Post-traumatic growth in breast cancer: how and when do distress and stress contribute?

Objective. While several theoretical models provide explanation for the genesis and development of post traumatic growth (PTG) in the aftermath of stressful events, empirical evidence regarding the predictors and consequences of PTG in breast cancer patients in active treatment and early survivorship is inconclusive. This study, therefore, examines the role of distress and stress, as predictors and outcomes of post-traumatic growth in women with breast cancer over an 18-month period.

Methods. These effects are tested in two structural equation models that track pathways of PTG in a sample of 253 recently diagnosed women. Questionnaires were completed at diagnosis and at 4 follow up time points assessing cancer-specific stress (IES), global stress (PSS), depression and anxiety (HADS). Post-traumatic growth (SLQ -38) was assessed at follow up time points.

Results. Cancer-specific stress was related to higher PTG concurrently and longitudinally. Anxiety was related concurrently to higher PTG but overall general distress had minimal impact on post-traumatic growth. Global stress was inversely related to PTG. Positive growth at six months was associated with subsequent reduction in stress.

Conclusions. This study showing that early stage higher cancer-specific stress and anxiety were related to positive growth supports the idea that struggle with a challenging illness may be instrumental in facilitating PTG and findings show positive implications of PTG for subsequent adjustment.