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Spirituality, Distress and Posttraumatic Growth in Breast Cancer Patients

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Abstract

Breast cancer is the most common type of cancer for women and is associated with increased distress. Spirituality and posttraumatic growth (PTG) have been associated with illness adjustment, but the relationship between these variables is still not well understood. A sample of 100 breast cancer patients completed a demographic and clinical questionnaire, the Posttraumatic Growth Inventory, Spiritual and Religious Attitudes in Dealing with Illness, and the Hospital Anxiety and Depression Scale. Results showed an association between PTG, spirituality and distress. Women with a longer diagnosis and recurrence showed more distress. Younger age, recurrent cancer and spirituality predicted higher PTG. Patients’ spirituality should be part of intervention with breast cancer patients since it seems to be related to greater growth and adjustment to the illness.

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References

  • American Cancer Society. (2015). Breast cancer facts & figures 2015–2016. Atlanta: American Cancer Society.

    Google Scholar 

  • Andersen, B. L., Shapiro, C. L., Farrar, W. B., Crespin, T., & Wells-DiGregorio, S. (2005). Psychological responses to cancer recurrence: A controlled prospective study. Cancer, 104(7), 1540–1547.

    Article  PubMed  PubMed Central  Google Scholar 

  • Andreu, Y., Galdon, M. J., Dura, E., Martinez, P., Perez, S., & Murgui, S. (2012). A longitudinal study of psychosocial distress in breast cancer: Prevalence and risk factors. Psychology and Health, 27(1), 72–87.

    Article  PubMed  Google Scholar 

  • Avis, N. E., Crawford, S., & Manuel, J. (2005). Quality of life among younger women with breast cancer. Journal of Clinical Oncology, 23(15), 3322–3330.

    Article  PubMed  Google Scholar 

  • Bellizzi, K. M., & Blank, T. O. (2006). Predicting posttraumatic growth in breast cancer survivors. Health Psychology, 25(1), 47–56.

    Article  PubMed  Google Scholar 

  • Ben-Zur, H., Gilbar, O., & Lev, S. (2001). Coping with breast cancer: Patient, spouse, and dyad models. Psychosomatic Medicine, 63(1), 32–39.

    Article  PubMed  CAS  Google Scholar 

  • Boyle, C.C., Stanton, A.L., Ganz, P.A., & Bower, J.E. (2016) Posttraumatic growth in breast cancer survivors: Does age matter? Psycho-Oncology (Advance online publication).

  • Burgess, C., Cornelius, V., Love, S., Graham, J., Richards, M., & Ramirez, A. (2005). Depression and anxiety in women with early breast cancer: Five year observational cohort study. British Medical Journal, 330(7493), 702–705.

    Article  PubMed  Google Scholar 

  • Büssing, A. (2010). Spirituality as a resource to rely on in chronic illness: The SpREUK questionnaire. Religions, 1(1), 9–17.

    Article  Google Scholar 

  • Cadell, S., Regehr, C., & Hemsworth, D. (2003). Factors contributing to posttraumatic growth: A proposed structural equation model. American Journal of Orthopsychiatry, 73(3), 279–287.

    Article  PubMed  Google Scholar 

  • Carver, C. S., & Antoni, M. H. (2004). Finding benefit in breast cancer during the year after diagnosis predicts better adjustment 5 to 8 years after diagnosis. Health Psychology, 23(6), 595–598.

    Article  PubMed  Google Scholar 

  • Casellas-Grau, A., Ochoa, C., & Ruini, C. (2017). Psychological and clinical correlates of posttraumatic growth in cancer. A systematic and critical review. Psycho-Oncology. Advance online publication. Retrieved from http://onlinelibrary.wiley.com/doi/ 10.1002/pon.4426/abstract.

  • Cordova, M., Cunningham, L. L., Carlson, C. R., & Andrykowski, M. A. (2001). Posttraumatic growth following breast cancer: A controlled comparison study. Health Psychology, 20(3), 176–185.

    Article  PubMed  CAS  Google Scholar 

  • Cordova, M., Giese-Davis, J., Golant, M., Kronenwetter, C., Chang, V., & Spiegel, D. (2007). Breast cancer as trauma: Posttraumatic stress and posttraumatic growth. Journal of Clinical Psychology in Medical Settings, 14(4), 308–319.

    Article  Google Scholar 

  • Cotton, S. P., Levine, E. G., Fitzpatrick, C. M., Dold, K. H., & Targ, E. (1999). Exploring the relationships among spiritual well-being, quality of life, and psychological adjustment in women with breast cancer. Psycho-Oncology, 8(5), 429–438.

