Depression and sexual adjustment following breast cancer in low‐income Hispanic and non‐Hispanic White women

Abstract

Objective-Hispanics are the largest and fastest growing ethnic minority group in the United States and breast cancer is the most commonly diagnosed cancer in Hispanic women. However, Hispanics are underrepresented in the psychosocial breast cancer literature.Methods-This study included 677 low-income women (425 Hispanic, 252 non-Hispanic White) enrolled in the Medi-Cal Breast and Cervical Cancer Treatment Program. Data were gathered through phone interviews conducted in English or Spanish 6 and 18 months following breast cancer diagnosis. We focus on three variables that the literature indicates are salient for breast cancer survivors, sexual function, body image and depression.Results-Results of an ANCOVA indicated worse sexual function for Hispanic women, even after controlling for significant covariates. Hispanics reported significantly less sexual desire, greater difficulty relaxing and enjoying sex, and greater difficulty becoming sexually aroused and having orgasms than non-Hispanic White women. Both Hispanic and non-Hispanic White women endorsed a lack of sexual desire more frequently than problems with sexual function. Body image did not differ between Hispanic and non-Hispanic White women. 38% of Hispanic and 48% of non-Hispanic White women scored above cut-off scores for depressive symptoms. While there was no ethnic difference in depressive symptoms, single women reported more depressive symptoms than partnered women.Conclusions-Findings suggest that low-income breast cancer survivors may experience symptoms of depression more than a year following diagnosis, and that sexual dysfunction may be particularly salient for low-income Hispanic women. KeywordsBreast cancer; Oncology; Hispanic Americans; Poverty; Depression; Psychosexual Dysfunctions Over a billion dollars have been spent researching the psychosocial impact of breast cancer [1]. This extensive body of research indicates that despite initial distress following diagnosis, the majority of women report good overall adjustment following breast cancer treatment [1,2]. Nonetheless, there are areas of ongoing difficulty, with many women reporting negative changes in body image and sexual function [3][4][5]. An important shortcoming in this research is that the majority of the studies are based on middle to upper- NIH Public Access Author ManuscriptPsychooncology. Author manuscript; available in PMC 2011 October 1. sample makes it possible to examine ethnic differences in adjustment while holding income constant. In addition, the longitudinal design of the parent study allowed us to examine aspects of adjustment that are more proximal to treatment such as body image, as well as potentially longer lasting aspects such as depression and sexual function.Consistent with prior literature, we hypothesized that surgery type would be associated with body image, such that women who underwent a mastectomy would report poorer body image than women who received breast conserving surgery. Additionally, we predicted that this association would be moderated...

Psychological Adjustment in Breast Cancer Survivors

“…It also is possible that the most distressed women are more likely to decline participation in research, leading to underestimates of prevalence of distress and life disruption. Furthermore, there is evidence that groups with particular characteristics, such as low-income and Latina women (e.g., Christie et al 2010 ;Yanez et al 2011 ), experience relatively high distress and low quality of life. Next, we address specifi c domains of adjustment, with a focus on depression and anxiety, as well as the factors that confer risk for or protection from negative outcomes.…”

Self-Image and Sexuality Issues among Young Women with Breast Cancer: Practical Recommendations

“…Overall, evidence indicates that women across ethnicities report similar self-image concerns related to their breast cancer treatment [36][37][38] . However, studies also reveal some distinct variations, with Hispanic/ Latina women more likely than non-Hispanic/Latina women to report difficulties one year post-treatment with sexual desire, relaxing and enjoying sex, and becoming sexually aroused and having orgasms 36 .…”

“…However, studies also reveal some distinct variations, with Hispanic/ Latina women more likely than non-Hispanic/Latina women to report difficulties one year post-treatment with sexual desire, relaxing and enjoying sex, and becoming sexually aroused and having orgasms 36 . There are traditional and spiritual values present in the Hispanic/Latino culture around gender roles and sexuality that may be influencing these differences.…”

Social support as a determinant of health-related quality of life in breast cancer survivors in California.

“…Studies among Hispanic populations suggest that family support is an important stress alleviator in women with breast cancer especially among Latinas with low income (210,216). In addition marital status is an important predictor for psycho-social stress in Latinas with breast cancer (216).…”

“…In addition marital status is an important predictor for psycho-social stress in Latinas with breast cancer (216). A comparison between women newly diagnosed with breast cancer and those who had recurrence of the disease showed that being married was associated with better emotional well-being among women in both groups (221).…”