John Merriman

Faculty

John Merriman Headshot

John Merriman

AOCNS PhD RN

Assistant Professor

1 212 998 5375

433 First Ave
New York, NY 10010
United States

Accepting PhD students

John Merriman's additional information

John Merriman, PhD, RN, AOCNS, is an assistant professor at NYU Rory Meyers College of Nursing. His primary research interest is improving cognitive function in postmenopausal women with breast cancer using stress management. He is particularly interested in how multiple determinants of health, including biobehavioral and social determinants, impact the efficacy of stress management interventions in this population.

His recent study was funded by a K99/R00 award from the National Institute of Nursing Research (NR015473). This study aimed to evaluate the feasibility and potential impact of Mindfulness-Based Stress Reduction, contrasting it with a health enhancement program, on cognitive function in postmenopausal women undergoing aromatase inhibitor therapy for breast cancer.

Prof. Merriman is President-Elect of the International Society of Nurses in Genetics. Before joining NYU, he completed postdoctoral training at the University of Pittsburgh School of Nursing, and his PhD and MS in Nursing from the University of California, San Francisco School of Nursing.

PhD, Nursing - University of California San Francisco
MS, Nursing - University of California San Francisco
BS, Communication - Mississippi College

Chronic disease
Complementary/integrative health

American Nurses Association
Eastern Nursing Research Society
International Society of Nurses in Genetics
Oncology Nursing Society
Sigma Theta Tau International

Faculty Honors Awards

Postdoctoral Alumni Award, University of Pittsburgh Postdoctoral Association (2016)
International inductee, Sigma Theta Tau (2006)

Publications

Identification of patient subgroups and risk factors for persistent arm/shoulder pain following breast cancer surgery

Miaskowski, C., Paul, S. M., Cooper, B., West, C., Levine, J. D., Elboim, C., Hamolsky, D., Abrams, G., Luce, J., Dhruva, A., Langford, D. J., Merriman, J. D., Kober, K., Baggott, C., Leutwyler, H., & Aouizerat, B. E. (2014). European Journal of Oncology Nursing, 18(3), 242-253. 10.1016/j.ejon.2013.12.002
Abstract
Abstract
Purpose: In this prospective, longitudinal study, we extend our findings on persistent breast pain in patients (n=398) following breast cancer surgery and evaluate the prevalence and characteristics of persistent pain in the arm/shoulder. In addition, differences in the severity of common symptoms and quality of life outcomes measured prior to surgery, among the arm pain classes, were evaluated. Methods and sample: Patients were recruited from Breast Care Centers located in a Comprehensive Cancer Center, two public hospitals, and four community practices. Patients were assessed prior to and monthly for six months following breast cancer surgery. Results: Using growth mixture modeling, patients were classified into no (41.6%), mild (23.6%), and moderate (34.8%) arm pain classes based on ratings of worst arm/shoulder pain. Compared to the no pain class, patients in the moderate pain class were significantly younger, had a higher body mass index, and were more likely to report preoperative breast pain and swelling in the affected breast. In addition, patients in the moderate pain class reported higher levels of depression, anxiety, and sleep disturbance than the no pain class. Conclusions: Findings suggest that approximately 35% of women experience persistent levels of moderate arm/shoulder pain in the first six months following breast cancer surgery. Moderate arm/shoulder pain is associated with clinically meaningful decrements in functional status and quality of life.

Preliminary Evidence of an Association Between an Interleukin 6 Promoter Polymorphism and Self-Reported Attentional Function in Oncology Patients and Their Family Caregivers

Merriman, J. D., Aouizerat, B. E., Langford, D. J., Cooper, B. A., Baggott, C. R., Cataldo, J. K., Dhruva, A., Dunn, L., West, C., Paul, S. M., Ritchie, C. S., Swift, P. S., & Miaskowski, C. (2014). Biological Research for Nursing, 16(2), 152-159. 10.1177/1099800413479441
Abstract
Abstract
Subgroups of individuals may be at greater risk of cytokine-induced changes in attentional function. The purposes of this study were to identify subgroups of individuals with distinct trajectories of attentional function and evaluate for phenotypic and genotypic (i.e., cytokine gene polymorphisms) differences among these subgroups. Self-reported attentional function was evaluated in 252 participants (167 oncology patients and 85 family caregivers) using the Attentional Function Index before radiation therapy and at six additional assessments over 6 months. Three latent classes of attentional function were identified using growth mixture modeling: moderate (36.5%), moderate-to-high (48.0%), and high (15.5%) attentional function. Participants in the moderate class were significantly younger, with more comorbidities and lower functional status, than those in the other two classes. However, only functional status remained significant in multivariable models. Included in the genetic association analyses were 92 single nucleotide polymorphisms (SNPs) among 15 candidate genes. Additive, dominant, and recessive genetic models were assessed for each SNP. Controlling for functional status, only Interleukin 6 (IL6) rs1800795 remained a significant genotypic predictor of class membership in multivariable models. Each additional copy of the rare "G" allele was associated with a 4-fold increase in the odds of belonging to the lower attentional function class (95% confidence interval: [1.78, 8.92]; p = .001). Findings provide preliminary evidence of subgroups of individuals with distinct trajectories of attentional function and of a genetic association with an IL6 promoter polymorphism.

