Department of Medical Psychology and Psychotherapy, Erasmus Medical Centre, Rotterdam, The Netherlands.
Psychooncology. 2011 Nov;20(11):1170-5. doi: 10.1002/pon.1824. Epub 2010 Aug 4.
Clarification of the role of several aspects of self-concept regarding psychological distress in women at risk of hereditary breast cancer will help to target counselling and psychosocial interventions more appropriately. In this study, we aimed (1) to examine the role of general self-esteem and specific aspects of self-concept (i.e. stigma, vulnerability, and mastery) in psychological distress in women at risk of hereditary breast cancer and (2) to compare the relative importance of these self-concept aspects in psychological distress in women with low versus high self-esteem.
General and breast-cancer-specific distress, self-esteem, self-concept, and demographics were assessed in 246 women being at risk of hereditary breast cancer, who opted either for regular breast surveillance or prophylactic surgery.
In the total study group, self-esteem was negatively associated with general distress. Furthermore, feeling stigmatized was strongly associated with more breast-cancer-specific distress, and to a lesser degree with general distress. In women with low-self esteem, feelings of stigmatization were strongly associated with higher levels of both breast-cancer-specific and general distress, while a sense of mastery was associated with less general distress. For women with high self-esteem, feelings of both stigmatization and vulnerability were associated with more breast-cancer-specific distress, whereas there were no significant associations with general distress.
Psychosocial interventions or support groups for women at risk of hereditary breast cancer should focus on self-esteem and feelings of stigmatization and isolation, and consequently tailor the interventions on specific items for respective women.
阐明自我概念的几个方面与遗传性乳腺癌风险女性心理困扰之间的关系，有助于更有针对性地进行咨询和心理社会干预。本研究旨在：(1) 探讨一般自尊和自我概念的特定方面（即耻辱感、脆弱性和掌控感）在遗传性乳腺癌风险女性心理困扰中的作用；(2) 比较这些自我概念方面在低自尊和高自尊女性心理困扰中的相对重要性。
在 246 名有遗传性乳腺癌风险的女性中评估一般和乳腺癌特异性困扰、自尊、自我概念和人口统计学特征，这些女性选择常规乳房监测或预防性手术。
在总研究组中，自尊与一般困扰呈负相关。此外，感到受辱与更多的乳腺癌特异性困扰密切相关，与一般困扰的关系较小。在低自尊的女性中，受辱感与更高水平的乳腺癌特异性和一般困扰密切相关，而掌控感与一般困扰程度较低相关。对于高自尊的女性，耻辱感和脆弱感都与更多的乳腺癌特异性困扰有关，而与一般困扰没有显著关联。
遗传性乳腺癌风险女性的心理社会干预或支持小组应关注自尊和耻辱感及孤立感，并根据特定女性的具体项目来调整干预措施。
