Attachment styles, self‐compassion, and psychological adjustment in long‐term breast cancer survivors

Abstract

Objective: The increasing numbers of breast cancer survivors highlight the importance of delineating factors that identify women who are at risk of poor psychological adjustment in the long term. In breast cancer survivors, higher attachment anxiety and attachment avoidance have been associated with poorer psychological adjustment. Moreover, there is evidence that self-compassion, a kind manner of treating oneself during difficulties, is associated with psychological adjustment in this population. This study aimed to extend the association between attachment styles and psychological adjustment to the context of long-term breast cancer survivors and to determine whether lower self-compassion underlies this association.Methods: Participants (N = 82) were recruited through emailed invitations to members of the Review and Survey Group of Breast Cancer Network Australia. Following online consent, participants completed measures assessing attachment styles, selfcompassion, psychological stress, and the perceived negative impact of cancer.Bootstrapping analyses using the PROCESS macro were used to test the significance of indirect effects.Results: As hypothesised, correlational analyses revealed that higher attachment anxiety and attachment avoidance were significantly and positively associated with stress and perceived negative impact of cancer. Bootstrapping analyses revealed significant indirect effects of attachment anxiety and attachment avoidance (on both stress and perceived negative impact of cancer) through lower self-compassion.Conclusions: These findings suggest that self-compassion training may be useful for enhancing the psychological adjustment of long-term breast cancer survivors.Future longitudinal and experimental studies in more diverse samples are needed to confirm causal directionality of these relationships and to expand upon these findings. KEYWORDS attachment style, breast cancer, cancer, negative impact of cancer, oncology, psychological stress, self-compassion, survivorship

Unmet Supportive Care Needs Among Women With Breast and Gynecological Cancer: Relevance of Attachment Anxiety and Psychological Distress

“…Studies in the context of chronic diseases such as cancer have demonstrated that attachment styles can predict psychological adjustment and well-being (Schmidt et al, 2002;Turner-Cobb et al, 2002;Hamama-Raz and Solomon, 2006;Porter et al, 2012;Vehling et al, 2019). It has been shown that attachment anxiety leads to higher psychological distress and increased levels of endocrine stress responses (Ehrenthal et al, 2011;Arambasic et al, 2019). Individuals with higher levels of attachment avoidance usually report lower levels of psychological burden than individuals with higher scores of attachment anxiety (Dozier and Lee, 1995).…”

“…Individuals with higher levels of attachment avoidance usually report lower levels of psychological burden than individuals with higher scores of attachment anxiety (Dozier and Lee, 1995). In patients with cancer, insecurely attached individuals use less active and less positive coping strategies to manage their diagnosis of cancer and survivorship issues, such as physical and emotional consequences of the cancer treatment (Schmidt et al, 2012;Arambasic et al, 2019;Romeo et al, 2019). Moreover, related studies have shown that attachment anxiety is associated with depression (Hunter et al, 2006;Porter et al, 2012;Nissen, 2016;Scheffold et al, 2017), higher symptoms of anxiety and reduced social well-being and quality of life among cancer patients (Porter et al, 2012;Smith et al, 2018;Arambasic et al, 2019;Romeo et al, 2019).…”

“…In patients with cancer, insecurely attached individuals use less active and less positive coping strategies to manage their diagnosis of cancer and survivorship issues, such as physical and emotional consequences of the cancer treatment (Schmidt et al, 2012;Arambasic et al, 2019;Romeo et al, 2019). Moreover, related studies have shown that attachment anxiety is associated with depression (Hunter et al, 2006;Porter et al, 2012;Nissen, 2016;Scheffold et al, 2017), higher symptoms of anxiety and reduced social well-being and quality of life among cancer patients (Porter et al, 2012;Smith et al, 2018;Arambasic et al, 2019;Romeo et al, 2019). This is of special relevance as the effect of attachment anxiety on health-related outcomes (e.g., medical symptoms, overall health and bodily pain) may be moderated by the perception of social support (Stanton and Campbell, 2014;McWilliams, 2017).…”

Relationship Between Self-Compassion and Depression in Cancer Patients Referring to the Oncology Ward of Shahid Baghaee Hospital in Ahvaz, Iran

“…According to a literature review by Sirois and Rowse, self-compassion is in connection with adaptive coping, lower stress and distress, and the practice of important health behaviors in chronic illness populations (20). Arambasic et al in their study concluded that self-compassion training may be useful for enhancing psychological adjustment in long-term breast cancer survivors (21). In other words, self-compassion can help chronic patients, especially cancer patients, to maintain their mental health and thus, their general health, more effectively.…”

The Effect of Self-Compassion on Psychosocial and Clinical Outcomes in Patients With Medical Conditions: A Systematic Review

“…Eight articles were further excluded, for reasons shown in the Appendix section ( Figure 1). Finally, 19 articles (n=2,713 patients, of which 73.3% were females) met our eligibility criteria and were included in this systematic review [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33]. The baseline characteristics of the included studies are comprehensively described in Table 1.…”