Purpose: According to the social-cognitive processing model(Lepore, 2001), the expression of one’s thoughts and feelings regarding cancer in a supportive social context represent an opportunity to confront representation, develop new perspectives and integrate threatening aspects of the disease. In line with these assumptions, this longitudinal and quantitative study focuses on the effects of the social sharing / support on psychological adjustment of women with breast cancer and explores mediator effects of illness perception.
Methods: Participants with breast cancer were recruited at the French Cancer Center Gustave Roussy Institute and followed from post-surgery (T1, N = 113) to the end of treatments by chemotherapy and radiotherapy (T2, N = 102). They all signed written informed consent to participate to this EC-approved longitudinal study. Patients responded to self-reported questionnaires on psychological adjustment (STAI, BDI-SF, IES), social sharing about the disease (PSM), perceived social support (SSQ6, QueSSSC) and illness perception (IPQ-R). Hierarchical regression analyses were used to test prediction and mediation over time.
Results: Instrumental support at T1 only accounts for a decrease in depressive symptoms at T2. However, the perception of aversive attitudes in the social environment and the avoidance of social sharing at T1 explain an increase of cancer-related intrusive thoughts at T2. The association of aversive attitudes in the environment at T1 with cancer-related intrusive thoughts at T2 was completely mediated by illness beliefs of cyclical-recurrent illness.
Conclusion: This longitudinal research suggests that the presence of aversive attitudes in the environment and the avoidance of social sharing as reported after surgery have a negative impact on the cognitive processing of cancer. However, the existence of instrumental support reduces depressive affects in the long term. From these results, clinical implications for patients and their relatives are proposed.