乳腺癌诊断后，特质性和情境性回避与趋近作为身体症状困扰的预测因素
Dispositional and Situational Avoidance and Approach as Predictors of Physical Symptom Bother Following Breast Cancer Diagnosis.
作者信息
Bauer Margaret R, Harris Lauren N, Wiley Joshua F, Crespi Catherine M, Krull Jennifer L, Weihs Karen L, Stanton Annette L
机构信息
Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA.
Department of Biostatistics, University of California, Los Angeles, Los Angeles, CA, USA.
出版信息
Ann Behav Med. 2016 Jun;50(3):370-84. doi: 10.1007/s12160-015-9763-7.
BACKGROUND
Few studies examine whether dispositional approach and avoidance coping and stressor-specific coping strategies differentially predict physical adjustment to cancer-related stress.
PURPOSE
This study examines dispositional and situational avoidance and approach coping as unique predictors of the bother women experience from physical symptoms after breast cancer treatment, as well as whether situational coping mediates the prediction of bother from physical symptoms by dispositional coping.
METHOD
Breast cancer patients (N = 460) diagnosed within the past 3 months completed self-report measures of dispositional coping at study entry and of situational coping and bother from physical symptoms every 6 weeks through 6 months.
RESULTS
In multilevel structural equation modeling analyses, both dispositional and situational avoidance predict greater symptom bother. Dispositional, but not situational, approach predicts less symptom bother. Supporting mediation models, dispositional avoidance predicts more symptom bother indirectly through greater situational avoidance. Dispositional approach predicts less symptom bother through less situational avoidance.
CONCLUSION
Psychosocial interventions to reduce cancer-related avoidance coping are warranted for cancer survivors who are high in dispositional avoidance and/or low in dispositional approach.
背景
很少有研究探讨特质性趋近和回避应对方式以及应激源特异性应对策略是否能不同程度地预测对癌症相关应激的身体适应情况。
目的
本研究考察特质性和情境性回避及趋近应对方式，作为乳腺癌治疗后女性身体症状困扰的独特预测因素，以及情境性应对方式是否介导特质性应对方式对身体症状困扰的预测作用。
方法
在过去3个月内确诊的乳腺癌患者（N = 460）在研究开始时完成特质性应对方式的自我报告测量，并在6个月内每6周完成一次情境性应对方式和身体症状困扰的自我报告测量。
结果
在多水平结构方程模型分析中，特质性和情境性回避均预测了更大的症状困扰。特质性趋近（而非情境性趋近）预测了较少的症状困扰。支持中介模型的结果显示，特质性回避通过更多的情境性回避间接预测了更多的症状困扰。特质性趋近通过较少的情境性回避预测了较少的症状困扰。
结论
对于特质性回避程度高和/或特质性趋近程度低的癌症幸存者，有必要采取心理社会干预措施以减少与癌症相关的回避应对方式。
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