Physical health, psychological distress, and younger breast cancer survivors: A stress and coping model

Jennifer R Lydon, Purdue University

Abstract

Young, long-term breast cancer survivors have infrequently been studied in the psycho-oncology literature; however, the limited research that is available suggests that young survivors are at particular risk for developing physical sequelae related to treatment as well as developing heightened depression and fear of recurrence. While is it recognized that physical health may impact mental health outcomes over time, the nature of this relationship is not fully understood. The goal of the present study was to examine the relationship between aspects of physical health and psychological distress in breast cancer survivors who were diagnosed before the age of 45, and to then place these constructs within a modified stress and coping model, examining the role of social support, coping, and spirituality as variables that might explain this relationship and help identify protective factors and points of intervention. As part of a larger American Cancer Society Grant, one hundred fifty-seven younger survivors were recruited through the Indiana University Cancer Center and the Eastern Cooperative Oncology Group database and completed a packet of questionnaires assessing a broad range of constructs. Results supported past findings regarding elevated distress in younger survivors. Specifically, breast cancer survivors diagnosed before the age of 45 reported heightened depressive symptomology compared to community norms and also reported moderate levels of fear of recurrence. Younger survivors were particularly prone to reporting high Death and Parenting Worries; having children in the home and having had mastectomy were significantly related to parenting worries. Path analysis examining the stress and coping model found that the relationship between physical health and depression was partially explained by social support and escapist coping, while the relationship between physical health and overall fear of recurrence was fully accounted for by active and escapist coping. Although spirituality was not related to physical health, it explained significant variance in overall fear of recurrence and appears to be an important variable in understanding fear outcomes. These results provide a beginning framework for understanding individual resource variables that may be drawn upon by younger survivors when experiencing physical health symptoms, which ultimately impacts mental health outcomes. Limitations and implications are discussed.

Degree

Ph.D.

Advisors

Bigatti, Purdue University.

Subject Area

Clinical psychology|Medicine

COinS