Variations in potassium channel genes are associated with breast pain in women prior to breast cancer surgery

Langford, D. J., West, C., Elboim, C., Cooper, B. A., Abrams, G., Paul, S. M., Schmidt, B. L., Levine, J. D., Merriman, J. D., Dhruva, A., Neuhaus, J., Leutwyler, H., Baggott, C., Sullivan, C. W., Aouizerat, B. E., & Miaskowski, C. (2014). Journal of Neurogenetics, 28(1), 122-135. 10.3109/01677063.2013.856430
Abstract
Abstract
Preoperative breast pain in women with breast cancer may result from a number of causes. Previous work from our team found that breast pain occurred in 28.2% of women (n = 398) who were about to undergo breast cancer surgery. The occurrence of preoperative breast pain was associated with a number of demographic and clinical characteristics, as well as variation in two cytokine genes. Given that ion channels regulate excitability of sensory neurons, we hypothesized that variations in potassium channel genes would be associated with preoperative breast pain in these patients. Therefore, in this study, we evaluated for associations between single-nucleotide polymorphisms and inferred haplotypes among 10 potassium channel genes and the occurrence of preoperative breast pain in patients scheduled to undergo breast cancer surgery. Multivariable logistic regression analyses were used to identify those genetic variations that were associated with the occurrence of preoperative breast pain while controlling for age and genomic estimates of and self-reported race/ethnicity. Variations in four potassium channel genes: (1) potassium voltage-gated channel, delayed rectifier, subfamily S, member 1 (KCNS1); (2) potassium inwardly rectifying channel, subfamily J, member 3 (KCNJ3); (3) KCNJ6; and (4) potassium channel, subfamily K, member 9 (KCNK9) were associated with the occurrence of breast pain. Findings from this study warrant replication in an independent sample of women who report breast pain following one or more breast biopsies.

Cytokine gene variation is associated with depressive symptom trajectories in oncology patients and family caregivers

Dunn, L. B., Aouizerat, B. E., Langford, D. J., Cooper, B. A., Dhruva, A., Cataldo, J. K., Baggott, C. R., Merriman, J. D., Dodd, M., West, C., Paul, S. M., & Miaskowski, C. (2013). European Journal of Oncology Nursing, 17(3), 346-353. 10.1016/j.ejon.2012.10.004
Abstract
Abstract
Purpose: Depressive symptoms are common in cancer patients and their family caregivers (FCs). While these symptoms are characterized by substantial interindividual variability, the factors that predict this variability remain largely unknown. This study sought to confirm latent classes of oncology patients and FCs with distinct depressive symptom trajectories and to examine differences in phenotypic and genotypic characteristics among these classes. Method: Among 167 oncology outpatients with breast, prostate, lung, or brain cancer and 85 of their FCs, growth mixture modeling (GMM) was used to identify latent classes of individuals based on Center for Epidemiological Studies-Depression (CES-D) scores obtained prior to, during, and for four months following completion of radiation therapy. One hundred four single nucleotide polymorphisms (SNPs) and haplotypes in 15 candidate cytokine genes were interrogated for differences between the two largest latent classes. Multivariate logistic regression analyses assessed effects of phenotypic and genotypic characteristics on class membership. Results: Four latent classes were confirmed: Resilient (56.3%), Subsyndromal (32.5%), Delayed (5.2%), and Peak (6.0%). Participants who were younger, female, non-white, and who reported higher baseline trait and state anxiety were more likely to be in the Subsyndromal, Delayed, or Peak groups. Variation in three cytokine genes (i.e., interleukin 1 receptor 2 [IL1R2], IL10, tumor necrosis factor alpha [TNFA]), age, and performance status predicted membership in the Resilient versus Subsyndromal classes. Conclusions: Findings confirm the four latent classes of depressive symptom trajectories previously identified in a sample of breast cancer patients. Variations in cytokine genes may influence variability in depressive symptom trajectories.

