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Resilience and Psychosocial Adjustment in Digestive System Cancer

Journal of Clinical Psychology in Medical Settings volume 22, pages 1–13 (2015)Cite this article

Abstract

The study aims to investigate the contributions of resilience, affective reactions and post traumatic growth (PTG) to psychosocial adjustment and behavioral changes among digestive system cancer patients in Israel. A sample of 200 participants, 57.5 % men (from the 46 to 70-year age range), 1–4 years following diagnosis, completed an inventory assessing demographic and medical information, resilience, current positive affect (PA) and negative affect (NA), PTG, psychosocial adjustment and retrospective report of behavioral changes following cancer treatment. Resilience, PA and NA, and PTG were related to adjustment and/or reported behavioral changes, and PA, NA and PTG mediated some of the effects of resilience on adjustment and/or reported behavioral changes. The data underline the importance of resilience, affect, and PTG in the adjustment of digestive system cancer patients. Future studies are needed to better understand the associations of resilience with psychosocial adjustment and behavioral changes. This knowledge may help improve cancer survivors’ adjustment.

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References

  • Arbuckle, J. L. (2006). Amos 7.0 User’s Guide. Chicago, IL: SPSS, Inc.

  • Aspinwall, L. G., & MacNamara, A. (2005). Taking positive changes seriously: Toward a positive psychology of cancer survivorship and resilience. Cancer, 104, 2549–2556.

    Article  PubMed  Google Scholar 

  • Bellizzi, K. M., & Blank, T. O. (2006). Predicting posttraumatic growth in breast cancer survivors. Health Psychology, 25, 47–56.

    Article  PubMed  Google Scholar 

  • Bensimon, M. (2012). Elaboration on the association between trauma, PTSD and posttraumatic growth: The role of trait resilience. Personality and Individual Differences, 52, 782–787.

    Article  Google Scholar 

  • Ben-Zur, H. (2002). Coping, affect and aging: The roles of mastery and self-esteem. Personality and Individual Differences, 32, 357–372.

    Article  Google Scholar 

  • Bjelakovic, G., Nikolova, D., Simonetti, R., G., & Gluud, C. (2008). Antioxidant supplements for preventing gastrointenstinal cancers. The Cochrane database of systematic reviews CD004183.

  • Blanchard, C. M., Courneya, K. S., Stein, K. & American Cancer Society’s SCS-II. (2008). Cancer survivors’ adherence to lifestyle behavior recommendations and associations with health-related quality of life: Results from the American Cancer Society’s SCS-II. Journal of Clinical Oncology, 26, 2198–2204.

    Article  Google Scholar 

  • Block, J. H., & Block, J. (1980). The role of ego-control and ego-resiliency in the organization of behavior. In W. A. Collins (Ed.), Development of cognition, affect and social relations: The Minnesota symposia on child psychology (Vol. 13, pp. 39–101). Hillsdale, NJ: Erlbaum.

    Google Scholar 

  • Bonanno, G. A. (2004). Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? American Psychologist, 59, 20–28.

    Article  PubMed  Google Scholar 

  • Bower, J. E., Meyerowitz, B. E., Desmond, K. A., Bernaards, C. A., Rowland, J. H., & Ganz, P. A. (2005). Perceptions of positive meaning and vulnerability following breast cancer: Predictors and outcomes among long-term breast cancer survivors. Annals of Behavioral Medicine, 29, 236–245.

    Article  PubMed  Google Scholar 

  • Brown, D. L. (2008). African American resiliency: Examining racial socialization and social support as protective factors. Journal of Black Psychology, 34, 32–48.

    Article  Google Scholar 

  • Brunet, J., McDonough, M. H., Hadd, V., Crocker, P. R. E., & Sabiston, C. M. (2009). The Posttraumatic Growth Inventory: An examination of the factor structure and invariance among breast cancer survivors. Psycho-Oncology, 19, 830–838.

    Article  Google Scholar 

  • Burke, S. M., Sabiston, C. M., & Vallerand, R. J. (2012). Passion in breast cancer survivors: Examining links to emotional well-being. Journal of Health Psychology, 17, 1161–1175.

