A Prospective Multi-National Study of Posttraumatic Stress and Posttraumatic Growth Among Women With Breast Cancer: A Serial Mediation Analysis.

IF 3.3 2区医学 Q2 ONCOLOGY

Psycho‐Oncology Pub Date : 2025-04-01 DOI:10.1002/pon.70126

L Kelada, I Roziner, R Dahabre, G Bentley, P Poikonen-Saksela, K Mazzocco, B Sousa, R Pat-Horenczyk

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引用次数: 0

Abstract

Objective: Research suggests that posttraumatic stress symptoms (PTSS) after a breast cancer (BC) diagnosis may lead to posttraumatic growth (PTG). Further prospective research is needed to confirm this, and to examine whether modifiable factors mediate the relationship. This study aimed to prospectively determine whether PTSS predicts PTG, and whether social support and cognitive emotion regulation mediate the relationship between PTSS and PTG among women with BC.

Methods: In this study, 489 women from four countries (Finland, Israel, Italy, Portugal) with BC completed questionnaires at diagnosis (M0), and 6-months (M6), 9-months (M9), 15-months (M15), and 18-months (M18) post-diagnosis. Questionnaires included the Posttraumatic Growth Inventory, PTSD Checklist for DSM-5, Cognitive Emotion Regulation Questionnaire, modified Medical Outcomes Study Social Support Survey, and sociodemographic questions. We used serial mediation to determine whether the relationship between PTSS (M6) and PTG (M18) was mediated by social support (M9) and positive cognitive emotion regulation (M15), controlling for age.

Results: PTSS (M6) (B = 0.18, 95%CI = 0.07, 0.28), social support (M9) (B = 1.71, 95%CI = 0.30, 3.14) and positive cognitive emotion regulation (M15) (B = 3.34, 95%CI = 1.76, 4.92) all directly predicted PTG (M18). The serial mediation was significant with a very small effect size: PTSS negatively predicted social support which positively predicted positive cognitive emotion regulation which positively predicted PTG (effect = -0.013, 95%CI = -0.02, -0.005).

Conclusions: Our study adds support for a prospective, positive relationship between PTSS and PTG among women with BC, and shows that this relationship may be mediated by social support and cognitive emotion regulation. Further research is needed to inform interventions to promote PTG.

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乳腺癌女性创伤后应激与创伤后成长的前瞻性多国研究：系列中介分析。

目的：研究表明乳腺癌（BC）诊断后的创伤后应激症状（PTSS）可能导致创伤后生长（PTG）。进一步的前瞻性研究需要证实这一点，并检查是否可修改的因素介导的关系。本研究旨在前瞻性地探讨创伤后应激障碍是否能预测创伤后应激障碍，以及社会支持和认知情绪调节是否在BC女性创伤后应激障碍和创伤后应激障碍之间起到中介作用。方法：在本研究中，来自四个国家（芬兰、以色列、意大利、葡萄牙）的489名BC患者在诊断时（M0）、诊断后6个月（M6）、9个月（M9）、15个月（M15）和18个月（M18）完成问卷调查。问卷包括创伤后成长量表、DSM-5创伤后应激障碍检查表、认知情绪调节问卷、修正医疗结果研究社会支持调查和社会人口学问题。在控制年龄的情况下，我们采用序列中介方法来确定社会支持（M9）和积极认知情绪调节（M15）是否对PTSS （M6）和PTG （M18）之间的关系起中介作用。结果：PTSS (M6) （B = 0.18, 95%CI = 0.07, 0.28）、社会支持（M9）（B = 1.71, 95%CI = 0.30, 3.14）和积极认知情绪调节（M15）（B = 3.34, 95%CI = 1.76, 4.92）均可直接预测PTG （M18）。ptsd对社会支持有负向预测，社会支持对积极认知情绪调节有正向预测，积极认知情绪调节对PTG有正向预测（effect = -0.013, 95%CI = -0.02, -0.005）。结论：我们的研究为BC女性ptsd与PTG之间的前瞻性正相关提供了支持，并表明这种关系可能由社会支持和认知情绪调节介导。需要进一步的研究来为促进PTG的干预措施提供信息。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Psycho‐Oncology 医学-心理学

CiteScore

6.30

自引率

8.30%

发文量

220

审稿时长

3-8 weeks

期刊介绍： Psycho-Oncology is concerned with the psychological, social, behavioral, and ethical aspects of cancer. This subspeciality addresses the two major psychological dimensions of cancer: the psychological responses of patients to cancer at all stages of the disease, and that of their families and caretakers; and the psychological, behavioral and social factors that may influence the disease process. Psycho-oncology is an area of multi-disciplinary interest and has boundaries with the major specialities in oncology: the clinical disciplines (surgery, medicine, pediatrics, radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology. This international journal is published twelve times a year and will consider contributions to research of clinical and theoretical interest. Topics covered are wide-ranging and relate to the psychosocial aspects of cancer and AIDS-related tumors, including: epidemiology, quality of life, palliative and supportive care, psychiatry, psychology, sociology, social work, nursing and educational issues. Special reviews are offered from time to time. There is a section reviewing recently published books. A society news section is available for the dissemination of information relating to meetings, conferences and other society-related topics. Summary proceedings of important national and international symposia falling within the aims of the journal are presented.