Differences in morning and evening fatigue in oncology patients and their family caregivers

Dhruva, A., Aouizerat, B. E., Cooper, B., Paul, S. M., Dodd, M., West, C., Wara, W., Lee, K., Dunn, L. B., Langford, D. J., Merriman, J. D., Baggott, C., Cataldo, J., Ritchie, C., Kober, K., Leutwyler, H., & Miaskowski, C. (2013). European Journal of Oncology Nursing, 17(6), 841-848. 10.1016/j.ejon.2013.06.002
Abstract
Abstract
Purpose of the research: To identify distinct latent classes of individuals based on ratings of morning and evening fatigue; evaluate for differences in phenotypic characteristics, as well as symptom and quality of life scores, among these latent classes; and evaluate for an overlap in morning and evening fatigue class membership. Patients and methods: In a sample of 167 oncology outpatients and 85 of their FCs, growth mixture modeling was used to identify distinct latent classes based on ratings of morning and evening fatigue obtained before, during, and after radiation therapy. Analyses of variance and Chi Square analyses were used to evaluate for differences among the morning and evening fatigue latent classes. Results: Three distinct latent classes for morning fatigue were identified. Participants in the High Morning Fatigue class (47%) were younger and had lower functional status. Three distinct latent classes for evening fatigue were identified. Participants in the High Evening Fatigue class (61%) were younger, more likely to be female, more likely to have children at home, and more likely to be a FC. Only 10.3% of participants were classified in both the Very Low Morning and Low Evening Fatigue classes and 41.3% were classified in both the High Morning and High Evening Fatigue classes. Conclusions: Different characteristics were associated with morning and evening fatigue, which suggests that morning and evening fatigue may be distinct but related symptoms. Additional research is needed to elucidate the mechanisms that may underlie diurnal variability in fatigue.

Differences in the symptom experience of older versus younger oncology outpatients: A cross-sectional study

Cataldo, J. K., Paul, S., Cooper, B., Skerman, H., Alexander, K., Aouizerat, B., Blackman, V., Merriman, J., Dunn, L., Ritchie, C., Yates, P., & Miaskowski, C. (2013). BMC Cancer, 13. 10.1186/1471-2407-13-6
Abstract
Abstract
Background: Mortality rates for cancer are decreasing in patients under 60 and increasing in those over 60 years of age. The reasons for these differences in mortality rates remain poorly understood. One explanation may be that older patients received substandard treatment because of concerns about adverse effects. Given the paucity of research on the multiple dimensions of the symptom experience in older oncology patients, the purpose of this study was to evaluate for differences in ratings of symptom occurrence, severity, frequency, and distress between younger (< 60 years) and older ( ≥ 60 years) adults undergoing cancer treatment. We hypothesized that older patients would have significantly lower ratings on four symptom dimensions.Methods: Data from two studies in the United States and one study in Australia were combined to conduct this analysis. All three studies used the MSAS to evaluate the occurrence, severity, frequency, and distress of 32 symptoms.Results: Data from 593 oncology outpatients receiving active treatment for their cancer (i.e., 44.4% were < 60 years and 55.6% were ≥ 60 years of age) were evaluated. Of the 32 MSAS symptoms, after controlling for significant covariates, older patients reported significantly lower occurrence rates for 15 (46.9%) symptoms, lower severity ratings for 6 (18.9%) symptoms, lower frequency ratings for 4 (12.5%) symptoms, and lower distress ratings for 14 (43.8%) symptoms.Conclusions: This study is the first to evaluate for differences in multiple dimensions of symptom experience in older oncology patients. For almost 50% of the MSAS symptoms, older patients reported significantly lower occurrence rates. While fewer age-related differences were found in ratings of symptom severity, frequency, and distress, a similar pattern was found across all three dimensions. Future research needs to focus on a detailed evaluation of patient and clinical characteristics (i.e., type and dose of treatment) that explain the differences in symptom experience identified in this study.

Proposed mechanisms for cancer- and treatment-related cognitive changes

Merriman, J. D., Von Ah, D., Miaskowski, C., & Aouizerat, B. E. (2013). Seminars in Oncology Nursing, 29(4), 260-269. 10.1016/j.soncn.2013.08.006
Abstract
Abstract
Objectives: To review the proposed mechanisms of cognitive changes associated with non-central nervous system cancers and cancer treatment. Data Sources: Review and synthesis of databased publications and review articles. Conclusion: Proposed mechanisms include cytokine upregulation, hormonal changes, neurotransmitter dysregulation, attentional fatigue, genetic predisposition, and comorbid symptoms. Implications for Nursing Practice: Oncology nurses need to understand the multiple mechanisms that may contribute to the development of cancer- and treatment-related cognitive changes so that they can identify patients at high risk and help patients understand why these changes occur.

