Coexistence And Influencing Mechanism Of Posttraumatic Stress Disorder And Growth In Breast Cancer Patients

Breast cancer is currently the most prevalent cancer in the world,and the treatment process can be a traumatic event for patients,threatening their mental health and risking Posttraumatic Stress Disorder(PTSD).However,patients can also experience positive psychological changes and achieve Post-traumatic Growth(PTG)in the process of battling with cancer.Therefore,during clinical interventions,clinical workers should focus on alleviating patients’ PTSD and promoting PTG.Although existing studies have explored PTSD and PTG in breast cancer patients and have highlighted that the two can co-exist.However,few studies have examined patients’ PTSD and PTG from an integrative perspective,and have clarified the specific relationship between the two and the differences in their influencing mechanisms.In particular,after breast cancer,patients receive a great deal of support from various sources.It is unclear how this support affects PTSD and PTG and how it differs from each other.To this end,based on existing trauma psychological theories,this study will explore the current status of PTSD and PTG in breast cancer patients from an integrative perspective,examine the relationship between the two from a network analysis perspective,and examine the differences in the mechanisms of influence between the two from a social support perspective.This study used a convenience sampling method and a self-reported scale to investigate breast cancer patients in 12 hospitals of Zhejiang and Anhui provinces,with a final sample of 259 patients.Study 1 examined the current status of PTSD and PTG in breast cancer patients and the differential characteristics of both in terms of sociodemographic and diagnostic factors.The results found that breast cancer patients showed higher levels of PTSD,with an incidence of 44.4%,and moderate levels of PTG,with an incidence of 52.8%.Better family economic status was a protective factor for PTSD,and cancer stage at intermediate to advanced stages,with a length of diagnosis between one and five years,served as risk factors for PTSD.In the results of PTG,patients’ PTG levels could be influenced only by the length of diagnosis,and patients with one to five years since diagnosis had higher PTG levels compared to the other groups of patients.Study 2 used network analysis to examine the internal structure of PTSD and PTG in breast cancer patients and the relationship between the two in a coexistence network.The results showed that nightmares,reckless behavior and avoidance of trauma-related thoughts were the core symptoms of PTSD,while valuing relationships and discovering the beauty of humanity were the growth components of PTG.PTSD and PTG formed two relatively independent clusters in the coexistence network.The lack of interconnected bridging nodes between the two clusters suggests that PTSD and PTG in breast cancer patients are two separate psychological responses.Study 3 used a structural equation modeling method to examine the mechanisms of social support’s influence on PTSD and PTG in breast cancer patients and the differences between them.The results found that social support could negatively influence PTSD levels in breast cancer patients directly and also indirectly through selfdisclosure and sense of hope,respectively.However,social support could not negatively influence PTSD levels through cognitive reappraisal.Meanwhile,the direct effect of social support on PTG was not significant,however,it could promote PTG through sense of hope via cognitive reappraisal and also through self-representation via cognitive reappraisal.Such results suggest that there are differences in the mechanisms of social support on PTSD and PTG,mainly due to the different mechanisms of social support activating cognitive reappraisal on both.Through the above three studies,it was found that breast cancer patients would experience both PTSD and PTG,with relatively high levels of PTSD and moderate levels of PTG.PTSD and PTG are two mutually independent psychological responses with different potencies after a traumatic events and have coexisting characteristics.Social support is an important psychosocial resource to alleviate PTSD and promote PTG in breast cancer patients,and can influence PTSD and PTG through hope,selfdisclosure and cognitive reappraisal.However,there are differences in the specific mechanisms that affect PTSD and PTG,mainly in that social support cannot affect PTSD through cognitive reappraisal,but can promote PTG through cognitive reappraisal.This suggests that psychological interventions for breast cancer patients should adopt multiple different approaches to target the alleviation of PTSD and enhancement of PTG to achieve the ultimate goal of promoting the physical and psychological recovery of breast cancer patients.