Testing reciprocal relationships between coping and post-traumatic growth among breast cancer patients: a cross-lagged structural equation study of approach, emotional, and disengage coping. (#515)
Aims
Studies has addressed the role of post-traumatic growth (PTG) as an outcome of adaptive coping according to the PTG models of Schaefer and Moos (1992) and Tedeschi and Calhoun (2004). However, Zoellner and Maercker (2006) argued that PTG might function as positive illusion or self-enhancing appraisal (Taylor, 1983). This argument implicates that PTG could predict the use of coping strategies. Moreover, according to Aspinwall (2001)’s upward spiral and downward spiral, PTG and different types of coping could have bidirectional associations. Little research has examined the latter two temporal relationships. The current study, adopting a longitudinal design, aims to explore the directional (i.e., temporal) relation between different types of coping and PTG among newly-diagnosed breast cancer patients.
Methods
A longitudinal study was conducted with 113 breast cancer patients at the third month after the cancer surgery (T1) and the sixth month after the surgery (T2). The Chinese version of the brief COPE (Carver, 1997) and the Post Traumatic Growth Inventory (PTGI) were assessed at both T1 and T2.
An autoregressive cross-lagged modeling strategy was applied to examine whether initial coping styles predicts subsequent PTG above and beyond PTG stability, or vice versa. Three models indicating three types of coping (approach, emotional, disengaged) were tested to examine whether different coping styles show different directions.
Results
Three models all fit the data adequately (χ2/df=1.90, 1.27, 2.37; CFI=.99, .96, 97; RMSEA=.064, .091, .092; for approach, emotional, disengaged coping respectively). Approach coping and PTG showed bidirectional associations (β=0.39, 0.32; p<.05) and emotional coping predicted later PTG (β=0.22, p<.05). Other cross-lagged relations were not significant.
Conclusions
The results indicate that different coping styles show different temporal relationships with PTG. Approach coping and PTG showed upward spiral relations (Aspinwall, 2001). Emotional coping facilitates PTG, a finding consistent with the notion of Tedeschi and Calhoun (2004)’s model.
- Tedeschi, R. G., & Calhoun, L. G. (2004b). Post-traumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry, 15, 1−18.
- Schaefer, J. A., & Moos, R. H. (1992). Life crises and personal growth. In B. N. Carpenter (Ed.), Personal coping: Theory, research and application (pp. 149−170). Westport, CT: Praeger.
- Zoellner, T., & Maercker, A. (2006). Posttraumatic growth in clinical psychology: A critical review and introduction of a two component model. Clinical Psychology Review, 26, 626-653.
- Aspinwall, L. G. 2001 Dealing with adversity: self-regulation, coping, adaptation, and health. In The Blackwell handbook of social psychology, vol 1. (Intraindividual processes) (ed. A. Tesser & N. Schwarz), pp. 591–614. Malden, MA: Blackwell.