The attachment-diathesis model of chronic pain, which associates insecure attachment with pain catastrophizing and worse pain-related outcomes, is well-supported in adults. Although Functional Abdominal Pain Disorders (FAPDs) are common in youth, with symptoms influenced by the parent–child dynamic, an attachment-diathesis model of FAPDs is unexplored. The aim of this study was to investigate if insecure parental attachment is associated with pain catastrophizing and pain-related variables in youth with FAPDs. Methods: Baseline questionnaire data from an RCT of cognitive behavioral therapy for children with FAPDs (n = 200, 73% girls, 93% White, and a mean age of 11.2 years old) were used to examine relationships between parental attachment (subscales include Alienation, Trust, and Communication), catastrophizing, and pain-related variables (depression, disability, and gastrointestinal (GI) symptom severity). Results: Alienation was significantly correlated with depression (r = 0.39), GI symptom severity (r = 0.30), and disability (r = 0.22; ps &lt; 0.05). Trust was also correlated with depression (r = −0.39), GI symptom severity (r = −0.19), and disability (r = −0.19; ps &lt; 0.05). Communication was associated with depression (r = −0.30, p &lt; 0.01). Catastrophizing mediated these associations, accounting for 22–89% of the relationship between attachment and pain-related variables. Conclusions: Children who report a less secure attachment to their parents report more physical and psychological symptomatology than children who describe their attachment as more secure. This association is partly explained by child catastrophizing. Results suggest that parent–child attachment and catastrophizing may be important treatment targets in children with FAPDs.

  PublisherOA PDFDOI

• Parenting Concerns, Psychological Distress, and Relationship Adjustment Among Patients With Cancer and Their Partners: A Longitudinal Study

  Psycho-Oncology · 2025-01-01 · 7 citations

  articleOpen access

  OBJECTIVE: Studies have found that cancer patients with dependent children exhibit high symptoms of anxiety, depression, and worry. Patients' parenting concerns can negatively impact their own and their family's adjustment to the cancer experience. However, relatively little is known about parenting concerns of partners of cancer patients, or associations between parenting concerns and couples' relationship adjustment. This longitudinal study investigated parenting concerns among both patients and partners, and their associations with psychological and relationship adjustment. METHODS: One hundred thirty-four patients with cancer and their partners (67 couples) completed the Parenting Concerns Questionnaire at baseline and measures of psychological distress, communication, and relationship adjustment at four time points (baseline, 4-, 8-, and 12-month follow up). RESULTS: Baseline parenting concerns did not differ by role, gender, cancer site or cancer stage (p > 0.05). Patients and partners who reported higher levels of parenting concerns at baseline reported significantly greater psychological distress and poorer communication concurrently and at each subsequent assessment. There were no significant associations between parenting concerns and relationship satisfaction either concurrently or over time. CONCLUSIONS: These findings reinforce the need for a dyadic perspective to assessing both patients' and partners' parenting concerns and a focus on processes such as communication as an avenue for managing and processing parenting concerns.

  PublisherOA PDFDOI

• Beliefs and Behaviors Related to Physical Activity in Black Girls with Asthma

  2025-09-11

  preprintOpen access

  not-yet-known not-yet-known not-yet-known unknown Introduction and Objective: Physical activity (PA) is associated with improved asthma outcomes. Black girls face higher rates of asthma morbidity and are less likely to meet recommended PA than their White and Black male peers. To address these health disparities, it is essential to understand beliefs and behaviors related to PA among Black girls with asthma. Methods: For this qualitative study, Black girls with asthma and their mothers or female caregivers were recruited through flyers and direct outreach to patients at one academic medical center. Semi-structured interviews focused on knowledge of PA recommendations, perceived risks and benefits of PA, barriers and facilitators to PA, and maternal influences on PA. Transcripts were coded iteratively through deductive thematic analysis. Findings: Twenty girls (age: mean=9.9 years, SD=1.33, range=8-12) and their caregivers participated. Most viewed asthma as a limitation to PA and could not identify a beneficial relationship between PA and asthma. Nonetheless, girls were enthusiastic about PA and shared strategies for managing asthma symptoms while exercising. Facilitators included outdoor access and social support, while barriers included program costs and safety concerns. Many girls said they would be more active with their mother/caregiver. Conclusions: Despite personal and structural barriers to PA, Black girls with asthma view PA as important for physical and social wellbeing. Mothers/female caregivers play a major role in motivating and creating opportunities for PA. Our findings inform efforts to promote PA in a vulnerable yet understudied population, including expanding asthma management education and leveraging mother-daughter relationships to facilitate engagement in PA.

