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Unformatted text preview: Finding Benefit in Breast Cancer During the Year After Diagnosis Predicts Better Adjustment 5 to 8 Years After Diagnosis Charles S. Carver and Michael H. Antoni University of Miami Cancer patients experience positive as well as adverse consequences from diagnosis and treatment. The study reported here examined longer term reverberations of such experiences. A set of benefit-finding items along with measures of well-being were completed by 230 early-stage breast cancer patients in the year postsurgery. Four to 7 years later, 96 of them again completed measures of well-being. Controlling for initial distress and depression, initial benefit finding in this sample predicted lower distress and depression at follow-up. Key words: quality of life, breast cancer, benefit finding, cancer sequelae Breast cancer patients confront many stressors. Most impactful is the diagnosis itself (e.g., Andrykowski, Cordova, Studts, & Miller, 1998). However, the medical procedures that follow are also stressful, as are treatment side effects (e.g., Hann, Jacobsen, Martin, Azzarello, & Greenberg, 1998). Beyond the physical chal- lenges, breast cancer patients experience a variety of psychological threats and losses. Although the cancer experience is distressing and disruptive, awareness is growing that there are aspects of the experience that patients view as beneficial. Many report outcomes such as im- proved personal resources, an enhanced sense of purpose, greater spirituality, closer ties with others, and changes in life priorities (e.g., Andrykowski, Brady, & Hunt, 1993; Cordova, Cunningham, Carlson, & Andrykowski, 2001; Dow, Ferrell, Leigh, Ly, & Gu- lasekaram, 1996; Ferrell, Dow, Leigh, Ly, & Gulasekaram, 1995; Kurtz, Wyatt, & Kurtz, 1995; Stanton et al., 2002; Taylor, Licht- man, & Wood, 1984). Though it seems paradoxical, some patients say having been diagnosed with cancer has been a positive expe- rience in their lives overall. Such findings join a literature in other areas suggesting that traumatic events can yield positive outcomes (e.g., Affleck & Tennen, 1996; Davis, Nolen-Hoeksema, & Lar- son, 1998; Ickovics & Park, 1998; McFarland & Alvaro, 2000; McMillen, Smith, & Fisher, 1997; Mohr et al., 1999; Park, Cohen, & Murch, 1996; Tedeschi & Calhoun, 1996; Tedeschi, Park, & Calhoun, 1998; Updegraff & Taylor, 2000). Assessing Benefits Finding benefit in cancer has been assessed in several ways. In some cases, assessment of spiritual benefit was a facet of a broad assessment of quality of life (e.g., Ferrell et al., 1995; Kurtz et al., 1995). Others have assessed blends of benefit and cost with bipolar scales (Andrykowski et al., 1993; Cordova et al., 2001). Often (though not always), the measures are limited to spiritual benefits....
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