    Article  PubMed  Google Scholar 

  • Cohen, M., & Numa, M. (2011). Posttraumatic growth in breast cancer survivors: A comparison of volunteers and non-volunteers. Psycho-Oncology, 20, 69–76.

    Article  PubMed  Google Scholar 

  • Connor, K. M., & Davidson, J. R. (2003). Development of a new resilience scale: The Connor–Davidson Resilience Scale (CD-RISC). Depression and Anxiety, 18, 76–82.

    Article  PubMed  Google Scholar 

  • Costanzo, E. S., Ryff, C. D., & Singer, B. H. (2009). Psychosocial adjustment among cancer survivors: Findings from a national survey of health and well-being. Health Psychology, 28, 147–156.

    Article  PubMed Central  PubMed  Google Scholar 

  • Coughlin, S. S. (2008). Surviving cancer or other serious illness: A review of individual and community resources. A Cancer Journal for Clinicians, 58, 60–64.

    Article  Google Scholar 

  • Crowne, D. P., & Marlowe, D. (1964). The approval motive: Studies in evaluative dependence. New York: Wiley.

    Google Scholar 

  • Fredrickson, B. L. (2001). The role of positive emotions in positive psychology: The broaden-and-build theory of positive emotions. American Psychologist, 56, 218–226.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Fredrickson, B. L., Tugade, M. M., Waugh, C. E., & Larkin, G. R. (2003). What good are positive emotions in crises? A prospective study of resilience and emotions following the terrorist attacks on the United States on September, 11th, 2001. Journal of Personality and Social Psychology, 84, 365–376.

    Article  PubMed Central  PubMed  Google Scholar 

  • Gotay, C. C., Ransom, S., & Pagano, I. S. (2007). Quality of life in survivors of multiple primary cancers compared with cancer survivor controls. Cancer, 110, 2101–2109.

    Article  PubMed  Google Scholar 

  • Grimmett, C., Wardle, J., & Steptoe, A. (2009). Health behaviors in older cancer survivors in the English longitudinal study of ageing. European Journal of Cancer, 45, 2180–2186.

    Article  PubMed  Google Scholar 

  • Hamer, M., Stamatakis, E., & Saxton, J. M. (2009). The impact of physical activity on all-cause mortality in men and women after a cancer diagnosis. Cancer Causes and Control, 20, 225–231.

    Article  PubMed  Google Scholar 

  • Han, J. Y., Shaw, B. R., Hawkins, R. P., Pingree, S., McTavish, F., & Gustafson, D. H. (2008). Expressing positive emotions within online support groups by women with breast cancer. Journal of Health Psychology, 13, 1002–1007.

    Article  PubMed Central  PubMed  Google Scholar 

  • Harper, F. W. K., Schmidt, J. E., Beacham, A. O., Salsman, J. M., Averill, A. J., Graves, K. D., & Andrykowski, M. A. (2007). The role of social cognitive processing theory and optimism in positive psychosocial and physical behavior change after cancer diagnosis and treatment. Psycho-Oncology, 16, 79–91.

    Article  Google Scholar 

  • Hayes, A. F. (2012). PROCESS: A versatile computational tool for observed variable mediation, moderation, and conditional process modeling [White paper]. Retrieved from http://www.afhayes.com/public/process2012.pdf. Accessed Jan 2014.

  • Helgeson, V. S., Reynolds, K. A., & Tomich, P. L. (2006). A meta-analytic review of benefit finding and growth. Journal of Consulting and Clinical Psychology, 74, 797–816.

    Article  PubMed  Google Scholar 

  • Hirsch, J. K., Floyd, A. R., & Duberstein, P. R. (2012). Perceived health in lung cancer patients: The role of positive and negative affect. Quality of Life Research, 21, 187–194.

    Article  PubMed Central  PubMed  Google Scholar 

  • Hobfoll, S. E., Hall, B. J., Canetti-Nisim, D., Galea, S., Johnson, R. J., & Palmieri, P. A. (2007). Refining our understanding of traumatic growth in the face of terrorism: Moving from meaning cognitions to doing what is meaningful. Applied Psychology: An International Review, 56, 345–366.

    Article  Google Scholar 

  • Hou, W. K., Lam, W. W. T., & Fielding, R. (2009). Adaptation process and psychosocial resources of Chinese colorectal cancer patients undergoing adjuvant treatment: A qualitative analysis. Psycho-Oncology, 18, 936–944.

