, Volume 29, Issue 3, pp 236-245

Perceptions of positive meaning and vulnerability following breast cancer: Predictors and outcomes among long-term breast cancer survivors

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Background: Survival rates for women with early-stage breast cancer have increased significantly in recent years. However, little is known about the long-term impact of the cancer experience on women's psychological functioning. Theoretical and descriptive accounts suggest that cancer may evoke both perceptions of vulnerability and positive meaning, with potentially different effects on mental health.Purpose: This study was designed to evaluate the prevalence and stability of these perceptions in a large sample of breast cancer survivors, to identify their antecedents, and to determine their impact on long-term adjustment.Methods: Breast cancer survivors (N = 763) were assessed longitudinally at 1 to 5 years and 5 to 10 years postdiagnosis. Participants completed surveys assessing perceptions of positive meaning and vulnerability and standard measures of psychological adjustment and quality of life.Results: The majority of women reported positive changes in outlook and priorities as well as feelings of vulnerability at both assessment points. Consistent with hypotheses, results showed that perceptions of positive meaning and vulnerability were positively correlated and were both associated with factors that increased the disruptiveness of the cancer experience. Vulnerability was strongly associated with negative affect, whereas meaning was associated with positive affect in cross-sectional and longitudinal analyses.Conclusions: Results suggest that a cancer diagnosis may lead to enduring feelings of vulnerability as well as positive changes in meaning; however, these perceptions have very different mental health correlates.

This research was supported by Public Health Service grant R01CA63028 from the National Cancer Institute and by the Jonsson Comprehensive Cancer Center. Dr. Bower was supported in part by career development awards from the National Cancer Institute and the California Breast Cancer Research Program. Dr. Ganzwas supported in part by an American Cancer Society Clinical Research Professorship.
We gratefully acknowledge Beth Leedham, Ph.D., who contributed to study design and implementation, and Katherine Masyn, Ph.D. and Annette Stanton, Ph.D., who provided consultation on data analysis and manuscript preparation.