Psychological adjustment in breast cancer: Processes of emotional distress

The process of psychological adjustment to breast cancer was examined at di agnosis and at 3- and 6-month follow-ups in a sample of 80 women with Stage I-Stage IV breast cancer. At diagnosis, symptoms of anxiety/depression wer e predicted by low dispositional optimism, and this path was partially medi ated by use of emotion-focused disengagement coping. Younger age also was p redictive of anxiety/depression symptoms at time of diagnosis, and this rel ationship was fully mediated by magnitude of intrusive thoughts. At 3 month s, changes in anxiety/depression symptoms were predicted only by intrusive thoughts. At 6 months, low dispositional optimism reemerged as a significan t predictor of changes in anxiety/depression and again was partially mediat ed by the use of emotion-focused disengagement coping. Independent effects for problem-focused engagement and disengagement and emotion-focused engage ment coping were also found at 6 months. Implications of these data for psy chosocial interventions with breast cancer patients are highlighted.