Amy R Senger, Chelsea G Ratcliff, Robin K Semelsberger, Alejandro Chaoul, Lorenzo Cohen
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The Role of Coping and Posttraumatic Stress in Fostering Posttraumatic Growth and Quality of Life Among Women with Breast Cancer.
Tedeschi & Calhoun's model of posttraumatic growth (PTG) suggests that intrusive thoughts about a traumatic event, in combination with helpful coping strategies, facilitates PTG. This manuscript applies this model to a sample of breast cancer survivors, augments it to conceptualize coping strategies as "active" or "avoidant," and extends it to include health-related quality of life (HRQOL). This is a secondary analysis of a subset of breast cancer patients (N = 123) in a randomized clinical trial of Tibetan yoga, which examines the associations of coping at study entry with PTG, PTSS (i.e., intrusive thoughts and avoidance), and HRQOL (physical (PCS) and mental (MCS) component scales) reported 9 and 15 months later. Mediation analyses revealed that higher baseline active coping predicted higher 9-month PTG, which in turn predicted higher 15-month PCS [effect = .46, 95% CI (.06, 1.07)]. Exploratory moderated mediation analyses revealed that higher baseline intrusive thoughts about cancer predicted lower 9-month PTG, which in turn predicted lower 15-month PCS, but only for those reporting low active coping [effect = - .06, 95% CI (- .16, - .003)]. Active coping may play a critical role of fostering PTG and improving subsequent HRQOL in the presence of rumination about cancer.
期刊介绍:
Journal of Clinical Psychology in Medical Settings is an international forum for the publication of peer-reviewed original papers related to all areas of the science and practice of psychologists in medical settings. Manuscripts are chosen that have a broad appeal across psychology as well as other health care disciplines, reflecting varying backgrounds, interests, and specializations. The journal publishes original research, treatment outcome trials, meta-analyses, literature reviews, conceptual papers, brief scientific reports, and scholarly case studies. Papers accepted address clinical matters in medical settings; integrated care; health disparities; education and training of the future psychology workforce; interdisciplinary collaboration, training, and professionalism; licensing, credentialing, and privileging in hospital practice; research and practice ethics; professional development of psychologists in academic health centers; professional practice matters in medical settings; and cultural, economic, political, regulatory, and systems factors in health care. In summary, the journal provides a forum for papers predicted to have significant theoretical or practical importance for the application of psychology in medical settings.