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Journal of Cancer Education

, Volume 25, Issue 3, pp 343–348 | Cite as

Self-blame, Self-forgiveness, and Spirituality in Breast Cancer Survivors in a Public Sector Setting

  • Lois C. Friedman
  • Catherine R. Barber
  • Jenny Chang
  • Yee Lu Tham
  • Mamta Kalidas
  • Mothaffar F. Rimawi
  • Mario F. Dulay
  • Richard Elledge
Article

Abstract

Cognitive appraisal affects adjustment to breast cancer. A self-forgiving attitude and spirituality may benefit breast cancer survivors who blame themselves for their cancer. One hundred and eight women with early breast cancers completed questionnaires assessing self-blame, self-forgiveness, spirituality, mood and quality of life (QoL) in an outpatient breast clinic. Women who blamed themselves reported more mood disturbance (p < 0.01) and poorer QoL (p < 0.01). Women who were more self-forgiving and more spiritual reported less mood disturbance and better QoL (p’s < 0.01). Interventions that reduce self-blame and facilitate self-forgiveness and spirituality could promote better adjustment to breast cancer.

Keywords

Breast cancer survivors Self-blame Self-forgiveness Spirituality 

References

  1. 1.
    Bennett KK, Compas BE, Beckjord E et al (2005) Self-blame and distress among women with newly diagnosed breast cancer. J Behav Med 28:313–323CrossRefPubMedGoogle Scholar
  2. 2.
    Kim Y, Schulz R, Carver CS (2007) Benefit finding in the cancer caregiving experience. Psychosom Med 69:283–291CrossRefPubMedGoogle Scholar
  3. 3.
    Glinder JG, Compas BE (1999) Self-blame attributions in women with newly diagnosed breast cancer: a prospective study of psychological adjustment. Health Psychol 18:475–481CrossRefPubMedGoogle Scholar
  4. 4.
    Li J, Lambert VA (2007) Coping strategies and predictors of general well-being in women with breast cancer in the People’s Republic of China. Nurs Health Sci 9:199–204CrossRefPubMedGoogle Scholar
  5. 5.
    Scharloo M, de Jong RJ Baatenburg, Langeveld TP et al (2005) Quality of life and illness perceptions in patients with recently diagnosed head and neck cancer. Head Neck 27:857–863CrossRefPubMedGoogle Scholar
  6. 6.
    Servaes P, Verhagen S, Bleijenberg G (2002) Determinants of chronic fatigue in disease-free breast cancer patients: a cross-sectional study. Ann Oncol 13:589–598CrossRefPubMedGoogle Scholar
  7. 7.
    Costanzo ES, Lutgendorf SK, Bradley SL et al (2005) Cancer attributions, distress, and health practices among gynecologic cancer survivors. Psychosom Med 7:972–980CrossRefGoogle Scholar
  8. 8.
    Block KI, Dafter R, Greenwald HP (2006) Cancer, the mind, and the problem of self-blame. Int Cancer Ther 5:123–130CrossRefGoogle Scholar
  9. 9.
    Houldin AD, Jacobsen B, Lowery BJ (1996) Self-blame and adjustment to breast cancer. Oncol Nurs Forum 23:75–79PubMedGoogle Scholar
  10. 10.
    Kainz K (2003) Avoiding patient self-blame. Complement Ther Med 11:46–48CrossRefPubMedGoogle Scholar
  11. 11.
    Peterson C, Schwartz SM, Seligman ME (1981) Self-blame and depressive symptoms. J Person Soc Psychol 41:253–259CrossRefGoogle Scholar
  12. 12.
    Janoff-Bulman R, Wortman CB (1977) Attributions of blame and coping in the “real world”: severe accident victims react to their lot. J Person Soc Psychol 35:351–363CrossRefGoogle Scholar
  13. 13.
    Malcarne VL, Compas BE, Epping-Jordan JE et al (1995) Cognitive factors in adjustment to cancer: attributions of self-blame and perceptions of control. J Behav Med 18:401–417CrossRefPubMedGoogle Scholar
  14. 14.
    Janoff-Bulman R (1992) Shattered Assumptions: Towards a New Psychology of Trauma. Free Press, New YorkGoogle Scholar
  15. 15.
    Timko C, Janoff-Bulman R (1985) Attributions, vulnerability, and psychological adjustment: the case of breast cancer. Health Psychol 4:521–544CrossRefPubMedGoogle Scholar
  16. 16.
    Enright RD, The Human Development Study Group (1996) Counseling within the forgiveness triad: on forgiving, receiving forgiveness, and self-forgiveness. Couns Values 40:107–126Google Scholar
  17. 17.
    Romero C, Friedman LC, Kalidas M et al (2006) Self-forgiveness, spirituality, and psychological adjustment in women with breast cancer. J Behav Med 29:29–36CrossRefPubMedGoogle Scholar
  18. 18.
