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SEEMEDJ 2024, Vol 8, No 1, Psychological Adjustment of Women with Breast Cancer
29 Southeastern European Medical Journal, 2024; 8(1)
Original article
The Role of Transgenerational Transmission in the Psychological
Adjustment of Women with Breast Cancer
Sanda Anton 1,2, Valentin Kordić 1,2
1 Psychiatric Clinic, University Hospital Center Osijek, Osijek, Croatia
2 Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
*Corresponding author: Sanda Anton, sanda.anton@kbco.hr
Received: May 15, 2024; revised version accepted: Jun 28, 2024; published: Sep 23, 2024
KEYWORDS: transgenerational transmission, trauma, psycho-oncology
Abstract
Introduction: Getting sick with cancer is a traumatic event for the affected person and can result with
various psychological difficulties, which is further deepened by invasive methods of treatment. The
previously experienced psychological trauma of a close person can influence the response of a
person who is currently experiencing trauma, because the far-reaching power of posttraumatic
consequences extends through a natural biological barrier far into the next generation (the so called
“transgenerational impact of traumatization”).
Objective: To assess the impact of transgenerational transmission on the development of PTSD in
women with breast cancer.
Methods: The sample consisted of 120 women treated at the Oncology Department of the University
Hospital Center Osijek, included in liaison psychiatric treatment. A detailed clinical examination with
a psychiatric interview was used with the application of DSM-IV diagnostic criteria, a specially
structured non-standardized questionnaire for the assessment of etiological factors and the Los
Angeles Symptom Checklist of PTSD symptoms (LASC) for determining PTSD.
Results: No statistical significance was obtained between the presence of a family member with
cancer and the average total score on the LASC in women with newly diagnosed breast cancer.
Conclusion: Although there was no correlation between the existence of a family member suffering
from cancer and the development of PTSD in the test subjects, during psychotherapy procedures
we observed the existence of symptoms that did not meet the criteria for establishing a diagnosis of
PTSD, but could interfere with the development of various psychological responses. By including
cancer patients in psychotherapy procedures, we can prevent the development of more severe
psychological responses in the second generation, which due to the genetic influence in the
inheritance of the disease will develop cancer, and the psychological disorder associated with it, and
achieve a far reaching effect on strengthening adaptation mechanisms.
(Anton S*, Kordić V. The Role of Transgenerational Transmission in the Psychological Adjustment of
Women with Breast Cancer. SEEMEDJ 2024; 8(1); 29-39)
SEEMEDJ 2024, Vol 8, No 1, Psychological Adjustment of Women with Breast Cancer
30 Southeastern European Medical Journal, 2024; 8(1)
Introduction
Breast cancer is a great stress for every woman,
but there is great variability in the psychological
responses of each individual. Although women
nowadays have more treatment options, the
psychological problems remain the same. The
age at which cancer occurs, earlier emotional
stability, personal coping skills and the existence
of interpersonal support are of particular
importance. Most researchers generally agree
that the most important period during
adjustment to cancer is the year following the
diagnosis. It is a crisis in the patient’s life, but
most patients overcome it in a satisfactory
manner, especially in the group of those with a
good prognosis (1, 2). However, some adapt
better than others. Psychological response
depends on the sociocultural environment in
which treatment is provided (treatment methods
available, decision-making during treatment),
psychological and psychosocial environmental
factors, and medical and physical factors
including disease stage, treatment, response
and clinical course (3).
Many studies emphasize that people with better
social support adapt better to the disease (4, 5).
Social support is an important factor in the
impact of stressful events on health, because
social factors and interpersonal relationships
can protect an individual from the dangerous
consequences of stress (6, 7). Stress can
mobilize a social network and elicit supportive
behavior from it, but it can also have a negative
impact, i.e. reduce help by worsening or
destroying relationships. Sources of social
support can be different. Nevertheless, most
people receive the largest part of emotional
support, warmth, belonging, material and
instrumental support in the family (8).
As it is often emphasized, psychosocial support
cannot be provided to all sufferers, therefore it is
important to determine which persons are more
at risk for adjustment difficulties, so that support
can be directed to them (3).
The previously experienced psychological
trauma of a close person through
transgenerational transmission can affect the
reactions of the person who is currently
experiencing the trauma, leading to repetitions
of earlier experiences and the development of
various psychological disorders (9, 10).
