Depressive Personality Vulnerability and Adaptation to Breast Cancer: A Matter of Self-Criticism?

Dependency and self-criticism are two dimensions of personality vulnerability to depression, whereas efficacy is a dimension of personality resilience. The aim of this study was to examine the unique role of these personality dimensions in adaptation following a diagnosis of breast cancer, while controlling for the potentially confounding role of symptoms of depression and anxiety. Three adaptation outcomes were examined: Functioning, symptomatic load, and fatigue. Patients residing in Germany, diagnosed with breast cancer and comorbid depression, participated in a Randomized Clinical Trial (RCT) testing Supportive-Expressive Psychodynamic Psychotherapy (SEP; N = 78)) versus Treatment as Usual (TAU; N = 79). Assessments were made pre-treatment, at termination, and at 6-month follow-up. Analyses were conducted via General Linear Modelling (GLM). Pretreatment self-criticism prospectively predicted a rank-order decrease in functioning and a rank order increase in symptomatic load and fatigue. Dependency predicted an increase in breast symptoms. No effects were found for efficacy. Self-criticism may complicate adaptation to breast cancer. Implications for early detection and illness management are discussed.