psych cancer

psych cancer - Journal of Consulting and Clinical...

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Curvilinear Associations Between Benefit Finding and Psychosocial Adjustment to Breast Cancer Suzanne C. Lechner University of Miami School of Medicine Charles S. Carver University of Miami Michael H. Antoni University of Miami and University of Miami School of Medicine Kathryn E. Weaver and Kristin M. Phillips University of Miami Two previously studied cohorts of women with nonmetastatic breast cancer ( N s 5 230 and 136) were reexamined. Participants were assessed during the year after surgery and 5–8 years later. Associations were examined between benefit finding (BF) and several indicators of psychosocial adjustment (e.g., perceived quality of life, positive affect, negative affect, social disruption, and intrusive thoughts). Significant curvilinear relations between BF and other outcomes were observed cross-sectionally during initial assessment and at long-term follow-up in both samples. Compared with the intermediate BF group, low and high BF groups had better psychosocial adjustment. Further analyses indicated that the high BF group reported higher optimism and more use of positive reframing and religious coping than the other BF groups. Discussion highlights the need to examine nonlinear as well as linear relationships. Keywords: benefit finding, growth, adjustment, quality of life, breast cancer A growing literature documents that, despite the adversity as- sociated with cancer diagnosis, treatment, and survivorship, posi- tive life changes may also accompany this experience. Such benefit-finding (BF; Tomich & Helgeson, 2004) or stress-related growth (Park, Cohen, & Murch, 1996) can include better relation- ships with family and friends, a sense of competence, shifts in priorities, enhanced emotional strength, deepened spirituality, and the desire to live each day to its fullest (Taylor, 1983). BF is by no means rare; in two studies, 53% (Taylor, Lichtman, & Wood, 1984) and 84% (Collins, Taylor, & Skokan, 1990) of women with breast cancer reported finding benefit in the cancer experience. Relationship of BF to Other Psychosocial Outcomes It was originally assumed that the ability to find benefits from an illness would contribute to better adjustment to the illness. In persons with various cancers, links have emerged between BF and lower distress (Fife, 1995; Ho, Chan, & Ho, 2004; Katz, Flasher, Cacciapaglia, & Nelson, 2001; Taylor et al., 1984; Urcuyo, Boy- ers, Carver, & Antoni, 2005; Vickberg, Bovbjerg, DuHamel, Cur- rie, & Redd, 2000; Vickberg et al., 2001), higher self-esteem, less anxiety (Lewis, 1989), greater well-being (Carpenter, Brockopp, & Andrykowski, 1999; Curbow, Somerfield, Baker, Wingard, & Legro, 1993; Urcuyo et al., 2005), more positive mood (Carver & Antoni, 2004; Katz et al., 2001; Sears, Stanton, & Danoff-Burg, 2003; Tomich & Helgeson, 2002), and higher current life satisfac- tion and estimates of future life satisfaction (Curbow et al., 1993). However, a number of studies of women with breast cancer have obtained discrepant findings. In some cases, BF related to more distress or poorer quality of life (Tomich & Helgeson, 2004). In others, no relation emerged between BF and distress or well-being (Antoni et al., 2001; Cordova, Cunningham, Carlson, & An- drykowski, 2001; Curbow et al., 1993; Fromm, Andrykowski, &
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psych cancer - Journal of Consulting and Clinical...

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