The success of therapeutic interventions is often
evaluated by the quality of life of patients. In the
past, only the quantity of life (survival time) was
measured. By prolonging the survival time of
patients, they began to think about what the life
of those who succeeded in this is like, whether
this continuation of life is of sufficient quality and
whether it justifies the costs of the treatment,
which is supported by earlier research (11).
Psychotherapeutic support with the support of
family and friends significantly affects the
quality of life of affected women and indicates
the need to involve a psychiatrist in the
treatment of patients who exhibit psychological
difficulties in adapting to a physical illness.
If a child has a parent who is burdened by
trauma, their early development of an
attachment model can be disrupted, creating
problems at the level of forming a healthy
personality. If this is not corrected at some point
in development, it creates a burden for the
development of interpersonal relationships
throughout life, because even new relationships
can be burdened by the shadow of trauma from
the past (12). Lack of self-esteem, experience of
inferiority, shame, guilt and other complex
experiences largely stem from the underlying
feeling of pain.
Important developmental processes, the
development of feelings of attachment,
separation and individuation are especially
disturbed, because a sick parent places the child
in an atmosphere of high anxiety, depression
and impulsivity. Some people have been
traumatized multiple times, by the so-called
cumulative trauma, worried about the future and
security without enough strength to adapt (13,
14).
Our first contact with reality, with the world, is
first affective, emotional and only then rational.
Our affective memory, which contains all the
emotions experienced in the past, colors the
reality we encounter so that our picture of the
SEEMEDJ 2024, Vol 8, No 1, Psychological Adjustment of Women with Breast Cancer
31 Southeastern European Medical Journal, 2024; 8(1)
world is first subjective, which means somewhat
distorted, due to the affective assessment of
reality that we made before rational judgment.
Affective judgment of reality predisposes a
person to adopt and maintain affective attitudes
that then determine, and in immature persons
often dictate, human behavior. According to M.
B. Arnold, it is a living memory of the history of
the feeling (emotional) life of every person. Since
it is always at our disposal, it plays an important
role in the judgment and interpretation of
everything around us, like the matrix of every
experience and action (15).
It should be said that the very use of emotionally
saturated words contributes to the affective
judgment of reality. Such words have a strong
impact on the recipient of the message so that
they immediately take a certain attitude towards
the conceptual content of the mentioned
emotionally saturated words (for example
“cancer”).
Mental trauma is an extremely complex
phenomenon, and it occurs when a person is
confronted with the so-called a catastrophic
experience, one that is far out of the ordinary
(e.g. near death or complete helplessness). A
traumatic event is easily recalled, with loss of
control, a tendency to avoid it, causes
overwhelming fear, mental pain, a sense of loss
of hope for the future and actions of the
autonomic nervous system. By destroying
values and beliefs in the structure of a person,
trauma destroys the relationship of trust
between the person and their world. The patient
no longer knows how to act in the fight for
survival and develops chronic post-traumatic
stress disorder, which leads to a reduced
capacity for adequate family and parental
functioning, which also affects the health of
children, increasing the predisposition to the
development of psychological disorders.
Patients transmit the fears they feel to the entire
family, and daughters or sisters of patients who
are at a higher risk of getting cancer may
develop special fears of their own disease by
resisting or worrying too much during the care of
the sick woman (16).
For many years, “epigenetic inheritance” has
been researched, i.e. the way in which
accumulated experiences during the life of
parents affect the genes of their offspring and
what role this plays in the development of
children. The term epigenetics consists of the
words genetics and epigenesis, i.e. the
development of a living being. Numerous
studies in recent years have investigated the
connection between experienced trauma and
the impact on genes (17–21). However, in
addition to affecting genetic transmission,
trauma can lead to changes in the behavior of
the next generation.
Aim of the study
To assess the role of transgenerational
transmission on the development of PTSD in
women with newly diagnosed breast cancer.
Patients
The sample consisted of 120 women treated at
the Oncology Department of University Hospital
Center Osijek, included in liaison psychiatric
treatment.
The criteria for inclusion in the research were:
female gender, aged 18–65, diagnosed with
breast cancer, radiotherapy as part of cancer
treatment, absence of serious physical illnesses,
no history or current signs of psychotic
disorders, completed elementary school as the
lowest educational level, adequate opportunity
to talk, signed informed consent for the patient.
The criteria for exclusion from the research
were: non-acceptance of participation in the
research according to the patient’s informed
consent, the presence of other serious physical
diseases, pregnancy, breastfeeding, data on the
previous or current existence of psychotic
disorders, mental retardation, severe personality
disorder, permanent personality changes, abuse
of psychoactive drugs substances or alcohol in
the last three months before the start of the
study, previous participation in any form of
psychotherapeutic treatment.
