Zhou Jia, Zhou Furong, Tang Yan, Ma Jun
School of Humanities and Management Science, Southwest Medical University, Luzhou, 646000, Sichuan, People's Republic of China.
Department of Science and Technology, Southwest Medical University, Luzhou, 646000, Sichuan, People's Republic of China.
BMC Psychol. 2025 Jul 22;13(1):817. doi: 10.1186/s40359-025-03037-9.
This study examines the dynamic changes between cultural worldview and self-esteem as distal defense mechanisms in cancer patients and explores the role of these mechanisms in the different psychological stages of cancer patients' resistance to death, thereby elucidating the unique responses of cancer patients to the salience of death.
Our sample comprises 113 cancer patients and 92 dental pain patients. We measured participants' levels of cultural worldview defenses, death thought accessibility (DTA), self-esteem, depression, and suicidal ideation in two studies.
In Study 1, increased levels of cultural worldview defenses coincided with increased levels of DTA. Initial avoidance and denial inhibited cultural worldview defenses in cancer patients, which were progressively strengthened in subsequent psychological stages of death. In Study 2, there were no significant differences in explicit self-esteem among cancer patients in different psychological stages of death; however, there were differences in tests of implicit self-esteem, with the lowest scores on the depression and suicidal ideation scales in the Acceptance of Death stage, the most pronounced suicidal ideation in the Bargaining stage, and the highest scores on depression in the Avoidance of Death stage.
The findings of the study indicate that cancer patients exhibited dynamic shifts in their cultural worldviews and self-esteem during the psychological phases of death. Interestingly, self-esteem may be a more effective defense mechanism than cultural worldview in this context.
本研究考察了文化世界观与自尊作为癌症患者远端防御机制之间的动态变化,并探讨了这些机制在癌症患者抗拒死亡的不同心理阶段中的作用,从而阐明癌症患者对死亡显著性的独特反应。
我们的样本包括113名癌症患者和92名牙科疼痛患者。我们在两项研究中测量了参与者的文化世界观防御水平、死亡想法可及性(DTA)、自尊、抑郁和自杀意念。
在研究1中,文化世界观防御水平的提高与DTA水平的提高相一致。最初的回避和否认抑制了癌症患者的文化世界观防御,在随后的死亡心理阶段逐渐增强。在研究2中,处于不同死亡心理阶段的癌症患者在显性自尊方面没有显著差异;然而,在隐性自尊测试中存在差异,在接受死亡阶段抑郁和自杀意念量表得分最低,在讨价还价阶段自杀意念最明显,在回避死亡阶段抑郁得分最高。
研究结果表明,癌症患者在死亡心理阶段其文化世界观和自尊表现出动态变化。有趣的是,在这种情况下,自尊可能是比文化世界观更有效的防御机制。