Adjustment to breast cancer: age-related differences in coping and emotional distress

Women who are diagnosed with breast cancer are at high risk for experiencin g affective distress; however, previous research suggests that older women may be less likely than younger women to experience extreme distress. Two i ssues remain unclear regarding age and affective distress: (a) the psycholo gical processes that account for the association of age and distress, and ( b) whether this association remains stable over the course of treatment and recovery from breast cancer. This study investigated symptoms of anxiety a nd depression in 80 women ages 36-80 years old with newly diagnosed breast cancer near the time of their diagnosis and at 3 and 6 months post-diagnosi s. Disease severity and coping style were also examined. Symptoms of anxiet y/depression and age were negatively correlated near the time of diagnosis. Path analysis controlling for disease severity revealed that coping involv ing the ventilation of emotion fully mediated the effect of age on symptoms of anxiety and depression. However, the association of age with symptoms o f anxiety/depression was no longer significant at 3 and 6 months post-diagn osis, although emotional ventilation still predicted greater emotional dist ress at 6 months. These findings suggest that age is a salient factor to co nsider in the psychological adjustment of women with breast cancer near the time of initial diagnosis, with younger women exhibiting greater affective distress and a tendency to engage in less adaptive ways of coping. However , younger and older women do not differ in their adjustment over the subseq uent course of their treatment and initial recovery. The use of emotional v entilation coping remains associated with poorer adjustment, independent of patients' age.