SEEMEDJ 2024, Vol 8, No 1, Psychological Adjustment of Women with Breast Cancer
32 Southeastern European Medical Journal, 2024; 8(1)
The patients were included in liaison psychiatric
treatment (pharmacotherapy and
psychotherapy). All applied psychiatric
therapeutic procedures were limited to one
year. Psychotherapy procedures were
conducted once a week during the first two
months of the study, and later according to the
intensity of the clinical picture and the
motivation of the test subjects for a total
duration of one year.
Methods
Before the start of the research, signed informed
consent for participation in the research was
obtained from all respondents.
The research included:
Detailed clinical examination with
psychiatric interview with application of
diagnostic criteria according to DSM-IV for
mental disorders (22).
The application of a specially structured
non-standardized questionnaire, which was
used to assess in detail the possible etiological
factors in the occurrence of psychological
disorders in the test subjects.
Psychological testing conducted by a
psychologist that assessed the existence of
PTSD symptoms using the Los Angeles
Symptom Checklist of PTSD symptoms (LASC)
in order to determine the existence of PTSD
when entering the study, or the development of
PTSD symptoms during the development of the
disease at the end of the study. The tests were
completed on day zero and after two months of
research.
Results
1. Demographic data of the sample
The average age of the respondents was 56.52
years (minimum 24, maximum 65) with a
standard deviation of 8.628.
According to the place of residence, 71 (59.17%)
respondents were from the village and 49
(40.83%) from the city. Seventy-four (61.67%)
respondents were married, and 33 (27.5%) were
widows. Most of them had two children (53
respondents, i.e. 44.17%) or three or more
children (34 respondents, i.e. 28.33%). Fifty-nine
(49.17%) respondents completed primary school,
and 49 (40.53%) completed secondary school.
Sixty-one (51%) respondents had a family
member with cancer, and 59 (49%) did not.
Twenty (32.79%) respondents had a parent
previously suffering from cancer, six (9.8%) had a
spouse, 16 (26.23%) had more members of the
immediate family suffering from cancer and 16
(26.23%) had a member of the extended family
suffering from cancer (the term refers only to the
first-degree relatives, i.e. the patient’s aunt or
grandmother) 14 (33.95%). Five respondents
(8.2%) had a child with cancer.
2. Analysis of the results according to the
total value on the LASC and the family
member suffering from cancer for the
studied groups
During the research, 10.83% of the subjects
developed a clinical picture of PTSD (Table 1).
Table 1. Total Los Angeles Symptom Checklist (LASC) score according to a family member diagnosed
with cancer
Family member
diagnosed with
cancer
Number of
subjects
Average total
LASC score
for the first
measurement
Maximum
total LASC
score for the
first
measurement
Average total
LASC score
for the
second
measurement
Maximum total LASC
score for the second
measurement
NO
59
20.88
56
22.4
55
YES
61
22.92
58
20.17
50
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33 Southeastern European Medical Journal, 2024; 8(1)
Table 2. Total Los Angeles Symptom Checklist (LASC) score according to a family member
diagnosed with cancer
Family member
diagnosed with
cancer
Number of
subjects
Average total
LASC score
for the first
measurement
Maximum
total LASC
score for the
first
measurement
Average total
LASC score
for the
second
measurement
Maximum total LASC
score for the second
measurement
Parent
20
25.53
50
22.68
50
More members of
the closer family
16
22.09
58
18
48
Member of the
extended family
14
20.9
36
20.36
44
Child
5
27.6
39
27
43
Spouse
6
15.2
27
14.6
19
Nobody
59
20.56
56
22.24
55
The t-test for independent samples showed no
statistical significance on the association
between the average total score on the LASC
and the presence of a family member with
cancer for the first (p<0.4630) or second
measurement (p<0.3852) (Table 2).
No statistical significance was obtained for the
first measurement (Median test p<0.1252,
Kruskal Wallis test p<0.5176) nor for the second
measurement (Median test p<0.1333, Kruskal
Wallis test p<0.5973) regarding the association
of having a family member with cancer and the
average total score on the LASC.
Discussion
The most significant information obtained from
this research is the fact that 51% of the women
examined had a family member who suffered
from cancer.