    Friedman LC, Romero C, Elledge R et al (2007) Attribution of blame, self-forgiving attitude and psychological adjustment in women with breast cancer. J Behav Med 30:351–357CrossRefPubMedGoogle Scholar
  19. 19.
    Powell LH, Shahabi L, Thoreson CE (2003) Religion and spirituality: linkages to physical health. Am Psychol 58:36–52CrossRefPubMedGoogle Scholar
  20. 20.
    Silvestri GA, Knittig S, Zoller JS et al (2003) Importance of faith on medical decisions regarding cancer care. J Clin Oncol 21:1379–1382CrossRefPubMedGoogle Scholar
  21. 21.
    Morgan PD, Gaston-Johansson F, Mock V (2006) Spiritual well-being, religious coping, and the quality of life of African American breast cancer treatment: a pilot study. ABNF J 17:73–77PubMedGoogle Scholar
  22. 22.
    Leak A, Hu J, King CR (2008) Symptom distress, spirituality, and quality of life in African American breast cancer survivors. Cancer Nurs 31:E15–21CrossRefPubMedGoogle Scholar
  23. 23.
    Astrow AB, Wexler A, Texeira K et al (2007) Is failure to meet spiritual needs associated with cancer patients’ perceptions of quality of care and their satisfaction with care? J Clin Oncol 25:5753–5757CrossRefPubMedGoogle Scholar
  24. 24.
    Yanez B, Edmondson D, Stanton AL et al (2009) Facets of spirituality as predictors of adjustment to cancer: relative contributions of having faith and finding meaning. J Consult Clin Psychol 77:730–741CrossRefPubMedGoogle Scholar
  25. 25.
    Nosarti C, Roberts JV, Crayford T et al (2002) Early psychological adjustment in breast cancer patients: a prospective study. J Psychosom Res 53:1123–1130CrossRefPubMedGoogle Scholar
  26. 26.
    Stewart DE, Cheung AM, Duff S et al (2001) Attributions of cause and recurrence in long-term breast cancer survivors. Psycho-Oncol 10:179–183CrossRefGoogle Scholar
  27. 27.
    Mauger PA, Perry JE, Freeman T et al (1992) The measurement of forgiveness: preliminary research. J Psychol Christ 11:170–180Google Scholar
  28. 28.
    Peterman AH, Fitchett G, Brady MJ et al (2002) Measuring spiritual well-being in people with cancer: the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale (FACIT-Sp). Ann Behav Med 24:49–58CrossRefPubMedGoogle Scholar
  29. 29.
    Shacham S (1983) A shortened version of the profile of mood states. J Pers Assess 47:305–306CrossRefPubMedGoogle Scholar
  30. 30.
    Baker F, Denniston M, Zabora J et al (2002) A POMS short form for cancer patients: psychometric and structural evaluation. Psycho-Oncol 11:273–281CrossRefGoogle Scholar
  31. 31.
    Cella DF. Manual of the Functional Assessment of Chronic Illness Therapy (quality of life) Scales (Version 4), Center on outcomes, research and education, Evanston Northwestern Healthcare and Northwestern University, Evanston, IL; 1997.Google Scholar
  32. 32.
    Chlebowski R (2007) Lifestyle change including dietary fat reduction and breast cancer outcome. J Nutr 137:233S–235SPubMedGoogle Scholar
  33. 33.
    Bardwell WA, Natarajan L, Dimsdale JE et al (2006) Objective cancer-related variables are not associated with depressive symptoms in women treated for early-stage breast cancer. J Clin Oncol 24:420–2427CrossRefGoogle Scholar
  34. 34.
    Cella DF, Tross S, Orav JE et al (1989) Mood states of patients after the diagnosis of cancer. J Psychosoc Oncol 7:45–54CrossRefGoogle Scholar
  35. 35.
    Ell K, Sanchez K, Vourlekis B et al (2005) Depression, correlates of depression, and receipt of depression care among low-income women with breast or gynecologic cancer. J Clin Oncol 23:3052–3060CrossRefPubMedGoogle Scholar

Copyright information

© Springer 2010

Authors and Affiliations

  • Lois C. Friedman
    • 1
  • Catherine R. Barber
    • 2
  • Jenny Chang
    • 3
  • Yee Lu Tham
    • 3
  • Mamta Kalidas
    • 4
  • Mothaffar F. Rimawi
    • 3
  • Mario F. Dulay
    • 5
  • Richard Elledge
    • 3
  1. 1.Department of Psychiatry, Ireland Cancer CenterUniversity Hospitals Case Medical CenterClevelandUSA
  2. 2.Menninger Department of Psychiatry and Behavioral SciencesBaylor College of MedicineHoustonUSA
  3. 3.Dan Duncan Cancer Center and Lester and Sue Smith Breast Center, Department of MedicineBaylor College of MedicineHoustonUSA
  4. 4.Austin Diagnostic ClinicAustinUSA
  5. 5.Department of NeurosurgeryThe Methodist Hospital Neurological InstituteHoustonUSA

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