Evidence of associations between cytokine genes and subjective reports of sleep disturbance in oncology patients and their family caregivers

Miaskowski, C., Cooper, B. A., Dhruva, A., Dunn, L. B., Langford, D. J., Cataldo, J. K., Baggott, C. R., Merriman, J. D., Dodd, M., Lee, K., West, C., Paul, S. M., & Aouizerat, B. E. (2012). PloS One, 7(7). 10.1371/journal.pone.0040560
Abstract
Abstract
The purposes of this study were to identify distinct latent classes of individuals based on subjective reports of sleep disturbance; to examine differences in demographic, clinical, and symptom characteristics between the latent classes; and to evaluate for variations in pro- and anti-inflammatory cytokine genes between the latent classes. Among 167 oncology outpatients with breast, prostate, lung, or brain cancer and 85 of their FCs, growth mixture modeling (GMM) was used to identify latent classes of individuals based on General Sleep Disturbance Scale (GSDS) obtained prior to, during, and for four months following completion of radiation therapy. Single nucleotide polymorphisms (SNPs) and haplotypes in candidate cytokine genes were interrogated for differences between the two latent classes. Multiple logistic regression was used to assess the effect of phenotypic and genotypic characteristics on GSDS group membership. Two latent classes were identified: lower sleep disturbance (88.5%) and higher sleep disturbance (11.5%). Participants who were younger and had a lower Karnofsky Performance status score were more likely to be in the higher sleep disturbance class. Variation in two cytokine genes (i.e., IL6, NFKB) predicted latent class membership. Evidence was found for latent classes with distinct sleep disturbance trajectories. Unique genetic markers in cytokine genes may partially explain the interindividual heterogeneity characterizing these trajectories.

Identification of patient subgroups and risk factors for persistent breast pain following breast cancer surgery

Miaskowski, C., Cooper, B., Paul, S. M., West, C., Langford, D., Levine, J. D., Abrams, G., Hamolsky, D., Dunn, L., Dodd, M., Neuhaus, J., Baggott, C., Dhruva, A., Schmidt, B., Cataldo, J., Merriman, J., & Aouizerat, B. E. (2012). Journal of Pain, 13(12), 1172-1187. 10.1016/j.jpain.2012.09.013
Abstract
Abstract
Study purposes were to determine the prevalence of persistent pain in the breast; characterize distinct persistent pain classes using growth mixture modeling; and evaluate for differences among these pain classes in demographic, preoperative, intraoperative, and postoperative characteristics. In addition, differences in the severity of common symptoms and quality of life outcomes measured prior to surgery, among the pain classes, were evaluated. Patients (n = 398) were recruited prior to surgery and followed for 6 months. Using growth mixture modeling, patients were classified into no (31.7%), mild (43.4%), moderate (13.3%), and severe (11.6%) pain groups based on ratings of worst breast pain. Differences in a number of demographic, preoperative, intraoperative, and postoperative characteristics differentiated among the pain classes. In addition, patients in the moderate and severe pain classes reported higher preoperative levels of depression, anxiety, and sleep disturbance than the no pain class. Findings suggest that approximately 25% of women experience significant and persistent levels of breast pain in the first 6 months following breast cancer surgery. Perspective: Persistent pain is a significant problem for 25% of women following surgery for breast cancer. Severe breast pain is associated with clinically meaningful decrements in functional status and quality of life.

Differences in self-reported attentional fatigue between patients with breast and prostate cancer at the initiation of radiation therapy

Merriman, J. D., Dodd, M., Lee, K., Paul, S. M., Cooper, B. A., Aouizerat, B. E., Swift, P. S., Wara, W., Dunn, L., & Miaskowski, C. (2011). Cancer Nursing, 34(5), 345-353. 10.1097/NCC.0b013e318202520a
Abstract
Abstract
Background: Attentional fatigue is experienced as a decreased ability to concentrate, engage in purposeful activity, and maintain social relationships when there are competing demands on attention. Breast and prostate cancer are the 2 most common cancers in women and men, respectively. Most previous studies on self-reported attentional fatigue evaluated patients with breast cancer. Objectives: The objectives of the study were to determine if self-reported attentional fatigue differed in patients with breast cancer and prostate cancer before radiation therapy (RT) and to determine the relationships between attentional fatigue and other symptoms in these 2 groups. Methods: Patients (n = 155) completed questionnaires before RT. Descriptive statistics, Pearson correlations, and analysis of covariance were used for data analyses. Results: After controlling for age, patients with breast cancer reported significantly higher levels of attentional fatigue. In both groups, more attentional fatigue correlated significantly with more anxiety, depression, sleep disturbance, and physical fatigue. These correlations were stronger for patients with breast cancer. Conclusions: The present study is the first to identify differences in self-reported attentional fatigue between these 2 groups before RT. Additional research is warranted to determine factors that contribute to these differences, as well as mechanisms that underlie the development of attentional fatigue. Implications for Practice: Clinicians should consider the capacity of their patients to direct attention when learning about RT and other treatments. It is important to simplify confusing healthcare terminology and reinforce teaching that is most important both verbally and in writing. Appropriate interventions for anxiety and depression may decrease attentional fatigue in these patients.

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