Mixed Psychological Changes Following Mastectomy: Unique Predictors and Heterogeneity of Post-traumatic Growth and Post-traumatic Depreciation.

Aleksandra Kroemeke,Kamilla Bargiel-Matusiewicz,Magdalena Kalamarz

doi:10.3389/fpsyg.2017.01245

Aleksandra Kroemeke, Kamilla Bargiel-Matusiewicz + Show 1 more

Open Access

https://doi.org/10.3389/fpsyg.2017.01245

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Abstract

Objectives: Post-traumatic growth (PTG) and its opposite—post-traumatic depreciation (PTD)—may be treated as important indicators of the patient quality of life. In the absence of studies on both, PTG and PTD in cancer patients, we investigated (1) coping strategies and support effectiveness as predictors of PTG and PTD in post-mastectomy women, (2) homogeneous classes with different intensity of PTG and PTD symptoms, and (3) correlates of class membership.Methods: Coping strategies (Brief COPE), support effectiveness (SSE-Q), PTG (PTGI), and PTD (negatively reworded items of PTGI) were measured in 84 post-mastectomy women (mean age = 62.27, SD = 8.38). Multiple regression, two-step cluster, and multinomial logistic regression were applied.Results: PTG and PTD had unique predictors: time since diagnosis and positive emotion-focused coping predicted PTG (R2 = 0.24), while negative emotion-focused and avoidance-focused coping and low support effectiveness were linked to PTD (R2 = 0.14). Four groups of PTG × PTD symptoms were identified: high PTG low PTD group (52.4%), low PTG low PTD group (17.9%), high PTG high PTD group (15.5%), and low PTG high PTD group (14.3%). Higher emotion- and avoidance-focused coping was characteristic for the high PTD low PTG group (R2 = 0.41).Conclusion: Our findings shed light on the coexistence and unique predictors of PTG and PTD after mastectomy, indicating heterogeneity in PTG and PTD levels among post-mastectomy women.

Highlights

Neoplastic disease and cancer-related treatment may significantly affect the well-being and quality of patient life
The level of post-traumatic growth (PTG) was significantly higher as compared to PTD (t83 = 14.69, p < 0.001)
Multiple regression analysis (Table 2) showed that higher PTG was predicted by higher positive emotion–focused coping and longer time since diagnosis

Summary

Introduction

Neoplastic disease and cancer-related treatment may significantly affect the well-being and quality of patient life. Positive and PTG and PTD Following Mastectomy negative perceived psychological changes in cancer continue to be investigated, only a few authors attempted to analyze them simultaneously (Schroevers et al, 2011). We attempted to address this matter by testing whether perceived positive (post-traumatic growth, PTG) and negative (post-traumatic depreciation, PTD) changes in women after mastectomy have unique or shared predictors in terms of coping strategies and effectiveness of social support attempts called ‘social support effectiveness’ (SSE). By applying a person-centered approach, which assumes that a population is heterogeneous in relation to the effect of the predictors on the outcome (Laursen and Hoff, 2006), we tested whether it was possible to identify homogeneous subgroups with particular intensity of both, PTG and PTD symptoms, and whether these subgroups differ in terms of coping strategies and SSE

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