Campo Rebecca A, Wu Lisa M, Austin Jane, Valdimarsdottir Heiddis, Rini Christine
a Department of Physical Medicine & Rehabilitation , University of North Carolina at Chapel Hill , Chapel Hill , NC , USA.
b Department of Medical Social Sciences , Northwestern University Feinberg School of Medicine , Chicago , IL , USA.
J Psychosoc Oncol. 2017 Nov-Dec;35(6):666-687. doi: 10.1080/07347332.2017.1342306. Epub 2017 Jun 14.
This longitudinal study examined whether post-transplant cancer survivors (N = 254, 9 months to 3 years after stem cell transplant treatment) with greater personal resilience resources demonstrated better psychological outcomes and whether this could be attributed to reductions in depressive symptoms and/or four meaning-making processes (searching for and finding reasons for one's illness; searching for and finding benefit from illness). Hierarchical linear regression analyses examined associations of survivors' baseline personal resilience resources (composite variable of self-esteem, mastery, and optimism), which occurred an average of 1.7 years after transplant, and 4-month changes in psychological outcomes highly relevant to recovering from this difficult and potentially traumatic treatment: post-traumatic stress disorder (PTSD) symptoms and purpose in life. Boot-strapped analyses tested mediation. Greater personal resilience resources predicted decreases in PTSD stress symptoms (b = -0.07, p = 0.005), mediated by reductions in depressive symptoms (b = -0.01, 95% CI: -0.027, -0.003) and in searching for a reason for one's illness (b = -0.01, 95% CI: -0.034, -0.0003). In addition, greater resilience resources predicted increases in purpose in life (b = 0.10, p < 0.001), mediated by reductions in depressive symptoms (b = 0.02, 95% CI: 0.003, 0.033). Having greater personal resilience resources may promote better psychological adjustment after a difficult cancer treatment, largely because of improvements in depressive symptoms, although decreased use of a potentially maladaptive form of meaning-making (searching for a reason for one's illness) was also important for reducing PTSD symptoms.
这项纵向研究调查了移植后癌症幸存者（N = 254，干细胞移植治疗后9个月至3年）中，拥有更多个人心理韧性资源的人是否表现出更好的心理结果，以及这是否可归因于抑郁症状的减轻和/或四种意义构建过程（寻找并找到患病原因；从疾病中寻找并发现益处）的减少。分层线性回归分析检验了幸存者的基线个人心理韧性资源（自尊、掌控感和乐观主义的综合变量）与心理结果4个月变化之间的关联，这些心理结果与从这种艰难且可能具有创伤性的治疗中恢复高度相关：创伤后应激障碍（PTSD）症状和生活目的。自举分析检验了中介作用。更多的个人心理韧性资源预示着PTSD应激症状的减轻（b = -0.07，p = 0.005），这是由抑郁症状的减轻（b = -0.01，95% CI：-0.027，-0.003）和寻找患病原因的减少（b = -0.01，95% CI：-0.034，-0.0003）介导的。此外，更多的心理韧性资源预示着生活目的的增加（b = 0.10，p < 0.001），这是由抑郁症状的减轻（b = 0.02，95% CI：0.003，0.033）介导的。拥有更多的个人心理韧性资源可能会促进在艰难的癌症治疗后更好的心理调适，这在很大程度上是因为抑郁症状的改善，尽管减少使用一种潜在适应不良的意义构建形式（寻找患病原因）对减轻PTSD症状也很重要。
