Mixed Psychological Changes Following Mastectomy: Unique Predictors and Heterogeneity of Post-traumatic Growth and Post-traumatic Depreciation

Abstract

Objectives: Post-traumatic growth (PTG) and its opposite—post-traumatic depreciation (PTD)—may be treated as important indicators of the patient quality of life. In the absence of studies on both, PTG and PTD in cancer patients, we investigated (1) coping strategies and support effectiveness as predictors of PTG and PTD in post-mastectomy women, (2) homogeneous classes with different intensity of PTG and PTD symptoms, and (3) correlates of class membership.Methods: Coping strategies (Brief COPE), support effectiveness (SSE-Q), PTG (PTGI), and PTD (negatively reworded items of PTGI) were measured in 84 post-mastectomy women (mean age = 62.27, SD = 8.38). Multiple regression, two-step cluster, and multinomial logistic regression were applied.Results: PTG and PTD had unique predictors: time since diagnosis and positive emotion-focused coping predicted PTG (R2 = 0.24), while negative emotion-focused and avoidance-focused coping and low support effectiveness were linked to PTD (R2 = 0.14). Four groups of PTG × PTD symptoms were identified: high PTG low PTD group (52.4%), low PTG low PTD group (17.9%), high PTG high PTD group (15.5%), and low PTG high PTD group (14.3%). Higher emotion- and avoidance-focused coping was characteristic for the high PTD low PTG group (R2 = 0.41).Conclusion: Our findings shed light on the coexistence and unique predictors of PTG and PTD after mastectomy, indicating heterogeneity in PTG and PTD levels among post-mastectomy women.

Coexistence of Post-traumatic Growth and Post-traumatic Depreciation in the Aftermath of Trauma: Qualitative and Quantitative Narrative Analysis

“…Research show that PTG and PTD should be considered as independent constructs. They are not or slightly correlated, and they have different predictors and outcomes (Baker et al, 2008; Cann et al, 2010; Barrington and Shakespeare-Finch, 2013; Kroemeke et al, 2017). For example, both deliberative and intrusive ruminations predict PTD, but only deliberative ruminations predict PTG (Allbaugh et al, 2016); PTD, but not PTG, relates to distress, depression, anxiety and satisfaction with life (Barrington and Shakespeare-Finch, 2013); problem-focused and positive emotion-focused coping predict PTG, but negative emotion and avoidance-focused coping predict PTD (Kroemeke et al, 2017).…”

The role of beliefs about the impact of illness on fertility and close relationships for psychopathological symptoms in women treated for hypothyroidism

“…This remains in accordance with the results of numerous studies indicating that a subjective interpretation of a given disease and the subjective appraisal of its impact on other aspects of life has the strongest impact on the emotional functioning of chronically ill patients (Kroemeke, Bargiel‐Matusiewicz, & Kalamarz, 2017). Our results further strengthen this claim by demonstrating that women who hold subjective IRBs about the negative impact of hypothyroidism on their close relationships and on fertility are more at risk of elevated ED symptoms.…”

Rumination and social support as predictors of posttraumatic growth in women with breast cancer: a systematic review

“…Despite of them all having evaluated women with breast cancer, there were some differences in the samples' characteristics. Kroemeke et al (29) focused the investigation in women who had undergone mastectomy. The study of Cohen and Numa (26) , on the other hand, looked to compare PTG between women who had and who had not engaged in volunteering.…”

“…Regardless of how almost all studies that included social support on their analysis concluded that there is a positive correlation between this variable and PTG, there was no consensus. On the study of Kroemeke et al (29) , social support showed no correlation with PTG, and was therefore not included on the model tested for predictor analysis. On the other hand, on the study of Tomita et al (28) the variable only affected the factor relating to others, being important especially when coming from one's spouse.…”