Missing Myself: The Role of Rumination in the Associations Between Physical Appearance Discrepancy and PTSD/Depressive Symptoms in Postoperative Women with Breast Cancer

• Main Authors: Li-Chi Yang, 楊立琪
• Other Authors: 陳淑惠
• Format: Others
• Language: zh-TW
• Published: 2019
• Online Access: http://ndltd.ncl.edu.tw/handle/nbb6d3

碩士 === 國立臺灣大學 === 心理學研究所 === 107 === OBJECTIVE: This study aimed to first examine whether perceiving the discrepancy between pre-surgery and current physical appearance (D_PACA) and discrepancy between ideal physical appearance and current physical appearance (D_IACA) could predict the severity of depressive symptoms and posttraumatic stress symptoms (PTSS) in the women with breast cancer (BC) who have undergone BC surgery. Second, viewing rumination as a cognitive vulnerability factor, this study also explored whether those patients adopt maladaptive cognitive strategy to cope with the perceived discrepancy may develop subsequent psychological symptoms. In addition, the current study explored whether intrusion symptoms played an important role in triggering other types of PTSS. By integrating the examinations of the physical appearance discrepancy, rumination, intrusion, and other types of PTSS, this study expected to propose a pathological model of PTSS in postoperative women with BC. Last, the study examined postoperative women with BC in different ages to seek whether age may affect the association of physical appearance and severity of psychological symptoms. METHODS: A total of 265 postoperative women with BC were recruited from the Breast Surgery Clinic of NTUH and Foundation of Breast Cancer Prevention, with average age 54.15±10.95 years. Measures included physical appearance evaluation inventory, Chinese Ruination Style Questionnaire-Short Form (CRSQ-SF), Breif Symptom Inventory (BSI)-Depression Subscale, and Post-Traumatic Stress Reaction Index-Short Form (PTSRI-SF). RESULTS: (1) The D_PACA, as well as the D_IACA, could significantly predict the severity of depressive symptoms and PTSS. (2) Rumination could respectively mediate the predictive effects of the D_PACA and D_IACA on the severity of depressive symptoms and PTSS. (3) Rumination and intrusions could serially mediate the predictive effects of the D_PACA and D_IACA on the severity of avoidance, negative alterations in cognitions and mood, and alterations in arousal and reactivity, respectively. (4) The younger group of postoperative women with BC showed a greater severity of rumination and PTSS; however, there was no significant difference in physical appearance score between different age groups. DISCCUSION: Perceiving the D_PACA as well as the D_IACA in the postoperative BC women may affect the patient’s negative psychological adaptation to depressive symptoms and PTSS, while rumination was confirmed as a cognitive vulnerability factor in cognitive coping process. In addition, intrusions could be seen as an important core symptom of PTSS, and might lead to other PTSS in postoperative BC women upon perceiving the physical appearance discrepancy. Furthermore, younger postoperative BC women were also found to have poorer psychological adjustment. Based on the above findings, future research and clinical implications are suggested.