Attribution of Blame, Self-forgiving Attitude and Psychological Adjustment in Women with Breast Cancer

Abstract

The purpose of this study was to examine relationships among self-blame for developing breast cancer, a self-forgiving attitude, mood, and quality of life among women with breast cancer. In this cross-sectional study, 123 women with Stages 0-III breast cancer completed questionnaires measuring demographic and medical characteristics, self-blame, self-forgiveness, mood, and quality of life. Women who blamed themselves reported more mood disturbance (p <or= .001) and poorer quality of life (p < .001) than those who did not blame themselves. Mediational analyses revealed that self-blame for cancer partially mediated the relationships between a self-forgiving attitude and both mood disturbance and quality of life (Z = -2.72, p = .006 and Z = -2.89, p = .004, respectively). Patients may benefit from a discussion with their oncologists and other healthcare providers about self-forgiveness and the potential benefits of reducing self-blame to facilitate adjustment to breast cancer.

Self-blame, Self-forgiveness, and Spirituality in Breast Cancer Survivors in a Public Sector Setting

“…We found that a more selfforgiving attitude was related to less mood disturbance and a better QoL which is consistent with what was found by Romero et al and Friedman et al [17,18]. We also found that a greater level of spirituality was associated with a reduced likelihood of mood disturbance and better QoL.…”

“…Romero et al found a positive relationship between self-forgiveness and psychological adjustment in a predominantly African American and Hispanic sample of low-income women with breast cancer [17]. A similar relationship was found in a predominantly Caucasian sample of women with breast cancer in a private sector breast clinic [18]. It is possible that women who are more self-forgiving are less likely to blame themselves for developing breast cancer, and consequently experience less mood disturbance and enhanced QoL.…”

A Qualitative Study of Perceived Responsibility and Self-Blame in Type 2 Diabetes: Reflections of Physicians and Patients

“…Selfblame is not a new concept in chronic disease management. [51][52][53][54][55][56][57] Self-blame may be an unintended consequence of the emphasis on patients' increased involvement in chronic disease management and their accepting greater responsibility for self-care. For patients with chronic conditions other than diabetes, self-blame is associated with poor psychological adjustment, depressive symptoms, and ineffectual coping.…”

“…For patients with chronic conditions other than diabetes, self-blame is associated with poor psychological adjustment, depressive symptoms, and ineffectual coping. 53,[56][57][58] In diabetes, self-blame may result from challenges managing the complex self-care regimen along with the potential for poor treatment outcomes, which can amplify a sense of failure and lead to self-blame. 54,59 In our study, patients described feeling a sense of personal failure when not achieving treatment goals.…”

What causes breast cancer? A systematic review of causal attributions among breast cancer survivors and how these compare to expert-endorsed risk factors

“…Previous studies suggest that these distinct viewpoints may be supported by observations that, for affected women, thinking about the possible causes of one's cancer may be driven by emotional processes as opposed to a logical or rational approach [20]. Some research suggests that breast cancer patients who attributed their cancer to behavioral choices experienced negative emotional states and poorer quality of life [21,22].…”