    Article  PubMed  CAS  Google Scholar 

  • Culver, J. L., Arena, P. L., Antoni, M. H., & Carver, C. S. (2002). Coping and distress among women under treatment for early stage breast cancer: Comparing African Americans, hispanics and non-hispanic whites. Psycho-Oncology, 11(6), 495–504.

    Article  PubMed  Google Scholar 

  • Danhauer, S. C., Case, L. D., Tadeschi, R., Russell, G., Vishnevsky, T., Triplett, K., et al. (2013). Predictors of posttraumatic growth in women with breast cancer. Psycho-Oncology, 22(12), 2676–2683.

    Article  PubMed  Google Scholar 

  • Danhauer, S. C., Russell, G., Case, L. D., Sohl, S. J., Tedeschi, R. G., Addington, E. L., et al. (2015). Trajectories of posttraumatic growth and associated characteristics in women with breast cancer. Annals of Behavioral Medicine, 49(5), 650–659.

    Article  PubMed  PubMed Central  Google Scholar 

  • David, D., Montgomery, G. H., & Bovbjerg, D. H. (2006). Relations between coping responses and optimism-pessimism in predicting anticipatory psychological distress in surgical breast cancer patients. Personality and Individual Differences, 40(2), 203–213.

    Article  PubMed  PubMed Central  Google Scholar 

  • Dekel, S., Levin, Y., & Solomon, Z. (2015). Posttraumatic growth among spouses of combat veterans: Adaptive or maladaptive for adjustment? Psychiatric Research, 230(2), 712–715.

    Article  Google Scholar 

  • Frost, M., Suman, V. J., Rummans, T. A., Dose, A. M., Taylor, M., Novotny, P., et al. (2000). Physical, psychological and social well-being of women with breast cancer: The influence of disease phase. Psycho-Oncology, 9(3), 221–231.

    Article  Google Scholar 

  • Gall, T. L., Guirguis-Younger, M., Charbonneau, C., & Florack, P. (2009). The trajectory of religious coping across time in response to the diagnosis of breast cancer. Psycho-Oncology, 18(11), 1165–1178.

    Article  PubMed  Google Scholar 

  • Gallagher, J., Parle, M., & Cairns, D. (2002). Appraisal and psychological distress six months after diagnosis of breast cancer. British Journal of Health Psychology, 7(Part 3), 365–376.

    Article  PubMed  Google Scholar 

  • Harcourt, D. (1999). Same-day diagnosis of symptomatic breast problems: Psychological impact and coping strategies. Psychology, Health & Medicine, 4(1), 57–71.

    Article  Google Scholar 

  • 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(5), 797–816.

    Article  PubMed  Google Scholar 

  • Kernan, W. D., & Lepore, S. J. (2009). Searching for and making meaning after breast cancer: Prevalence, patterns, and negative affect. Social Science and Medicine, 68(6), 1176–1182.

    Article  PubMed  Google Scholar 

  • Leak, A., Hu, J., & King, C. R. (2008). Symptom distress, spirituality, and quality of life in African American breast cancer survivors. Cancer Nursing, 31(1), E15–E21.

    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(1), 14–22.

    Article  PubMed  CAS  Google Scholar 

  • Linley, P. A., & Joseph, S. (2004). Positive change following trauma and adversity: A review. Journal of Traumatic Stress, 17(1), 11–21.

    Article  PubMed  Google Scholar 

  • Manne, S., Ostroff, J., Winkel, G., Goldstein, L., Fox, K., & Grana, G. (2004). Posttraumatic growth after breast cancer: Patient, partner, and couple perspectives. Psychosomatic Medicine, 66(3), 442–454.

    PubMed  Google Scholar 

  • Manzanera, C., Lafay, N., Papet, N., & Senon, J. (2003). Depression, anxiety and cancer. Annales Médico Psychologiques, 161, 140–141.

    Article  Google Scholar 

  • Matos, P., & Pereira, M. (2002). Áreas de intervenção da doença oncológica. In M. Pereira & C. Lopes (Eds.), O doente oncológico e a sua família (pp. 15–25). Lisbon: Climepsi Editores.

    Google Scholar 

  • McCoubrie, R. C., & Davies, A. N. (2006). Is there a correlation between spirituality and anxiety and depression in patients with advanced cancer? Supportive Care in Cancer, 14(4), 379–385.

    Article  PubMed  Google Scholar 

  • McDonough, M. H., Sabiston, C. M., & Wrosch, C. (2014). Predicting changes in posttraumatic growth and subjective well-being among breast cancer survivors: The role of social support and stress. Psycho-Oncology, 23(1), 114–120.

