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Stress and Quality of Life in Breast Cancer Recurrence: Moderation or Mediation of Coping?

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background/Purpose

Diagnosis with breast cancer recurrence often brings high levels of stress. Successful coping to alleviate stress could improve patients’ quality of life (QoL). The intervening role coping plays between stress and QoL may depend on the types of stress encountered and the types of coping strategies used. The present study investigates the longitudinal relationships between stress, coping, and mental health QoL.

Methods

Breast cancer patients recently diagnosed with recurrence (N = 65) were assessed shortly after the diagnosis and 4 months later. Four moderation and four mediation models were tested using hierarchical multiple regressions and path analyses. In the models, either traumatic stress or symptom-related stress at recurrence diagnosis was a predictor of mental health QoL at follow-up. Both engagement and disengagement coping strategies were tested as moderators or mediators between stress and QoL.

Results

Engagement coping moderated the effect of symptom stress on mental health QoL, whereas disengagement coping mediated the effects of both traumatic stress and symptom stress on mental health QoL.

Conclusion

The findings imply that interventions teaching engagement coping strategies would be important for patients experiencing high symptom stress, while discouraging the use of disengagement coping strategies would be important for all patients.

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Acknowledgment

We thank the participants in the Stress and Immunity Breast Cancer Project and the professional and research staff. Special thanks to Dr. Lisa Thornton, Dr. Wendy Blakely, and Dr. Timothy Crespin for comments. This research was supported by the following: American Cancer Society (PBR-89, RSGPB-03–248–01-PBP), Longaberger Company-American Cancer Society Grant for Breast Cancer Research (PBR-89A), U.S. Army Medical Research Acquisition Activity Grants (DAMD17–94-J-4165, DAMD17–96–1–6294, DAMD17–97–1–7062), National Institutes of Mental Health (1 R01 MH51487), the National Cancer Institute (K05 CA098133, R01 CA92704), the General Clinical Research Center (M01-RR0034), and The Ohio State University Comprehensive Cancer Center (P30 CA16058).

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Authors and Affiliations

  1. Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210-1222, USA

    Hae-Chung Yang Ph.D., Brittany M. Brothers M.A. & Barbara L. Andersen Ph.D.

  2. Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA

    Barbara L. Andersen Ph.D.

Authors
  1. Hae-Chung Yang Ph.D.
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  2. Brittany M. Brothers M.A.
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  3. Barbara L. Andersen Ph.D.
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Correspondence to Barbara L. Andersen Ph.D..

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Yang, HC., Brothers, B.M. & Andersen, B.L. Stress and Quality of Life in Breast Cancer Recurrence: Moderation or Mediation of Coping?. ann. behav. med. 35, 188–197 (2008). https://doi.org/10.1007/s12160-008-9016-0

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  • DOI: https://doi.org/10.1007/s12160-008-9016-0

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