A network analysis of benefit finding, posttraumatic growth, anxiety, and depression in breast cancer patients

Breast cancer patients often experience psychological distress, such as anxiety and depression, during diagnosis and treatment; however, positive psychological changes, including benefit finding (BF) and posttraumatic growth (PTG), may also occur. This study aimed to construct a co-occurrence network of BF, PTG, anxiety, and depression and to identify central and bridge dimensions across different psychological communities.

A total of 707 breast cancer patients were recruited from five tertiary hospitals in northern Anhui Province, China, between September 2025 and January 2026. Participants completed the Benefit Finding Scale (BFS), the Posttraumatic Growth Inventory (PTGI), and the Hospital Anxiety and Depression Scale (HADS). Network analysis was conducted to construct the network, identify central and bridge dimensions, and assess network stability. Expected influence (EI) and bridge expected influence (BEI) were calculated to assess centrality and bridge centrality, respectively.

A total of 707 breast cancer patients participated in the study. Network analysis revealed that BFS4 ("personal growth", EI = 1.034) was the most central dimension in the co-occurrence network. The strongest edge was observed between HADS1 and HADS2 ("anxiety-depression", edge weight = 0.527), both within the distress community. Key bridge dimensions included BFS4 ("personal growth", BEI = 0.504), PTGI4 ("relating to others", BEI = 0.481), and BFS3 ("worldview", BEI = 0.401). The network showed high stability.

"Personal growth" (BFS4) occupied both central and bridge positions in the estimated network. Together with the bridge positions of PTGI4 ("relating to others") and BFS3 ("worldview"), these findings highlight the potential relevance of personal growth-related resources, interpersonal relationships, and worldview when considering psychological distress and positive psychological constructs in breast cancer patients. These dimensions may warrant attention in comprehensive psychological assessment and supportive care.