    Article  PubMed  Google Scholar 

  • Meraviglia, M. (2006). Effects of spirituality in breast cancer survivors. Oncology Nursing Forum, 33(1), E1–E7.

    Article  PubMed  Google Scholar 

  • Mystakidou, K., Tsilika, E., Parpa, E., Pathiaki, M., Patiraki, E., Galanos, A., et al. (2007). Exploring the relationships between depression, hopelessness, cognitive status, pain, and spirituality in patients with advanced cancer. Archives of Psychiatric Nursing, 21(3), 150–161.

    Article  PubMed  Google Scholar 

  • Nelson, C. J., Rosenfeld, B., Breitbart, W., & Galietta, M. (2002). Spirituality, religion, and depression in the terminally ill. Psychosomatics, 43(3), 213–220.

    Article  PubMed  Google Scholar 

  • Northouse, L. L., Mood, D., Kershaw, T., Schafenacker, A., Mellon, S., Walker, J., et al. (2002). Quality of life of women with recurrent breast cancer and their family members. Journal of Clinical Oncology, 20(19), 4050–4064.

    Article  PubMed  Google Scholar 

  • Occiointi, S., Chamber, S., Lepore, S., Aitken, J., & Dunn, J. (2015). A longitudinal study of post-traumatic growth and psychological distress in colorectal cancer survivors. Plos ONE, 10(9), 1–12.

    Google Scholar 

  • Oh, S., Heflin, L., Meyerowitz, B. E., Desmond, K. A., Rowland, J. H., & Ganz, P. A. (2004). Quality of life of breast cancer survivors after a recurrence: A follow-up study. Breast Cancer Research and Treatment, 87(1), 45–57.

    Article  PubMed  Google Scholar 

  • Ostermann, T., Büssing, A., & Matthiessen, P. (2004). Pilotstudie zur Entwicklung eines Fragebogens zur Erfassung der spirituellen und religiösen Einstellung und des Umgangs mit Krankheit (SpREUK). Forsch Komplementärmed Klass Naturheilkd, 11, 346–353.

    PubMed  CAS  Google Scholar 

  • Pereira, M., & Figueiredo, A. (2008). Depressão, ansiedade e stress pós-traumático em doentes com cancro colo-retal—Validação do Hospital Anxiety and Depression Scale (HADS) e Impacto of Events Scale (IES) numa amostra de doentes oncológicos. Onco News, 2(5), 11–19.

    Google Scholar 

  • Pinto, C., & Ribeiro, J. L. (2010). Avaliação da espiritualidade dos sobreviventes de cancro: Implicações na qualidade de vida. Revista Portuguesa de Saúde Pública, 28, 49–56.

    Google Scholar 

  • Reich, M., Lesur, A., & Perdrizet-Chevallier, C. (2008). Depression, quality of life and breast cancer: A review of the literature. Breast Cancer Research and Treatment, 110(1), 9–17.

    Article  PubMed  CAS  Google Scholar 

  • Romero, C., Friedman, L. C., Kalidas, M., Elledge, R., Chang, J., & Liscum, K. R. (2006). Self-forgiveness, spirituality, and psychological adjustment in women with breast cancer. Journal of Behavioral Medicine, 29(1), 29–36.

    Article  PubMed  Google Scholar 

  • Schreiber, J. A., & Brockopp, D. Y. (2012). Twenty-five years later—what do we know about religion/spirituality and psychological well-being among breast cancer survivors? A systematic review. Systematic Reviews and Meta Analysis, 6(1), 82–94.

    Google Scholar 

  • Schroevers, M. J., Helgeson, V. S., Sanderman, R., & Ranchor, A. V. (2010). Type of social support matters for prediction of posttraumatic growth among cancer survivors. Psycho-Oncology, 19(1), 46–53.

    Article  PubMed  Google Scholar 

  • Scrignaro, M., Barni, S., & Magrin, M. E. (2011). The combined contribution of social support and coping strategies in predicting post-traumatic growth: a longitudinal study on cancer patients. Psycho-Oncology, 20(8), 823–831.

    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(5), 487–497.

    Article  PubMed  Google Scholar 

  • Shaw, A., Joseph, S., & Linley, P. A. (2005). Religion, spirituality, and posttraumatic growth: A systematic review. Mental Health, Religion & Culture, 8(1), 1–11.

