An experimental study to identify key psychological mechanisms that promote and predict resilience in the aftermath of treatment for breast cancer

Abstract

Objective: Women living with and beyond breast cancer (BC) frequently encounter cancer-related information in day-to-day life. The extent they are emotionally resilient to this information differs between women. Identifying key modifiable psychological mechanisms predicting resilience in these women could highlight targets for interventions to improve resilience in others. This study investigates resilience over time in women living beyond BC and how this relates to individual differences in the way the brain processes information.Methods: Seventy women within a year of finishing first-line treatment for BC (clinical and community recruitment) completed computerised tasks to assess the tendency to attend to cancer information (dot-probe task), the tendency to draw negative cancer-related interpretations from ambiguous information (ambiguous scenarios task) and extent of executive functioning (attentional network task). Questionnaires were completed assessing resilience, and other clinically relevant psychological variables (fear of cancer recurrence, distress, quality of life, and worry) at the time of the laboratory tasks (T1) and again 6 months later (T2). Results:The only cognitive process associated with self-reported resilience was interpretation bias. Generating more negative cancer-related interpretations of ambiguous information at T1 significantly predicted resilience at T2, whilst controlling for T1 resilience and other clinically relevant variables. Furthermore, resilience scores were relatively stable over time and moderately correlated with other clinically relevant variables. Conclusions:This study is the first to identify a key cognitive mechanism that predicts resilience in women living beyond BC. This finding suggests interventions to reduce cancer-related interpretations of ambiguous information could promote resilience in women living beyond BC.

The role of illness‐related cognition in the relationships between resilience and depression/anxiety in nasopharyngeal cancer patients

“…Further, we conducted a stratified analysis based on the time interval from diagnosis to survey, examining the associations between resilience, mental health outcomes, and cognitive processes of illness in patients within the early and long‐term periods, as well as the entire sample. Consistent with our findings, a cohort study also reported that resilience was associated with anxiety, depression, and cognitive processes of illness at both baseline and 6‐month follow‐up 15 . Specifically, in the early periods (0–1 year) after diagnosis, resilience had a direct effect on symptoms of depression and anxiety.…”

“…Consistent with our findings, a cohort study also reported that resilience was associated with anxiety, depression, and cognitive processes of illness at both baseline and 6‐month follow‐up. 15 Specifically, in the early periods (0–1 year) after diagnosis, resilience had a direct effect on symptoms of depression and anxiety. However, in the long‐term periods (over 1 year) following cancer diagnosis, the relationships between resilience and symptoms of depression and anxiety were completely mediated by illness perception, stigma, and meaning in life.…”

“…Plasticity and sociality focus on the development of the nervous system and social networks; while meaning focuses on giving significance and inspiring strength in the face of human suffering, indicating its role in cognitive reconstruction 14 . Studies have reported correlations between illness‐related cognitive processes (such as tending to pay attention to cancer‐related information and draw negative conclusions) and mental health with resilience in cancer patients 15 . Illness perceptions and stigma have been reported as ones of most important illness‐related cognitive factors that impact mental health among NPC patients 16–18 .…”

“… 14 Studies have reported correlations between illness‐related cognitive processes (such as tending to pay attention to cancer‐related information and draw negative conclusions) and mental health with resilience in cancer patients. 15 Illness perceptions and stigma have been reported as ones of most important illness‐related cognitive factors that impact mental health among NPC patients. 16 , 17 , 18 Illness perceptions, which encompass patients' cognitive, emotional, and affective responses to their symptoms and disease, are associated with mental health outcomes in individuals with cancer.…”

Psychological processes associated with resilience in UK-based unpaid caregivers during the COVID-19 pandemic

“…Another psychological mechanism that might potentially expand our understanding of resilience in caregivers is interpretation bias, which is the tendency to draw negative conclusions from ambiguous information ( Hirsch et al, 2016 ). There is already data to suggest that lower levels of interpretation bias are linked to greater resilience in groups such as women living beyond breast cancer ( Booth et al, 2022 ; Gordon et al, 2022 ) and in adolescents ( Booth et al, 2022 ). Such findings support a cognitive model of psychological resilience ( Booth et al, 2022 ), whereby interpretation bias influences levels of resilience and is a key mechanism for maintaining internalising disorders such as mood conditions.…”