Salsman John M, Segerstrom Suzanne C, Brechting Emily H, Carlson Charles R, Andrykowski Michael A
Evanston Northwestern Healthcare, Evanston, Illinois, USA.
Psychooncology. 2009 Jan;18(1):30-41. doi: 10.1002/pon.1367.
The experience of cancer can be understood as a psychosocial transition, producing both positive and negative outcomes. Cognitive processing may facilitate psychological adjustment.
Fifty-five post-treatment, colorectal cancer survivors (M=65.9 years old; SD=12.7), an average of 13 months post-diagnosis, were recruited from a state cancer registry and completed baseline and 3-month questionnaires assessing dispositional (social desirability), cognitive processing (cognitive intrusions, cognitive rehearsal), and psychological adjustment variables (posttraumatic growth (PTG), posttraumatic stress disorder (PTSD) symptomatology, depression, anxiety, positive affectivity).
PTSD symptomatology was positively associated with depression, anxiety, and negatively associated with positive affectivity. In contrast, PTG scores were unrelated to PTSD symptomatology, depression, anxiety, and positive affectivity. In addition, PTG was independent of social desirability. Notably, after controlling for age at diagnosis and education, multiple regression analyses indicated that cognitive processing (intrusions, rehearsal) was differentially predictive of psychological adjustment. Baseline cognitive intrusions predicted 3-month PTSD symptomatology and there was a trend for baseline cognitive rehearsal predicting 3-month PTG.
Additional research is needed to clarify the association between PTG and other indices of psychological adjustment, further delineate the nature of cognitive processing, and understand the trajectory of PTG over time for survivors with colorectal cancer.
癌症经历可被视为一种心理社会转变,会产生积极和消极的结果。认知加工可能有助于心理调适。
从一个州癌症登记处招募了55名治疗后的结直肠癌幸存者(平均年龄65.9岁;标准差12.7),诊断后平均13个月,他们完成了基线和3个月的问卷调查,评估倾向性(社会期望性)、认知加工(认知侵入、认知演练)和心理调适变量(创伤后成长(PTG)、创伤后应激障碍(PTSD)症状、抑郁、焦虑、积极情感)。
PTSD症状与抑郁、焦虑呈正相关,与积极情感呈负相关。相比之下,PTG得分与PTSD症状、抑郁、焦虑和积极情感无关。此外,PTG独立于社会期望性。值得注意的是,在控制诊断时的年龄和教育程度后,多元回归分析表明认知加工(侵入、演练)对心理调适有不同的预测作用。基线认知侵入可预测3个月时的PTSD症状,基线认知演练有预测3个月时PTG的趋势。
需要进一步研究以阐明PTG与其他心理调适指标之间的关联,进一步界定认知加工的性质,并了解结直肠癌幸存者PTG随时间的变化轨迹。