Understanding the dynamics of posttraumatic growth in breast cancer survivors

Much of the breast cancer research that has been conducted to date has focused on understanding the negative sequelae of the illness. While the negative impact of breast cancer can be profound, there is a growing body of evidence that suggests many breast cancer survivors report posttraumatic growth or positive life changes following their diagnosis. The current breast cancer literature offers little to explain which factors predict perceptions of posttraumatic growth. In addition much of the research in this area is atheoretical and primarily focuses on intra-individual predictors. The current study is guided by Carver\u27s theory of self-regulation and Ajzen\u27s theory of planned behavior. Two hundred and fifteen breast cancer survivors who were randomly selected from the Hartford Hospital Tumor Registry (mean age 60, range 32–86) answered a mail questionnaire. This cross-sectional study examined contextual, disease related factors, as well as intra-individual variables that predict posttraumatic growth. Results of a series of hierarchical regression analyses found that distinct variations of age at diagnosis, marital status, employment, education, prognosis, emotional intensity of disease, and adaptive coping account for 34%, 35%, and 28% of the variance in posttraumatic growth in relationships with others, new possibilities, and appreciation for life, respectively. At the same time, hope, optimism, time since illness, surgical procedure, prior health status, the presence of children, and ethnicity were not significantly related to any of the sub-domains of the Posttraumatic Growth Inventory (PTGI). Results support the inclusion of contextual, disease, and intra-individual factors in posttraumatic growth models of breast cancer. The present study suggests different domains of the PTGI have different sets of predictors supporting a multidimensional measure of growth. These findings suggest different threat thresholds may exist among the different posttraumatic growth sub-domains before growth can occur. Although hope and optimism might offer protective features or provide the basic resources for psychological adjustment, their usefulness may not necessarily equate to being influential in similar, but also very different, posttraumatic growth outcomes.