A model of psychosocial adjustment to cancer : additional contributions of agency, communion, unmitigated agency, and unmitigated communion

Prior research shows a wealth of investigation into the variables contributing to psychosocial adjustment to cancer. However, the literature consistently calls for more complex investigation of the contributing factors. This investigation attempted to clarify and expand the adjustment literature in two primary areas. First, the study investigated the relationships between the variables suspected of predicting adjustment to cancer, such as socidemographic, social support, and gender-related personality variables. Second, the study determined the differential influence that the traits of agency, communion, and the unmitigated constructs had on adjustment to cancer, compared to sex. The investigator used two statistical approaches to identify the differential importance: hierarchical regression and structural equation modeling (SEM). Using SEM, the investigator tested three models to determine which variables had direct and indirect effects on adjustment.The study used a sample of 417 (238 used in final analyses) early stage (0, I, and II) male and female cancer patients diagnosed between 1998 and 2000. The patients completed mail surveys assessing their social support, gender-related personality characteristics, and adjustment to cancer. Results from bivariate correaltional analyses found that being male, having less functional social support, experiencing more problematic support encounters, and possessing unmitigated agentic traits contributed to more maladjustment. In contrast, the results revealed that possessing communion traits related to less maladjustment.Results from the regression analysis also supported that the unmitigated agentic and communal traits contributed significantly to the variance in maladjustment. When determining strength of associations, less social support from family, more informationfrom friends, and being male more strongly predicted the likelihood of maladjustment. However, findings also suggested that being on medical leave and possessing either traits of unmitigated agency or communion contributed to maladjustment to cancer.Finally, while structural models exhibited less than adequate fit, the significant paths within the models supported many of the proposed relationships. Overall, the findings supported the multifactorial nature of maladjustment, such that sex, social support, and personality traits all emerged as significant predictors. The study concluded with a discussion on improving model fit and directions for future research.Department of Counseling Psychology and Guidance ServicesThesis (Ph. D.