{"title":"The Mediating Role of Early Maladaptive Schemas in the Relationship Between Attachment Styles and Adjustment to Early-Stage Breast Cancer.","authors":"Spyridoula Karveli, Evangelos Karademas, Fiorita Poulakaki, Zoe Antonopoulou, Nikolaos Arkadopoulos, Christos Markopoulos","doi":"10.1002/pon.70196","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Individual differences play an important role in adjustment to breast cancer. This longitudinal study explored the potential mediating role of Early Maladaptive Schemas (EMSs) in the relationship between attachment styles and psychological adjustment.</p><p><strong>Methods: </strong>Ninety-five early-stage female breast cancer patients participated in this longitudinal study and completed validated self-report questionnaires within 4 weeks and 12 months post-surgery measuring attachment styles (ECR-R), EMSs (YSQ-S3), anxiety (HADS-A), depression (HADS-D), and quality of life (EORTC-QLQ C30). Structural equation modeling was utilized to test direct and indirect effects.</p><p><strong>Results: </strong>Vulnerability to harm/illness schema had a direct effect on all outcomes, while the enmeshment EMS had a direct effect on anxiety only. Moreover, vulnerability to harm/illness schema fully mediated the relationship between attachment anxiety and psychological outcomes. No significant direct or indirect effects were observed for attachment avoidance.</p><p><strong>Conclusion: </strong>The findings underscore the role of the illness-specific EMS -vulnerability to harm/illness-in psychological distress pathways among breast cancer patients. In non-clinical samples, cancer-related demands and stressors likely amplify the activation of only those schemas closely tied to the psychological challenges of living with cancer, while other EMSs may hold little relevance. Interventions targeting illness-specific EMSs may enhance coping and emotional well-being in this population.</p>","PeriodicalId":20779,"journal":{"name":"Psycho‐Oncology","volume":"34 6","pages":"e70196"},"PeriodicalIF":3.5000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128901/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Psycho‐Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/pon.70196","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Individual differences play an important role in adjustment to breast cancer. This longitudinal study explored the potential mediating role of Early Maladaptive Schemas (EMSs) in the relationship between attachment styles and psychological adjustment.
Methods: Ninety-five early-stage female breast cancer patients participated in this longitudinal study and completed validated self-report questionnaires within 4 weeks and 12 months post-surgery measuring attachment styles (ECR-R), EMSs (YSQ-S3), anxiety (HADS-A), depression (HADS-D), and quality of life (EORTC-QLQ C30). Structural equation modeling was utilized to test direct and indirect effects.
Results: Vulnerability to harm/illness schema had a direct effect on all outcomes, while the enmeshment EMS had a direct effect on anxiety only. Moreover, vulnerability to harm/illness schema fully mediated the relationship between attachment anxiety and psychological outcomes. No significant direct or indirect effects were observed for attachment avoidance.
Conclusion: The findings underscore the role of the illness-specific EMS -vulnerability to harm/illness-in psychological distress pathways among breast cancer patients. In non-clinical samples, cancer-related demands and stressors likely amplify the activation of only those schemas closely tied to the psychological challenges of living with cancer, while other EMSs may hold little relevance. Interventions targeting illness-specific EMSs may enhance coping and emotional well-being in this population.
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.