    Article  PubMed  Google Scholar 

  • Hou, W. K., Law, C. C., & Fu, Y. T. (2010). Does change in positive affect mediate and/or moderate the impact of symptom distress on psychological adjustment after cancer diagnosis? A prospective analysis. Psychology & Health, 25, 417–431.

    Article  Google Scholar 

  • Lapierre, S., Erlangsen, A., Waern, M., De Leo, D., Oyama, H., Scocco, P.,…The International Research Group for Suicide among the Elderly. (2011). A systematic review of elderly suicide prevention programs. Crisis, 32, 88–98.

  • Lechner, S. C., Carver, C. S., Antoni, M. H., Weaver, K. E., & Phillips, K. M. (2006). Curvilinear associations between benefit finding and psychological adjustment to breast cancer. Journal of Consulting and Clinical Psychology, 74, 828–840.

    Article  PubMed  Google Scholar 

  • Lelorain, S., Bonnaud-Antignac, A., & Florin, A. (2010). Long term posttraumatic growth after breast cancer: Prevalence, predictors and relationships with psychological health. Journal of Clinical Psychology in Medical Settings, 17, 14–22.

    Article  CAS  PubMed  Google Scholar 

  • Levine, S. Z., Laufer, A., Stein, E., Hamama-Raz, Y., & Solomon, Z. (2009). Examining the relationship between resilience and posttraumatic growth. Journal of Traumatic Stress, 22, 282–286.

    Article  PubMed  Google Scholar 

  • Masten, A. S. (2009). Ordinary Magic: Lessons from research on resilience in human development. Education Canada, 49, 28–32.

    Google Scholar 

  • Meyerhardt, J. A., Giovannucci, E. L., Holmes, M. D., Chan, A. T., Chan, J. A., Colditz, G. A., & Fuchs, C. S. (2006). Physical activity and survival after colorectal cancer diagnosis. Journal of Clinical Oncology, 24, 3527–3534.

    Article  PubMed  Google Scholar 

  • National Cancer Institute (2013). www.cancer.gov/cancertopics/factsheet/detection/staging. Retrieved 4 January 2015.

  • Oken, M. M., Creech, R. H., Tormey, D. C., Horton, J., Davis, T. E., McFadden, E. T., & Carbone, P. P. (1982). Toxicity and response criteria of the Eastern Cooperative Oncology Group. American Journal of Clinical Oncology, 5, 649–655.

    Article  CAS  PubMed  Google Scholar 

  • Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40, 879–891.

    Article  PubMed  Google Scholar 

  • Rennert, G. (2002). Dietary intervention studies and cancer prevention. European Journal of Cancer Prevention, 11, 419–425.

    Article  CAS  PubMed  Google Scholar 

  • Roberts, K. J., Lepore, S. J., & Helgeson, V. (2006). Social-cognitive correlates of adjustment to prostate cancer. Psycho-Oncology, 14, 1–10.

    Google Scholar 

  • Rodrigue, J. R., Kanasky, W. F., Jackson, S. I., & Perri, M. G. (2000). The Psychosocial Adjustment to Illness Scale-Self-Report: Factor structure and item stability. Psychological Assessment, 12, 409–413.

    Article  CAS  PubMed  Google Scholar 

  • Rowland, J., Marriotto, A., Aziz, N., et al. (2004). Cancer survivorship – United States, 1971-2001. MMWR, 53, 526–529.

    Google Scholar 

  • Salsman, J. M., Segerstrom, S. C., Brechting, E. H., Carlson, C. R., & Andrykowski, M. A. (2009). Posttraumatic growth and PTSD symptomatology among colorectal cancer survivors: A 3-month longitudinal examination of cognitive processing. Psycho-Oncology, 18, 30–41.

    Article  PubMed Central  PubMed  Google Scholar 

  • Sawyer, A., Ayers, S., & Field, A. P. (2010). Posttraumatic growth and adjustment among individuals with cancer or HIV/AIDS: A meta-analysis. Clinical Psychology Review, 30, 436–447.