In this paper, we do not observe the genetic
influence in the development of cancer,
although this information opens up the need to
analyze this problem as well, but we focus on
the observation that this fact had a significant
impact on adaptation and the type of fears that
developed after realizing that they too had the
disease from a serious illness with which they
had negative previous experiences.
During psychotherapeutic treatment, feelings
and thoughts related to earlier traumatic
experiences with regards to the illness, as well
as suffering and dying experienced by people
from their close family, were often processed. It
was a superimposed trauma.
The criteria according to DSM-IV for the
diagnosis of post-traumatic stress disorder
(PTSD) include symptoms that are present at
least one month after exposure to a traumatic
event in the form of repetition of the traumatic
event, symptoms of heightened arousal and
avoidance behavior, and loss of psychosocial
functioning (22).
Epidemiological studies indicate that 25–33% of
people exposed to traumatic events, including
cancer, develop PTSD (23), and the results of our
research found that 10.83% of respondents
showed PTSD during the entire study.
In cancer patients, defining the traumatic
stressor is a problem. Within the multiple crises
that the cancer experience is comprised of, it is
difficult to single out and define a stressor. A
stressor can be a diagnosis, the realization that
the disease can be fatal, a long period of severe
pain, symptoms and signs of the return of the
disease, aversive actions or being in the room
with a person who is dying or has died. In 1994,
by redefining the criteria for a traumatic event, in
the DSM-IV classification, contracting a life-
threatening disease and the knowledge of one’s
own child developing a life-threatening disease
were included as a stressful event that meets
the criteria for a diagnosis of PTSD (22).
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The severity, duration and proximity of a
person’s exposure to a traumatic event affect
the development of PTSD, and the suddenness
and threat to life and physical integrity are
important causes of the development of the
disorder, while the presence of pain and other
physical symptoms correlate with intrusive
thoughts (23).
Earlier research additionally suggests that PTSD
leads to deficits in some social functions
(reduced interest in returning to work, poorer
work performance, inadequate parental role,
participation in household activities and general
social functioning), which additionally leads to
the development of anxiety and depression (24).
The far-reaching power of post-traumatic
consequences also extends through a natural
biological barrier, namely far into the next
generation (the so-called “transgenerational
impact of traumatization”) (25). Research on the
descendants of people who lived through the
Holocaust indicates that their descendants were
more anxious (26), showed excessive narcissistic
vulnerability, more aggression (27) and guilt for
having survived (28).
Also, symptoms of chronic PTSD can develop in
family members who were not born when the
trauma occurred, as described in children of
Vietnam veterans, who suffer from low self-
esteem and reality testing, are hyperactive,
unstable, aggressive, have difficulty coping with
problems and own feelings such as fear, anger,
guilt and mistrust. That is why they may have
more problems in behavior, relationships with
peers or in learning. In the families of
traumatized persons, the percentage of intimate
partner and family violence is higher, and
exposed children may also develop
psychological disorders as a result (27).
We are born with our unique, inherited
combination of genetic potential, but perhaps
even more than genes, a child’s emotional
development is influenced by the people with
whom they are in closest contact. Thus, the so-
called “secondary transmission of trauma”,
which is called indirect, secondary or empathic
traumatization, occurs almost according to the
type of transference identification, and happens
to children, wives or caregivers of sick people,
even to healthy children who play with the
traumatized (29). Thus, the traumatic experience
indirectly gains new victims.
A child in a family with a traumatized parent
grows up with a distorted idea of roles and
conflicts, is ashamed of themselves, carries a
core of self-hatred that is difficult to undo later.
Some are withdrawn and cautious so as not to
be emotionally betrayed again, while others
uncritically get involved in relationships and
repeat disappointments, they are emotionally
numb, unavailable and find it difficult to
experience positive emotions.
Basically, communication is primarily damaged,
so it is easy to enter into a vicious cycle of
anxiety, frustration and withdrawal, until the
feeling of complete exclusion. Silence and
avoidance are most often the basis of
relationship disorders, as well as the inability to
show real feelings, which the traumatized
person cannot bear, so the child has no one to
ask for help and develop the protective feeling
that a parent should evoke. Sometimes the
parent overwhelms the child by excessively
openly describing the traumatic event in minute
detail, which terrifies the child.
For reintegration after trauma, an effective
struggle for healing is needed, which is
recognized by the establishment of a
relationship of trust in oneself and the world, by
offering healthy patterns of communication and
behavior, which strengthen growth and
progress. This requires a systematic and team
approach, raising the level of awareness and
understanding, and creating quality social
support in the community.
