Posttraumatic Growth in Breast Cancer Survivors: Constructive and Illusory Aspects

Abstract

This study investigated the impact of a building-resilience intervention on coping and posttraumatic growth (PTG) in a convenience sample of 94 breast cancer survivors. PTG was divided into constructive and illusory components, based on the two-sided Janus face model (Maercker & Zoellner, 2004). We operationalized constructive PTG as an improvement in both PTG and coping, and illusory PTG as an improvement in PTG only. An 8-session group intervention was delivered to 49 women (mean age = 51.5 years, SD = 10.7) who completed self-report questionnaires at baseline and at 6 months follow-up; a control group of 45 women only completed questionnaires. More than half the participants (n = 53; 56.38%) reported increased PTG at 6 months (mean change = 0.56, SD = 0.48, η(2) = .58). The increase in both PTG and positive coping was significantly greater in the intervention group than the control group (B = 0.23 for PTG, and B = 0.35 for positive coping). Further, a higher proportion of constructive PTG (vs. illusory PTG) was reported by the participants in the intervention group (89.3%), as compared to the control group (56.3%; z = 2.57). The distinction between constructive and illusory PTG has clinical implications for interventions promoting coping and growth among cancer survivors.

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

“…Coexisting PTG and PTD provide evidence for the high complexity of the coping processes, and the need for a comprehensive analysis of the potential changes, for example using the person-centered approach (Laursen and Hoff, 2006). The results might offer supporting arguments for the debate on the real vs. illusory facet of PTG (Maercker and Zoellner, 2004; Zoellner et al, 2008; Frazier et al, 2009; Pat-Horenczyk et al, 2015; Lahav et al, 2016). Women from the fourth group had low PTG and high PTD, and experienced the highest level of discomfort.…”

Returning to work: The cancer survivor’s transformational journey of adjustment and coping

“…Psychologically, cancer survivors have to cope with a sense of loss (Brannon & Feist, 2004), uncertainty, sadness, shame (Messner & Vera, 2011), and the fear of recurrence, resulting in persistent anxiety (Adler & Page, 2008; Lee-Jones, Humphris, Dixon, & Hatcher, 1997; Sarkar et al, 2015). It is not surprising that a number of cancer survivors present with post-traumatic stress disorder as a delayed psychological reaction to the cancer experience (Pat-Horenczyk et al, 2015). Having returned to work, with weakened physical and cognitive capacity, emotional concerns and self-confidence issues, cancer survivors also have to cope with colleagues’ and employers’ limited understanding of the effects of cancer (Munir, Yarker, & McDermott, 2009).…”

“…In coping with the trauma of cancer diagnosis, its treatment, and the resumption of work life, cancer survivors experience psychological adjustment and transition (Mayan et al, 2006; Pat-Horenczyk et al, 2015). Constructs indicating positive psychological adjustment of cancer survivors such as self-formulation (Mayan et al, 2006), stress-related growth (Park & Fenster, 2004), resilience, personal growth, and mastery (Rowland, 2008) align with the strength-based notion of coping that is fundamental to the positive psychology paradigm (Hoffman et al, 2013).…”

“…Constructs indicating positive psychological adjustment of cancer survivors such as self-formulation (Mayan et al, 2006), stress-related growth (Park & Fenster, 2004), resilience, personal growth, and mastery (Rowland, 2008) align with the strength-based notion of coping that is fundamental to the positive psychology paradigm (Hoffman et al, 2013). Post-traumatic growth, a construct indicating positive psychological change as a result of coping with trauma (Calhoun & Tedeschi, 2001) has also, for example, recently been explored in a sample of breast cancer survivors (Pat-Horenczyk et al, 2015). Although strength-based coping strategies have thus been emphasized in the context of cancer survivorship, Hoffman et al (2013) acknowledge impaired well-being and protracted coping in the cancer survivor’s psychological adjustment.…”

Can posttraumatic growth after breast cancer promote positive coping?—A cross‐lagged study

“…Most of the literature conceptualized PTG as a potential outcome following trauma, which is manifested in positive psychological changes and qualitative changes in functioning . However, others conceptualized and assessed PTG as a process of struggling in the aftermath of traumatic events and further differentiated between constructive and illusory trajectories of PTG …”