    Article  Google Scholar 

  • Silva, S. M., Crespo, C., & Canavarro, M. C. (2012a). Pathways for psychological adjustment in breast cancer: A longitudinal study on coping strategies and posttraumatic growth. Psychology & Health, 27(11), 1323–1341.

    Article  Google Scholar 

  • Silva, S., Moreira, H., & Canavarro, M. C. (2012b). Examining the links between perceived impact of breast cancer and psychosocial adjustment: The buffering role of posttraumatic growth. Psycho-Oncology, 21(4), 409–418.

    Article  PubMed  Google Scholar 

  • Silva, S., Moreira, H., Pinto, S., & Canavarro, M. C. (2009). Cancro da mama e desenvolvimento pessoal e relacional: Estudo das características psicométricas do Inventário de Desenvolvimento Pós-Traumático (Posttraumatic Growth Inventory) numa amostra de mulheres da população portuguesa. Revista Iberoamericana de Diagnóstico e Avaliação Psicológica, 28(2), 105–133.

    Google Scholar 

  • Spencer, R., Nilsson, M., Wright, A., Pirl, W., & Prigerson, H. (2010). Anxiety disorders in advanced cancer patients: Correlates and predictors of end-of-life outcomes. Cancer, 116(7), 1810–1819.

    Article  PubMed  PubMed Central  Google Scholar 

  • Step, M. M., Kypriotakis, G. M., & Rose, J. H. (2013). An exploration of the relative influence of patient's age and cancer recurrence status on symptom distress, anxiety, and depression over time. Journal of Psychosocial Oncology, 31(2), 168–190.

    Article  PubMed  Google Scholar 

  • Sumalla, E. C., Ochoa, C., & Blanco, I. (2009). Posttraumatic growth in cancer: Reality or illusion? Clinical Psychology Review, 29(1), 24–33.

    Article  PubMed  Google Scholar 

  • Swinton, J. (2003). Spirituality and mental health care: Rediscovering a ‘forgotten’ dimension. London: Jessica Kingsley Publishers.

    Google Scholar 

  • Tedeschi, R. G., & Calhoun, L. G. (1996). The posttraumatic growth inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9(3), 455–471.

    Article  PubMed  CAS  Google Scholar 

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

    Article  Google Scholar 

  • Thornton, A. A. (2002). Perceiving benefits in the cancer experience. Journal of Clinical Psychology in Medical Settings, 9(2), 153–165.

    Article  Google Scholar 

  • Thune-Boyle, I. C., Stygall, J. A., Keshtgar, M. R., & Newman, S. P. (2006). Do religious/spiritual coping strategies affect illness adjustment in patients with cancer? A systematic review of the literature. Social Science and Medicine, 63(1), 151–164.

    Article  PubMed  Google Scholar 

  • Tomich, P. L., & Helgeson, V. S. (2004). Is finding something good in the bad always good? Benefit finding among women with breast cancer. Health Psychology, 23(1), 16–23.

    Article  PubMed  Google Scholar 

  • Urcuyo, K. R., Boyers, A. E., Carver, C. S., & Antoni, M. H. (2005). Finding benefit in breast cancer: Relations with personality, coping, and concurrent well-being. Psychology & Health, 20(2), 175–192.

    Article  Google Scholar 

  • Vahdaninia, M., Omidvari, S., & Montazeri, A. (2010). What do predict anxiety and depression in breast cancer patients? A follow-up study. Social Psychiatry and Psychiatric Epidemiology, 45(3), 355–361.

    Article  PubMed  Google Scholar 

  • Vis, J., & Boynton, M. H. (2008). Spirituality and transcendent meaning making: Possibilities for enhancing posttraumatic growth. Journal of Religion & Spirituality in Social Work, 27(1–2), 69–86.

    Article  Google Scholar 

  • Weiss, T. (2002). Posttraumatic growth in women with breast cancer and their husbands. Journal of Psychosocial Oncology, 20(2), 65–80.

    Article  Google Scholar 

  • Wildes, K. A., Miller, A. R., de Majors, S. S., & Ramirez, A. G. (2009). The religiosity/spirituality of Latina breast cancer survivors and influence on health-related quality of life. Psycho-Oncology, 18(8), 831–840.

    Article  PubMed  PubMed Central  Google Scholar 

  • Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361–370.

    Article  PubMed  CAS  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(5), 626–653.

    Article  PubMed  Google Scholar 

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Correspondence to M. Graça Pereira.

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Paredes, A.C., Pereira, M.G. Spirituality, Distress and Posttraumatic Growth in Breast Cancer Patients. J Relig Health 57, 1606–1617 (2018). https://doi.org/10.1007/s10943-017-0452-7

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