The family, as a center within whose
relationships all the child’s psychological
processes take place, represents a place of
safety and support, a place of identification and
the creation of relationships, and a place where
numerous pathological events responsible for
the subsequent development and functioning of
each family member, especially the child, take
place. The family is significantly influenced by
cultural, ethnic and socioeconomic factors, all of
which, together with the specifics and
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expectations of each member within the family,
form a whole, which is in a constant dynamic of
change (30).
Such a milieu is responsible for the child’s early
development and relationships. The family is not
only determined by the socioeconomic status,
but also by the experience, knowledge and
expectations of each member within the family,
and each of the aforementioned factors models
and influences each member (31). In this
interplay of numerous factors, all psychological
influences and problems take place in the
earliest phase of the child’s life. The child brings
such experiences into all other relationships, and
when assessing any pathological process, the
assessment of early family relationships is an
indivisible part, especially when the direct
connection of these processes with acceptance
or rejection, love and emotions is known (32).
Social learning theories, as well as
psychoanalytic and ethological ones, each using
different mechanisms, emphasize the
importance of the dyadic relationship between
the child and the mother or some other person
who cares for them.
Bowlby’s conception of attachment is
particularly important, according to which a
human being has an innate need to create
strong bonds with people who provide a sense
of protection and security and who are
emotionally important to them, and the early
experience of connection with parents shapes
the development and quality of close
relationships in adulthood. Unconditional trust in
the availability of the object of attachment
(parents) and their support are the basis of a
stable person (30, 31).
In states of interruption or threat of interruption
of these connections and the impossibility of
realizing them again, there are strong emotional
responses and a search for an object. Bowlby
believes that the established connection and
attachment to an important person stems from
our need for security and protection. This bond
is established after birth and develops in the
relationship with the mother, and then with other
important persons for us (father, brothers,
sisters, partner) and lasts throughout life.
If the mother and child do not “fit” well, their
relationship will be marked by a weak
attachment or a bond filled with fear. Early
losses (abandonment of the mother) are
experienced as death. The experience of being
“abandoned” (by the mother) in early childhood
can be distorted as complete abandonment
because we are bad and unloved, to which we
respond with helplessness, guilt, anger, fear and
horror. Therefore, early losses will affect the way
of mourning subsequent losses and make it
difficult to overcome separation and loss (32).
As attachment theory deals with social behavior,
an individual’s expectations about themselves,
others and relationships, it also makes
predictions about an individual’s self-esteem
and ability to form close relationships.
Parents remain permanent components in the
attachment hierarchy, but over time they occupy
a secondary position in terms of importance, and
partners become the most important objects of
attachment.
The way people perceive existing social support
can strengthen their belief that others care
about them and value them, and can also
increase their self-esteem and confidence in
their own ability to cope with future stress (33,
34).
Symptoms of anxiety and depression are
present in various psychological disorders and
often overlap, with comorbid conditions that are
difficult to distinguish, and timely diagnosis is of
theoretical, diagnostic and therapeutic
importance (33, 34).
Establishing a diagnosis is complicated by the
fact that cancer is not an acute and discrete
event, but an experience of strong, repeated
traumas of indefinite duration. Therefore, the
sufferer can show symptoms of PTSD at any
time from diagnosis, during treatment and
recurrence of cancer which also leads to
symptoms of stress reaction in sufferers (35).
These observations suggest the need for
continuous reassessments of the diagnosis
throughout the course of treatment, and
according to DSM-IV, although PTSD symptoms
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usually appear within the first three months after
the trauma, they may be delayed for months,
even years.
PTSD in women who have had a family member
with cancer can be reactivated PTSD when the
old clinical picture of PTSD reactivates, but it can
also manifest as a new disorder. Second-
generation PTSD, i.e. reactivated PTSD, lasts
longer and often remains as strong as it was at
the beginning. Exposure to trauma, in the second
generation, exposes a latent sensitivity that was
not triggered by ordinary life events. In the
second generation, there is also a deepening of
the experience of failure, because that
generation was raised to compensate for the
damage experienced by their parents, and this
experience is often present in the treatment of
cancer. Recovery can also be hindered by
excess secondary gains stemming from an
overprotective parenting relationship, which is
well documented for parents of Holocaust
survivors (36).
