Abstract
BackgroundBreast cancer can be perceived as a traumatic event with disturbing effects on psychological domains such as depression, anxiety, and Posttraumatic Stress Disorder. In contrast, growing evidence has shown that posttraumatic growth can occur as a result of coping with breast cancer. Challenging the assumptive world, deliberate rumination, and emotional disclosure are recognized as strong predictors of posttraumatic growth. Group interventions may also increase social support, distress disclosure, and posttraumatic growth. The aim of this study is to evaluate how group-based interventions can facilitate posttraumatic growth and promote improved psychosocial adjustment to breast cancer. This article describes the study protocol and the applied research methods.MethodsTo measure the impact of a group-based intervention on posttraumatic growth, a multi-center randomized control trial was developed for Portuguese breast cancer patients. 205 women with nonmetastatic breast cancer (stages 1 to 3) were recruited for the study and were randomly assigned either to the experimental group, which participated in an 8-session group intervention, or to the control group. Psychosocial variables, which consisted of posttraumatic growth, illness perception, stressfulness of the event, Posttraumatic Stress Disorder, core beliefs, rumination, social support, and distress disclosure were measured at three time points. The designated points in time for the assessments were baseline, 6 months post-intervention, and follow-up (12 months after baseline).DiscussionThis study is the first trial to assess the efficacy of a group-based intervention designed to facilitate posttraumatic growth following a breast cancer diagnosis. If proven to be effective, group-based intervention could be recommended as a complementary program to be included in hospital health-care and clinical practice.Trial registrationThe trial was registered on 28/10/2013 at the Current Controlled Trials (ISRCTN02221709).
Highlights
Breast cancer can be perceived as a traumatic event with disturbing effects on psychological domains such as depression, anxiety, and Posttraumatic Stress Disorder
posttraumatic growth (PTG) involves the reappraisal of traumatic events through different cognitive perspectives, with the main objective of reconstructing the basic assumptions or core beliefs about one’s self, the world, and the future, which are frequently disrupted in the aftermath of a traumatic event [15,16,17]
The challenge to one’s core beliefs appears to be a major antecedent to PTG, since the stressfulness of the event shatters the assumptive world and leads the survivor to engage in a cognitive process to understand what happened [15, 16, 18]
Summary
Breast cancer can be perceived as a traumatic event with disturbing effects on psychological domains such as depression, anxiety, and Posttraumatic Stress Disorder. Challenging the assumptive world, deliberate rumination, and emotional disclosure are recognized as strong predictors of posttraumatic growth. Breast cancer diagnosis can induce several negative psychological symptoms such as distress, anxiety, and even cancer-related Posttraumatic Stress Disorder (PTSD) [1, 2]. The challenge to one’s core beliefs appears to be a major antecedent to PTG, since the stressfulness of the event shatters the assumptive world and leads the survivor to engage in a cognitive process to understand what happened [15, 16, 18]. Within the cognitive process, the rumination related to the event is a crucial factor in the pathway of growth, since it is a key component with an intermediary function between the shattering of the assumptive world and PTG [19]. Deliberate thinking is the type of rumination that is most associated with the development of PTG [15, 20, 22]
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