Posttraumatic Growth, Positive Psychology, Perceived Spousal Support, and Psychological Complications in Head and Neck Cancer: Evaluating Their Association in a Longitudinal Study

Abstract

Despite head and neck cancer (HNC) association with various negative impacts, collective evidence is accumulating regarding the positive impacts of positive psychology on cancer survivors. However, data on how positive psychology is related to the psychological complications of HNC across time are lacking. This longitudinal study examined the trends of positive psychology (e.g., posttraumatic growth [PTG], hope, and optimism), perceived spousal support, and psychological complications (e.g., depression, anxiety, and posttraumatic stress symptoms) and determined the association between them, psychological complications, and PTG across two timelines among a cohort of HNC patients. A total of 175 HNC respondents exhibited an increasing trend of positive psychology and perceived spousal support while reporting a decreasing trend of psychological complications between baseline and follow-up assessments. A greater degree of hope and perceived spousal support contributed to a higher degree of PTG across time. Conversely, a higher severity of anxiety symptoms was associated with a lower degree of PTG over time. Female gender had a moderating effect on the association between severity of anxiety symptoms and PTG, but did not moderate the association between hope, perceived spousal support and PTG. This study indicates the pivotal role of incorporating psychosocial interventions into the treatment regimen to enhance the degree of hope and perceived spousal support and reduce the severity of anxiety symptoms, which, in turn, will facilitate the development of PTG in HNC patients.

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“…More recently, the possibility of transformative positive changes, beyond mere recovery, namely, posttraumatic growth (PTG; Tedeschi and Calhoun, 1995, 2004, following psychological trauma has attracted considerable attention. Similar to other concepts within positive psychology such as hope, optimism, and gratitude, PTG has been recognised as a buffer for the detrimental effects of life adversities (Nik Jaafar et al, 2022;Confino et al, 2023).…”

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“…With the development of positive psychology, many research results showed that significant trauma would not only bring adverse effects to individuals, but also promote them to show positive changes related to growth [ 3 ]. This phenomenon was defined as post-traumatic growth (PTG) by Tedeschi and Calhoun in 1996 [ 4 ].…”

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“…PTG is manifested in five aspects: more meaningful interpersonal relationships, new possibilities, increased sense of personal strength, deeper appreciation for life, and richer understanding of spiritual matters ( 12 ). Previously, numerous studies have demonstrated that individuals who have experienced life-threatening events such as cancer ( 13 ), natural disasters ( 14 ) and major life changes such as divorce ( 15 ) and bereavement ( 16 ) would experience PTG. And PTG encompasses extensive benefits, varying from making meaning of the adversity ( 17 ) and turning wounds into wisdom ( 18 ) to reducing the risk of psychiatric disorders and suicide intention ( 19 , 20 ) and increasing personal development and life satisfaction ( 21 ).…”