    Article  PubMed  Google Scholar 

  • Sears, S. R., Stanton, A. L., & Danoff-Burg, S. (2003). The yellow brick road and the emerald city: Benefit finding, positive reappraisal coping and posttraumatic growth in women with early-stage breast cancer. Health Psychology, 22, 487–497.

    Article  PubMed  Google Scholar 

  • Shakespeare-Finch, J., & Barrington, A. J. (2012). Behavioral changes add validity to the construct of posttraumatic growth. Journal of Traumatic Stress, 25, 433–439.

    Article  PubMed  Google Scholar 

  • Sharma, A., Sharp, D. M., Walker, L. G., & Monson, J. R. T. (2008). Patient personality predicts postoperative stay after colorectal cancer resection. Colorectal Disease, 10, 151–156.

    Article  CAS  PubMed  Google Scholar 

  • Tedeschi, R. G., & Calhoun, L. G. (1996). The posttraumatic growth inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9, 455–471.

    Article  CAS  PubMed  Google Scholar 

  • Tedeschi, R. G., & Calhoun, L. G. (2004). Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry, 15, 1–18.

    Article  Google Scholar 

  • Wagnild, G. M., & Young, H. M. (1993). Development and psychometric evaluation of the Resilience Scale. Journal of Nursing Measurement, 1, 165–178.

    CAS  PubMed  Google Scholar 

  • Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54, 1063–1070.

    Article  CAS  PubMed  Google Scholar 

  • Weiss, T. (2004). Posttraumatic growth in women with breast cancer and their husbands: An intersubjective validation study. Journal of Psychosocial Oncology, 20, 65–80.

    Article  Google Scholar 

  • Westphal, M., & Bonanno, G. A. (2007). Posttraumatic growth and resilience to trauma: Different sides of the same coin of different coins? Applied Psychology: An International Review, 56, 417–427.

    Article  Google Scholar 

  • Yamada, T., Alpers, D. H., Kalloo, A. N., Kaplowitz, N., Owyang, C., & Powell, D. W. (2009). Textbook of gastroenterology (5th ed.). Chichester, West Sussex: Blackwel Pub.

    Google Scholar 

  • Zautra, A., Smith, B., Affleck, G., & Tennen, H. (2001). Examinations of chronic pain and affect relationships: Applications of a dynamic model of affect. Journal of Consulting and Clinical Psychology, 69, 786–795.

    Article  CAS  PubMed  Google Scholar 

  • Zoellner, T., & Maercker, A. (2006). Posttraumatic growth in clinical psychology - A critical review and introduction of a two component model. Clinical Psychology Review, 26, 626–653.

    Article  PubMed  Google Scholar 

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Conflict of Interest

Julia Gouzman, Miri Cohen, Hasida Ben-Zur, Einat Shacham-Shmueli, Dan Aderka, Nava Siegelmann-Danieli and Alex Beny have all declared that no conflicts of interest exist.

Informed Consent

All procedures were conducted in accordance with the standards of the Ethics Committees on Human Experimentation of Maccabi Health Services, Tel Aviv Medical Center, The Chaim Sheba Medical Center, Rambam Health Care Campus and with the Helsinki Declaration of 1975, as revised in 2000. The informed consent of all patients included in the study was obtained.

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Authors and Affiliations

  1. Faculty of Social Welfare and Health Services, School of Social Work, University of Haifa, Mount Carmel, Haifa, Israel

    Julia Gouzman, Miri Cohen & Hasida Ben-Zur

  2. Maccabi Health Services, 21, Benyamin blvd, Netanya, Israel

    Julia Gouzman & Nava Siegelmann-Danieli

  3. Tel Aviv Medical Center, Tel Aviv, Israel

    Einat Shacham-Shmueli

  4. The Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel

    Dan Aderka

  5. Rambam Health Care Campus, Haifa, Israel

    Alex Beny

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  1. Julia Gouzman
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  2. Miri Cohen
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  3. Hasida Ben-Zur
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Correspondence to Julia Gouzman.

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Gouzman, J., Cohen, M., Ben-Zur, H. et al. Resilience and Psychosocial Adjustment in Digestive System Cancer. J Clin Psychol Med Settings 22, 1–13 (2015). https://doi.org/10.1007/s10880-015-9416-9

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Keywords

  • Resilience
  • PTG
  • Affective reactions
  • Adjustment
  • Behavioral changes