This application proposes to conduct secondary data analyses to capitalize on a unique opportunity to expand existing knowledge of positive psychological adaptation, specifically posttraumatic growth (PTG), in female breast cancer survivors. We propose to use of a large, existing, longitudinal dataset of female breast cancer survivors (N=653) followed at up to five time points over 18 months (up to 24 months post-diagnosis). PTG is a multidimensional construct defined as one's perception of "positive psychological change experienced as a result of the struggle with highly challenging life circumstances."1,2 Since the Posttraumatic Growth Inventory (PTGI) was introduced in 1996, it has been widely used to study PTG and is the most frequently used measure of positive psychological change in cancer patients. The proposed analyses will allow us to examine some important, unanswered questions about PTG and the PTGI. Previous research on PTG indicates that cancer survivors often report some level of PTG following diagnosis. The research on PTG also points to the potential relationships with long-term psychological and physical health, but has been predominantly cross-sectional in nature and has not sufficiently explored potential outcomes associated with PTG. The primary purpose of the original study was to examine mechanisms that may explain age differences in the health-related quality of life (with a particular emphasis on psychological morbidity) of women who have been diagnosed with a first-time breast cancer. Newly diagnosed cancer survivors across two sites completed measures of PTG, cancer- specific and general quality of life (QOL), depression, spirituality, coping, illness intrusiveness, optimism, and positive and negative social support at baseline, 3, 6, 12, and 18 months post diagnosis. Sociodemographic variables and extensive medical/treatment variables were collected as well. Preliminary results suggest that the women in this dataset experienced PTG and it increased over time.
Aims of this study are: (1) to increase understanding of the meaning and significance of specific PTGI scores in relation to mental and physical health;(2) to identify predictors of PTG over time;and (3) to identify and examine common PTG trajectories and their predictors as well as relationships between common trajectories and mental and physical health outcomes. No prior study has examined common PTG trajectories in a cancer survivor sample. The proposed analyses will allow us to better understand the timing, patterns, and clinical significance of PTG in breast cancer survivors.

Public Health Relevance

The goal of this study is to examine osttraumatic growth (PTG) in breast cancer survivors using an existing longitudinal dataset (N=653). PTG is a multidimensional construct defined as "positive psychological change experienced as a result of the struggle with highly challenging life circumstances" and is commonly reported by cancer survivors, even in the midst of significant physical and emotional stressors. Given the increasing number of breast cancer survivors and the need to better understand their needs, we will examine trajectories of PTG and their predictors and whether PTG self-reported is associated with better mental and physical health.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Small Research Grants (R03)
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Special Emphasis Panel (ZCA1-SRLB-Y (O3))
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Alfano, Catherine M
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Wake Forest University Health Sciences
Internal Medicine/Medicine
Schools of Medicine
United States
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