The effectiveness of a group intervention to facilitate posttraumatic growth among women with breast cancer

Abstract

Objective: This longitudinal study tested the effectiveness of a group intervention designed to facilitate posttraumatic growth (PTG).Methods: Sample consisted of 205 women diagnosed with non-metastatic breast cancer who were either assigned to an intervention group (n = 58) or to a control group (n = 147). PTG, challenge to core beliefs, and rumination (intrusive and deliberate) were assessed at baseline (T1), at 6 months (T2), and at 12 months after baseline (T3). Results:Results from the Latent Growth Modeling suggested that participants from the intervention group have higher levels of PTG. The challenge to core beliefs and the intrusive rumination have a moderator role on PTG, since group intervention is also linked to the enhancement of both variables.Conclusions: Participation in the intervention group increase PTG. Challenge to core beliefs and intrusive rumination are improved by group intervention, which to a certain extent facilitate PTG. KEYWORDSbreast cancer, cancer, challenge to core beliefs, group intervention, oncology, posttraumatic growth, rumination 1 | BACKGROUND Breast cancer is the most prevalent cancer among women, 1 and it is recognized as a stressful life event as it is considered a threat to one 0 s life and well-being. Several negative psychological reactions such as anxiety, depression, helplessness, hopelessness, and symptoms of posttraumatic stress disorder (PTSD) 2 may arise during the disease process.Despite the fact that these features have been well documented in the literature, a growing body of evidence suggests that adverse life circumstances such as cancer can also encourage positive outcomes. 3 The perceived positive changes resulting from personal coping efforts with traumatic events are described as PTG. 4,5 Research confirmed that women with a diagnosis of breast cancer reported personal growth in the aftermath of a life-threatening cancer experience. In addition, PTG has been consistently documented within 5 years of a breast cancer diagnosis. 3,6,7 In fact, it is the seismic nature and perceived stressfulness of the event that threat the individual 0 s core belief system, which in turn sets in motion the restructuring of one 0 s life. 8 Core beliefs are the "general set of beliefs a person has about the universe, how it works, and the individual 0 s place in it" 9(p16) . In the aftermath of a stressful event, core beliefs might be challenged, and the previous foundations of a person 0 s assumptive world become unstable, uncontrollable, and unpredictable. 9 In order to manage distress (also created by challenge to core beliefs) and reappraise the pretrauma cognitive schemas, the survivor initiates various cognitive mechanisms such as using coping strategies, seeking social support, and engaging in cognitive processing (intrusive and deliberate thinking), in an attempt to give meaning to the stressful experience. 10,11 Cognitive processing, and more specifically rumination, is a crucial process of the posttrauma individual adaptation. 12 Rumination encompasses 2 ...

Posttraumatic growth and predictor variables in Brazilian women with breast cancer

“…The second one is that only the total score of rumination was evaluated, and not different forms of rumination. Studies that have shown correlation between this variable and PTG (15,29) included the differences of types of rumination and ways of doing so in relation to PTG. Therefore, the evaluation of different types and individual ways of rumination must be evaluated in order to verify if any of those would be found to be explanatory for this model in this sample.…”

“…Later, other studies pursued the establishment of variables that were correlated to a greater PTG score and that explained this model (9,(12)(13)(14) . Different authors concluded that rumination, social support, the use of adaptive coping strategies and the perception of the experienced situation as actually stressing have proven to be major predictors of a greater PTG (11,14,15) .…”

Rumination and social support as predictors of posttraumatic growth in women with breast cancer: a systematic review

“…From the analyzed studies, five opted to use cultural adaptions of the original PTGI (24)(25)(26)(27)(28) . Only in the studies of Chan et al (25) e Tomita et al (28) the adapted instruments went through alterations in the amount of items and factors.…”

“…Three articles evaluated and analyzed rumination in their samples. In two studies this variable was included in the main objective (25,33) , and in one it was used as a benchmark variable of differences between compared groups (27) .…”

“…However, there are differences in the types of rumination. Ramos et al (27) point out that only deliberate rumination showed correlation with PTG. On the study of Soo and Sherman (33) , however, the factors Intrusion, Instrumentality e Brooding correlated to different factors of PTGI, while the subscale instrumental rumination correlated with all five factors of PTGI.…”