Identification of posttraumatic growth trajectories in the first year after breast cancer surgery

Psychooncology. 2014 Dec;23(12):1399-405. doi: 10.1002/pon.3577. Epub 2014 May 16.

Abstract

Background: Empirical studies of the relationship between posttraumatic growth (PTG) and adjustment outcomes reveal a fairly inconclusive picture. We argue that the inconsistent findings are likely due to the heterogeneity of the PTG experience over time. In this regard, we predicted that individuals with different PTG trajectories vary in the level of adjustment and the correlational patterns between PTG and adjustment.

Methods: Participants were 124 Taiwanese women who underwent surgery for breast cancer. Measures of PTG and adjustment variables, including positive affect, negative affect, mental and physical quality of life, anxiety, and depression, were assessed at 1 day and 3, 6, and 12 months after surgery. A group-based trajectory model was used to identify subpopulations of individuals who shared homogenous growth patterns. Then, we determined whether the trajectory predicted adjustment at 12 months after surgery. The correlations between PTG and adjustment outcomes were computed in each subpopulation across every time point.

Results: The patients were categorized into the following four groups, which showed very different patterns of PTG change over the first year after breast cancer surgery: stable high (27.4%), high decreasing (39.4%), low increasing (16.9%), and low decreasing (16.9%). Differences in the level of adjustment at 12 months and the patterns of the correlations across time were found among these latent subgroups

Conclusions: This study was the first longitudinal examination of PTG trajectories and their different levels of adjustment. The findings support our argument that identifying distinct PTG trajectories can better determine the nature of the relationship between PTG and adjustment.

Keywords: breast cancer; group-based trajectory modeling; oncology; posttraumatic growth; psychological adjustment; trajectory.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Affect
  • Aged
  • Anxiety / psychology*
  • Breast Neoplasms / psychology*
  • Breast Neoplasms / surgery
  • Cohort Studies
  • Depression / psychology*
  • Female
  • Health Status*
  • Humans
  • Longitudinal Studies
  • Mastectomy / psychology*
  • Middle Aged
  • Prospective Studies
  • Quality of Life / psychology*
  • Taiwan