  PublisherOA PDFDOI

• Author response for "Addressing Challenges in Research Aimed at Reducing Financial Toxicity Among Cancer Patients and Caregivers: An Example From the CREDIT Study (SWOG S1912CD)"

  2025-04-23

  peer-review
  PublisherDOI

• Educational Targets for Patient-Reported Outcomes and Caregiver-Reported Outcomes in Psycho-oncology Research

  Journal of Cancer Education · 2025-08-18

  articleSenior author
  PublisherDOI

• Addressing Challenges in Research Aimed at Reducing Financial Toxicity Among Cancer Patients and Caregivers: An Example From the CREDIT Study (SWOG S1912CD)

  Cancer Control · 2025-05-19 · 2 citations

  articleOpen access

  IntroductionCancer-related financial hardship is pervasive, impacting both patients and caregivers, making it crucial to address financial hardship at the household level. The CREDIT (S1912CD) study was designed to enroll and randomize cancer patients and spousal caregivers as dyads to proactive financial navigation compared to usual care. The study faced several challenges to recruitment. This paper discusses the changes made to successfully complete the study.MethodsThe study took place among NCI Community Oncology Research Program (NCORP) sites and allowed several venues for protocol feedback, including SWOG group meetings, NCORP administrator meetings, and individual calls with recruiting sites. A patient advocate worked with the study team to review and update documents to ensure the study was relevant and accessible to potential participants.ResultsSeveral barriers were identified including sites facing challenges in enrolling patient-spouse dyads, multiple financial navigation partners causing confusion and delays in delivery of the intervention, eligibility criteria concerns, and participant discomfort with providing social security numbers. Several modifications were made to address these obstacles during a study restructure, including making caregiver participation optional, streamlining intervention delivery, and modifying eligibility criteria to allow more time between diagnosis and enrollment. Changes from the restructure resulted, on average, in a 9.5 patient per month increase in accrual (4.1 to 13.6) and has enabled the study to reach overall accrual within the study timeline. Importantly, the study maintained diverse accrual and continued to accrue willing caregivers to enable exploratory analysis of caregiver outcomes.ConclusionInterventions examining how to mitigate financial hardship for cancer patients and those affected by cancer, must be pragmatic in order to be translated into sustainable programs in real world settings. Providing recruiting sites an avenue for feedback ensured that the study team could adjust the protocol to meet site needs and successfully complete this financial navigation study.

  PublisherDOI

• Couple communication in cancer: A tale of two conceptual models.

  Health Psychology · 2024-09-19 · 2 citations

  articleOpen access1st authorCorresponding

  Cancer poses significant challenges for patients and caregiving partners. Avoidant communication has been linked to poorer psychosocial adjustment to cancer. Two conceptual models have been proposed to account for this linkage: the social-cognitive processing and relationship intimacy models. OBJECTIVE: To examine the utility of these models in explaining patient and partner psychological and relationship adjustment on a day-to-day basis using ecological momentary assessment. METHOD: Patients with breast, colorectal, or lung cancer and their partners (286 dyads) were prompted twice daily for 14 days via smartphone to answer questions about communication with their partner, adjustment (psychological distress and relationship satisfaction), and hypothesized mediators (avoidant thoughts and intimacy). Data were collected from 2017 to 2020. RESULTS: s < .005). CONCLUSIONS: Findings offer implications for interventions designed to improve communication and enhance closeness. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

  PublisherDOI

Recent grants

• NIH Grant R03CA096468

  NIH · $168k · 2005

• Couple Communication in Cancer: A Multi-Method Examination - Renewal - 1

  NIH · $5.3M · 2016–2029

• NIH Grant R21CA112477

  NIH · $348k · 2010

• NIH Grant R21HD068592

  NIH · $436k · 2015

Frequent coauthors

• Rona L. Levy

  University of Washington

  83 shared

• Karen L. Syrjala

  University of Washington

  55 shared

• Joan M. Romano

  University of Washington

  46 shared

• William E. Whitehead

  University of North Carolina at Chapel Hill

  35 shared

• Lynn S. Walker

  Vanderbilt University

  33 shared

• Dennis L. Christie

  28 shared

• Miranda A.L. van Tilburg

  University of North Carolina at Chapel Hill

  26 shared

• Melissa M. DuPen

  University of Washington

  20 shared

Education

• Ph.D., Personality/ Social Psychology

  Lehigh University

  1996

• M.S., Experimental Psychology

  Villanova University

  1992

• Other, Behavioral Science

  University of Kentucky College of Medicine

  1999

• Other, Psychosocial Oncology

  University of Washington and Fred Hutchinson Cancer Research Center

  2002

Awards & honors

• Fellow of the Society of Behavioral Medicine