Karveli Spyridoula, Karademas Evangelos, Poulakaki Fiorita, Antonopoulou Zoe, Arkadopoulos Nikolaos, Markopoulos Christos
School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
Department of Psychology, Faculty of Social Sciences, University of Crete, Athens, Greece.
Psychooncology. 2025 Jun;34(6):e70196. doi: 10.1002/pon.70196.
Individual differences play an important role in adjustment to breast cancer. This longitudinal study explored the potential mediating role of Early Maladaptive Schemas (EMSs) in the relationship between attachment styles and psychological adjustment.
Ninety-five early-stage female breast cancer patients participated in this longitudinal study and completed validated self-report questionnaires within 4 weeks and 12 months post-surgery measuring attachment styles (ECR-R), EMSs (YSQ-S3), anxiety (HADS-A), depression (HADS-D), and quality of life (EORTC-QLQ C30). Structural equation modeling was utilized to test direct and indirect effects.
Vulnerability to harm/illness schema had a direct effect on all outcomes, while the enmeshment EMS had a direct effect on anxiety only. Moreover, vulnerability to harm/illness schema fully mediated the relationship between attachment anxiety and psychological outcomes. No significant direct or indirect effects were observed for attachment avoidance.
The findings underscore the role of the illness-specific EMS -vulnerability to harm/illness-in psychological distress pathways among breast cancer patients. In non-clinical samples, cancer-related demands and stressors likely amplify the activation of only those schemas closely tied to the psychological challenges of living with cancer, while other EMSs may hold little relevance. Interventions targeting illness-specific EMSs may enhance coping and emotional well-being in this population.
个体差异在乳腺癌适应过程中起着重要作用。这项纵向研究探讨了早期适应不良图式（EMSs）在依恋风格与心理适应关系中的潜在中介作用。
95名早期女性乳腺癌患者参与了这项纵向研究，并在术后4周和12个月内完成了经过验证的自我报告问卷，测量依恋风格（ECR-R）、EMSs（YSQ-S3）、焦虑（HADS-A）、抑郁（HADS-D）和生活质量（EORTC-QLQ C30）。采用结构方程模型来检验直接和间接效应。
易受伤害/疾病图式对所有结果都有直接影响，而纠缠型EMSs仅对焦虑有直接影响。此外，易受伤害/疾病图式完全中介了依恋焦虑与心理结果之间的关系。未观察到依恋回避有显著的直接或间接效应。
研究结果强调了特定疾病的EMSs——易受伤害/疾病——在乳腺癌患者心理困扰途径中的作用。在非临床样本中，与癌症相关的需求和压力源可能只会放大那些与患癌生活的心理挑战紧密相关的图式的激活，而其他EMSs可能相关性不大。针对特定疾病EMSs的干预措施可能会增强这一人群的应对能力和情绪幸福感。
