Illness- and Gender- Related Identity Processes and Psychosocial Well-being among Young Breast Cancer Survivors: A Mixed Method Study

The purpose of the current investigation was to explore Identity Integration, defined as the reformation of post-illness identities, and its impact on psychosocial well-being among young breast cancer survivors. Two key aspects of identity were assessed: a) illness-related identity—women’s experience of themselves in relation to developing breast cancer and b) gender-related identity—women’s experience of themselves in relation to stereotypic and hegemonic gender constructions. A triangulation mixed method design was utilized to collect data on identity processes and related shifts among young breast cancer survivors. In the quantitative inquiry, 113 young women breast cancer survivors, diagnosed at age 36.25 (SD=5.89), mostly between stages I-III (93.9%) completed a measure of illness-related identity: the Impact on Self-Concept Scale (ISCS), four measures of gender-related identity: Gender Role Socialization Scale (GRSS), Objectify Body Consciousness Scale (OBCS), Mental Freedom Scale (MF), and Silencing the Self Scale (SS), as well as two measures of well-being: the Functional Assessment of Cancer Therapy-Breast (FACT-B), and the Experience of Embodiment Scale (EES). As predicted, the illness- and gender-related identity subscales were significantly correlated with both measures of well-being. In the multiple regression models, GRSS and MF significantly predicted FACT-B scores, R2=40.0%. In contrast, OBCS and MF predicted EES scores, R2=61%. In the qualitative inquiry, 12 women between the ages of 24 and 44 at diagnosis participated in one interview about identity processes and related shifts before, during, and after their breast cancer experience. Six core dimensions of women’s identity emerged in the Constructivist Grounded Theory analysis: 1) Loss and Adversity, 2) Connection to the Physical Body, 3) Social Power Related to Bodily Experiences, 4) Internalization Versus Rejection of Gender- and Illness-Related Discourses, 5) Relational Connections, and 6) Meaning and Life Goals. Related to the centrality of body experiences in these emergent themes, the results suggested that identity was intertwined with bodily experiences and was therefore referred to as ‘embodied identity’. Taken together, findings from the study highlighted a critical relationship between young women’s altered bodies, illness- and gender-related identities, and their psychosocial well-being after a breast cancer experience. Unlike previous research in psychosocial oncology, which considered identity as disconnected from the body, this study underscored the importance of examining identity through an embodied lens. Theoretical innovation and clinical implications for psychological intervention are discussed.Ph.D