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      The Traumatic Experience of Breast Cancer: Which Factors Can Relate to the Post-traumatic Outcomes?

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          Abstract

          Background: Post-traumatic growth (PTG) is considered a positive outcome of struggling with a traumatic event, distinct, and opposite from negative outcomes, i.e., psychological distress. The present study aimed to shed light on the relationship between potentially relating factors (i.e., coping strategies, perceived social support, and attachment style) and both positive and negative psychological outcomes.

          Methods: A total of 123 breast cancer survivors were recruited, who completed a battery of self-report questionnaires, assessing PTG, psychological distress, coping strategies, perceived social support, and attachment style. Three regression analyses were run to evaluate whether relating factors were significant predictors of the positive and negative psychological outcomes.

          Results: The regression analyses showed that the “Fatalism” coping strategy and perceived social support were two significant predictors of PTG. Instead, the “Helpless-Hopeless” and “Anxious Preoccupation” coping strategies, as well as an insecure attachment style, were significant predictors of depression, while the “Anxious Preoccupation” coping strategy and an insecure attachment style were significant predictors of anxiety.

          Conclusions: The present findings showed that the factors underlying a positive or negative outcome are different and specific. While perceived social support and a fatalistic attitude seem to play a key role in the positive outcome, dysfunctional coping strategies, together with an insecure attachment style, appear to be related with negative psychological outcome. Considering these factors in clinical practice would help patients to give meaning to their traumatic experience, enhancing psychological growth.

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          Most cited references41

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          Dynamics of a stressful encounter: cognitive appraisal, coping, and encounter outcomes.

          Despite the importance that is attributed to coping as a factor in psychological and somatic health outcomes, little is known about actual coping processes, the variables that influence them, and their relation to the outcomes of the stressful encounters people experience in their day-to-day lives. This study uses an intraindividual analysis of the interrelations among primary appraisal (what was at stake in the encounter), secondary appraisal (coping options), eight forms of problem- and emotion-focused coping, and encounter outcomes in a sample of community-residing adults. Coping was strongly related to cognitive appraisal; the forms of coping that were used varied depending on what was at stake and the options for coping. Coping was also differentially related to satisfactory and unsatisfactory encounter outcomes. The findings clarify the functional relations among appraisal and coping variables and the outcomes of stressful encounters.
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            Positive change following trauma and adversity: a review.

            Empirical studies (n = 39) that documented positive change following trauma and adversity (e.g., posttraumatic growth, stress-related growth, perceived benefit, thriving; collectively described as adversarial growth) were reviewed. The review indicated that cognitive appraisal variables (threat, harm, and controllability), problem-focused, acceptance and positive reinterpretation coping, optimism, religion, cognitive processing, and positive affect were consistently associated with adversarial growth. The review revealed inconsistent associations between adversarial growth, sociodemographic variables (gender, age, education, and income), and psychological distress variables (e.g., depression, anxiety, posttraumatic stress disorder). However, the evidence showed that people who reported and maintained adversarial growth over time were less distressed subsequently. Methodological limitations and recommended future directions in adversarial growth research are discussed, and the implications of adversarial growth for clinical practice are briefly considered.
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              Attachment styles among young adults: a test of a four-category model.

              A new 4-group model of attachment styles in adulthood is proposed. Four prototypic attachment patterns are defined using combinations of a person's self-image (positive or negative) and image of others (positive or negative). In Study 1, an interview was developed to yield continuous and categorical ratings of the 4 attachment styles. Intercorrelations of the attachment ratings were consistent with the proposed model. Attachment ratings were validated by self-report measures of self-concept and interpersonal functioning. Each style was associated with a distinct profile of interpersonal problems, according to both self- and friend-reports. In Study 2, attachment styles within the family of origin and with peers were assessed independently. Results of Study 1 were replicated. The proposed model was shown to be applicable to representations of family relations; Ss' attachment styles with peers were correlated with family attachment ratings.
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                Author and article information

                Contributors
                Journal
                Front Psychol
                Front Psychol
                Front. Psychol.
                Frontiers in Psychology
                Frontiers Media S.A.
                1664-1078
                24 April 2019
                2019
                : 10
                : 891
                Affiliations
                [1] 1Department of Psychology, University of Turin , Turin, Italy
                [2] 2Clinical Psychology Unit, Città della Salute e della Scienza Hospital , Turin, Italy
                [3] 3Department of Neuroscience, University of Turin , Turin, Italy
                Author notes

                Edited by: Gianluca Castelnuovo, Università Cattolica del Sacro Cuore, Italy

                Reviewed by: Jasminka Despot Lučanin, University of Zagreb, Croatia; Claudia Cormio, Istituto Tumori Giovanni Paolo II (IRCCS), Italy

                *Correspondence: Marialaura Di Tella, marialaura.ditella@ 123456unito.it

                These authors have contributed equally to this work

                This article was submitted to Psychology for Clinical Settings, a section of the journal Frontiers in Psychology

                Article
                10.3389/fpsyg.2019.00891
                6491882
                31105621
                eadac8d4-a16e-4ea9-bb5d-b918abe5780b
                Copyright © 2019 Romeo, Di Tella, Ghiggia, Tesio, Gasparetto, Stanizzo, Torta and Castelli.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 13 December 2018
                : 03 April 2019
                Page count
                Figures: 0, Tables: 5, Equations: 0, References: 48, Pages: 9, Words: 0
                Categories
                Psychology
                Original Research

                Clinical Psychology & Psychiatry
                breast cancer survivors,post-traumatic growth,psychological distress,coping strategies,perceived social support,attachment style

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