Predictors of positive and negative post-traumatic psychological outcomes in a sample of Iranian cancer survivors.

Abstract

Objectives This study aimed to identify predictors of positive and negative post-traumatic psychological outcomes within a sample of Iranian cancer survivors. Methods In this cross-sectional research, 300 (167 females; age M=53.00, SD=27.57) cancer survivors (breast cancer, leukaemia, colorectal cancer) were recruited from oncology outpatient clinics in Iran. Participants completed measures of post-traumatic stress disorder (PTSD), post-traumatic growth (PTG), cognitive processing, attentional biases, and autobiographical memory specificity. Results Using partial least square structural equation modelling, it was found that the proposed model was capable of predicting PTSD and PTG. Negative attentional biases were significantly associated with PTSD symptoms, but were not significantly associated with PTG. In contrast, memory specificity and positive attentional biases tended to be associated with PTG, but were not significantly associated with PTSD symptoms. Second, negative cognitive processing was significantly associated with PTSD symptoms, while positive cognitive processing was significantly associated with PTG. Finally, there was support for indirect pathways between positive cognitive tendencies and PTG through positive cognitive processing, while there were indirect pathways between negative habitual cognitive tendencies and PTSD symptoms through negative cognitive processing. Conclusions Our findings support growing evidence for differential trajectories to PTG and PTSD symptoms in cancer. Such cognitive factors may be important therapeutic targets in psycho-oncology interventions. Statement of contribution What is already known on this subject? The diagnosis of cancer and its subsequent treatment can result in symptoms of post-traumatic stress disorder (PTSD). Positive changes and psychosocial growth (post-traumatic growth; PTG) are also common as a result of patients' experience of cancer. What does this study add? This study identified predictors of positive (PTG) and negative trauma (PTSD) outcomes within a sample of Iranian cancer survivors (N=300). General habitual cognitive tendencies (memory specificity, attentional biases) were associated with cognitive processing, which in turn contributed to psycho-traumatic adaption. There was support for indirect pathways between positive cognitive tendencies and PTG through positive cognitive processing, while there were indirect pathways between negative habitual cognitive tendencies and PTSD symptoms through negative cognitive processing.