Abstract
Tedeschi & Calhoun’s model of posttraumatic growth (PTG) suggests that intrusive thoughts about a traumatic event, in combination with helpful coping strategies, facilitates PTG. This manuscript applies this model to a sample of breast cancer survivors, augments it to conceptualize coping strategies as “active” or “avoidant,” and extends it to include health-related quality of life (HRQOL). This is a secondary analysis of a subset of breast cancer patients (N = 123) in a randomized clinical trial of Tibetan yoga, which examines the associations of coping at study entry with PTG, PTSS (i.e., intrusive thoughts and avoidance), and HRQOL (physical (PCS) and mental (MCS) component scales) reported 9 and 15 months later. Mediation analyses revealed that higher baseline active coping predicted higher 9-month PTG, which in turn predicted higher 15-month PCS [effect = .46, 95% CI (.06, 1.07)]. Exploratory moderated mediation analyses revealed that higher baseline intrusive thoughts about cancer predicted lower 9-month PTG, which in turn predicted lower 15-month PCS, but only for those reporting low active coping [effect = − .06, 95% CI (− .16, − .003)]. Active coping may play a critical role of fostering PTG and improving subsequent HRQOL in the presence of rumination about cancer.
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Funding
This work was supported by a National Cancer Institute cancer prevention fellowship for Chelsea G. Ratcliff [R25T CA057730, PI: Shine Chang], the National Cancer Institute grants [R01CA105023, PI: Lorenzo Cohen and P30CA016672], and the Richard E. Haynes Distinguished Professorship for Clinical Cancer Prevention at The University of Texas MD Anderson Cancer Center.
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Initial study design was developed by LC and AC. Acquisition of data was led by LC. Data analysis was conducted by AS with supervision from CR. The first draft of the manuscript was written by AS, RS and CR and all authors commented on previous versions of the manuscript. Revisions were led by CR with input from all authors. All authors read and approved the final manuscript.
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Authors Amy R. Senger, Chelsea G. Ratcliff, Robin Semelsberger, Alejandro Chaoul and Lorenzo Cohen declare that they have no conflict of interest.
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Senger, A.R., G. Ratcliff, C., K. Semelsberger, R. et al. The Role of Coping and Posttraumatic Stress in Fostering Posttraumatic Growth and Quality of Life Among Women with Breast Cancer. J Clin Psychol Med Settings 31, 368–378 (2024). https://doi.org/10.1007/s10880-023-09977-x
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DOI: https://doi.org/10.1007/s10880-023-09977-x