Predicting negative mood state and personal growth in African American and White long-term breast cancer survivors

Duke University, Durham, North Carolina, United States
Annals of Behavioral Medicine (Impact Factor: 4.2). 07/2006; 31(3):195-204. DOI: 10.1207/s15324796abm3103_1
Source: PubMed


Relatively little research has examined cognitive processes that may impact psychological adaptation in older long-term breast cancer survivors (BCS).
This study investigated the strength of a conceptual model based on the literature and Uncertainty in Illness Theories which proposes that negative mood state and personal growth in older long-term White and African American BCS would be predicted by the combined influences of demographic and disease variables, social support, religious participation, and cognitive processes (uncertainty, catastrophizing, troublesome thoughts, and cognitive reframing).
Baseline data were gathered from 524 BCS (369 Whites and 155 African Americans, 5-9 years postdiagnosis) prior to their participating in an uncertainty management intervention program. The conceptual model was tested using structural equation modeling.
The multigroup model showed good fit to the data and explained substantial variance in negative mood state and personal growth. Cognitive processes showed both direct and indirect effects on outcomes in the expected directions. Several ethnic differences were found: African Americans were more negatively affected by comorbidities and Whites by symptom distress, whereas cognitive reframing was a stronger predictor of personal growth for African Americans than Whites.
This is one of the first studies to explore predictors of both negative mood and personal growth in a multiethnic sample of BCS. These findings suggest that cognitive processes play an important role in psychological adaptation to breast cancer survivorship. These processes are amenable to change, suggesting a logical target for intervention with this population.

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    • "Concerning catastrophizing, we found a small negative effect on personal growth. This finding fits well with research examining catastrophizing in the context of chronic pain and illness, showing that this strategy leads to higher levels of negative mood and reduced personal growth (Porter et al. 2006; Sturgeon and Zautra 2013). One unexpected finding concerned the few significant effects on wellbeing of positive refocusing, putting into perspective and acceptance—which are theoretically considered as adaptive forms of emotion regulation (e.g., Carver et al. 1989; Garnefski et al. 2001). "
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    ABSTRACT: Although research has extensively examined the link between cognitive emotion regulation and psychopathological symptoms, scant attention has been given to the relationship between dispositional use of cognitive emotion regulation strategies and individuals’ positive functioning. In a cross-sectional study on 470 adults, we examined whether individual differences in the use of nine cognitive strategies were associated with subjective and psychological well-being. Results show that positive reappraisal and refocus on planning are positively related to both subjective and psychological well-being. Rumination, catastrophizing and self-blame are linked to poorer well-being, while positive refocusing, putting into perspective, and acceptance show few significant associations. These results suggest that cognitive emotion regulation strategies may be differently effective in promoting individual’s well-being.
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    • "We thought that Bruchon-Schweitzer's (2002, p. 92) integrative model stemming from the Lazarus and Folkman's (1984) transactional model of stress could be heuristic to that purpose. Indeed, (1) this model has proven its validity in many health-related issues (e.g., Echteld, van Elderen, & van der Kamp, 2003; Epping-Jordan et al., 1999; Luszczynska, Mohamed, & Schwarzer, 2005; Porter et al., 2006); (2) it takes into account different types of variables such as medical and social, personality variables, and variables of how people perceive and react to a stressful event, called transactional variables; and (3) this model tests direct and indirect effects because it specifies that transactional variables mediate the effect of antecedent ones (i.e., medical, social, and personality variables) on quality of life. Among the antecedents, two variables emerge as being of particular interest with regard to mental health after cancer: age as a protective factor (Bloom, Peterson, & Kang, 2007; Tomich & Helgeson, 2002) and chemotherapy as a risk factor (Casso, Buist, & Taplin, 2004; Le Corroller-Soriano, Bouhinik, Auquier, & Moatti, 2008b; Paskett et al., 2008). "
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    ABSTRACT: The objective of this research is to propose a comprehensive model for the prediction of long-term mental health in breast cancer survivors diagnosed 5 to 15 years earlier, compared to female participants referring to the most stressful event that occurred within the last 20 years. Nearly 300 survivors and 132 comparison participants were consulted using a questionnaire, which evaluated personality variables, transactional variables, and current mental quality of life. Structural equation modeling was used. The transactional proposed model was able to account for long-term mental health variance in both groups but was more relevant to women with breast cancer.
    Full-text · Article · Jul 2011 · Journal of Psychosocial Oncology
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    • "Regarding psychological predictors, consistent with our hypothesis, dispositional positive affectivity and adaptative coping (active, positive, relational, religious and denial coping) were positively associated with posttraumatic growth. These findings are consistent with literature pointing out the beneficial effect on growth of positive, active and religious coping (Lechner et al., 2006; Park et al., 1996; Porter et al., 2006; Urcuyo et al., 2005), as well as relational coping (Armeli, Gunthert, & Cohen, 2001) or denial coping (Helgeson et al., 2006; Park & Fenster, 2004). But there are two important conclusions to be drawn here: first the very long term persistent effect of coping on perceived positive changes due to cancer experience, and second the additional 25.1% of explained variance by coping strategies controlling for personality, thus demonstrating that posttraumatic growth is not only dependent on positive personality, but also on what happened during disease and treatment. "
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    ABSTRACT: This study evaluated the prevalence and predictors of long term posttraumatic growth (PTG) after breast cancer, and relationships of PTG with psychological health in a random sample of 307 currently disease-free women 5-15 years after diagnosis. This cross-sectional study reveals long term posttraumatic growth scores comparable to those found in shorter term studies. Prevalence of a better appreciation of life is especially noteworthy. With the exception of perceived current sequelae of disease associated in a somewhat curvilinear fashion with PTG, demographic and medical variables are poor predictors of the issue. On the contrary, dispositional positive affectivity and adaptative coping of positive, active, relational, religious and to some extent denial coping have a strong effect on growth. Finally, PTG is slightly associated with mental quality of life and happiness. Findings are discussed in the light of posttraumatic growth theory.
    Full-text · Article · Mar 2010 · Journal of Clinical Psychology in Medical Settings
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