Benefit Finding in Women with Breast Cancer: Assessment and Relations with Cortisol

Despite the stress associated with the diagnosis of breast cancer, many women are able to find benefits in the experience. Recent work has characterized benefit finding (BF) as a multidimensional construct with perceived benefits found in a variety of distinct domains, including family relations and world view, among others (Weaver, Llabre, Lechner, Penedo, & Antoni, 2008). However, factor analysis results from the Benefit Finding Scale (BFS; Antoni et al., 2001; Tomich & Helgeson, 2004) have been mixed, demonstrating the need for further examination of the question. Increased BF after psychological intervention has predicted improvements in physical health-related measures in breast cancer patients, including improved profiles of the stress hormone cortisol. An interesting question is whether women’s ability to find benefit (independent of an intervention) in early stages of breast cancer treatment predicts lower levels of stress as measured by cortisol. An exploratory factor analysis of the BFS was conducted on a sample of 419 women with early-stage breast cancer who were 2-10 weeks post-surgery. A subset of 179 women from this larger sample also provided serum and salivary cortisol samples. This subset was utilized to assess the cross-sectional relationship between BF and cortisol, controlling for relevant sociodemographic and medical variables. A single-factor model of BF best represented perceived benefits in post-surgical breast cancer patients. Higher levels of BF were reported in younger and premenopausal women, Hispanic women, and those who had undergone a mastectomy rather than a lumpectomy. Higher evening cortisol levels were found in women with less education. Finally, BF was found to be unrelated to cortisol except in pre-menopausal women and those with lower income. In these subgroups, higher BF predicted lower cortisol awakening response. Findings suggest that time of assessment may influence the factor structure of BF such that the BFS generates a unitary measure of BF in the weeks after surgery. Furthermore, relations between BF and cortisol indicators during this period seem to be most evident in specific subgroups of women. This work may be relevant in planning future biobehavioral studies of BF-related processes in women with breast cancer