In addition, as it is a well-known fact that breast
cancer occurs more often in the daughters of
affected women, we should also bear in mind
the transgenerational transmission of the impact
of the current trauma on the next generation (i.e.
the daughters of the examined women) and the
prospective impact of current psychiatric
procedures and their impact on reducing severe
psychological reactions in the future.
The chronification of the PTSD process and
malignant forms usually occurs in those women
who are not satisfied with their physical or
mental condition and self-care (11), and the
contents that were processed during the
psychotherapy process indicate exactly that.
There are frequent repetitions of various
traumatic experiences experienced both during
diagnostic and therapeutic procedures, which
do not have to meet the criteria for establishing
a diagnosis of PTSD, but can interfere with the
development of psychological responses,
disorders or just the intensity of anxiety and
depression.
Affected women often transfer their own fears to
their children, changing their ways of responding
and intensifying anxiety and depression.
Psychotherapeutic treatment has far-reaching
effects and can lead to major changes in
relationships in the entire family of the woman
being treated. Positive therapeutic advances
(through insight and changing responses and
leading to changes in the attitudes and reactions
of sick children) can have an impact on the next
generation as well and help children (if they get
sick in the future) in their psychological
adaptation and fight against this serious disease.
Recent research on the transmission of
transgenerational trauma as a transmission of
resistance, and not only as a transmission of
problems or psychological pathology, points in
this direction, emphasizing that earlier collective
trauma can also result in the strengthening of
some positive family values (37).
The transgenerational transmission of emotions
in cancer is important, but still insufficiently
researched and it is a challenge for future
research, opening up many complex questions.
Acknowledgement. None.
Disclosure
Funding. No specific funding was received for
this study.
Competing interests. None to declare.
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Author contribution. Acquisition of data: SA, VK
Administrative, technical or logistic support: SA, VK
Analysis and interpretation of data: SA, VK
Conception and design: SA, VK
Critical revision of the article for important intellectual
content: SA, VK
Drafting of the article: SA, VK
Final approval of the article: SA, VK
Guarantor of the study: SA, VK
Provision of study materials or patients: SA, VK
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39 Southeastern European Medical Journal, 2024; 8(1)
Utjecaj transgeneracijskog prijenosa u psihičkoj prilagodbi žena s karcinomom
dojke
Sažetak
Uvod: Obolijevanje od karcinoma predstavlja traumatski događaj za oboljelu osobu i može
rezultirati cijelim nizom psihičkih poteškoća, a invazivni načini liječenja dodatno ih
produbljuju. Ranije proživljena psihička trauma bliske osobe može utjecati na odgovor osobe
koja u sadašnjosti proživljava traumu jer se dalekosežna moć poslijetraumatskih posljedica
proteže i kroz prirodnu biološku prepreku daleko u sljedeći naraštaj (tzv. pojam
“transgeneracijskog utjecaja traumatizacije”).
Cilj: Procijeniti utjecaj transgeneracijskog prijenosa na razvoj PTSP-a kod žena oboljelih od
karcinoma dojke koje su u obitelji imale člana oboljelog od karcinoma.
Metode: Uzorak se sastojao od 120 žena liječenih na Odjelu za onkologiju KBC Osijek
uključenih u liaison psihijatrijsko liječenje. Korišten je detaljan klinički pregled s psihijatrijskim
intervjuom uz primjenu DSM-IV dijagnostičkih kriterija, posebno strukturirani
nestandardizirani upitnik za procjenu etioloških čimbenika i LASC za utvrđivanje PTSP-a.
Rezultati: Nije dobivena statistička bitnost o povezanosti postojanja člana obitelji oboljelog
od karcinoma i prosječne ukupne vrijednosti na LASC-u.
Zaključak: Iako nije dobivena povezanost postojanja člana obitelji oboljelog od karcinoma i
razvoja PTSP-a kod ispitanica, tijekom psihoterapijskih postupaka je uočeno postojanje
simptoma koji ne zadovoljavaju kriterije za postavljanje dijagnoze PTSP-a, ali mogu
interferirati s razvojem raznih psihičkih odgovora, poremećaja ili samo jačine anksioznosti i
depresivnosti. Uključivanjem oboljelih od karcinoma u psihoterapijske postupke, možemo
prevenirati razvoj težih psihičkih odgovora kod drugog naraštaja, koji će zbog genetskog
utjecaja u nasljeđivanju bolesti tek razviti karcinom i uz njega vezan psihički poremećaj te
dalekosežno djelovati na jačanje mehanizama prilagodbe.
