Posttraumatic stress symptoms in breast cancer patients: temporal evolution, predictors, and mediation

This study (N = 102 women) evaluated the time course of posttraumatic stress symptomatology (PTSS) at different stages of nonmetastastic cancer diagnosis and treatment: during treatment, at the end of treatment, and at a 6-12 months follow-up. We also assessed the contribution of demographic, trait, and state predictors to PTSS, and coping processes as proximal mediators of the relation between Type C personality and PTSS. Results indicated that PTSS remained constant across all phases. There were significant correlations (range = .28 to .81) between PTSS and psychosocial variables and age, but not with other sociodemographic or medical factors. A linear growth curve model showed that hopelessness/helplessness (B = 1.45) and Type C personality (B = 1.40) were the best predictors of PTSD symptomatology, followed by trait dissociation (B = 0.55), and the coping strategies of anxious preoccupation (B = 1.20), cognitive avoidance (B = 0.91), and symptoms of acute stress disorder (B = 0.19). A mediation model showed that the coping strategies of anxious preoccupation, cognitive avoidance, and helplessness/hopelessness mediated the relationship between Type C personality and PTSS during treatment, posttreatment, and follow-up. These results clarify the contribution of different predictors of PTSS and can help develop prevention programs.