Attachment and wellbeing in women undergoing breast cancer treatment
Abstract
This study investigates the contribution of the attachment to the wellbeing of patients during breast cancer treatment with the aim to provide evidence on how to enhance coping with cancer and its related difficulties. The sample consisted of 58 women who were about to begin radiotherapy for breast cancer. They completed questionnaires about: symptoms and dysfunctions related to disease and treatment, positive and negative affect, emotional wellbeing, daily hassles, and adult attachment. A regression analysis revealed that the component Fear of rejection and abandonment of attachment, the presence of daily hassles ―mainly economic―, and physical symptoms predict the degree of wellbeing. The other two components of attachment (Desire for closeness and Preference for independence) show no significant relationships, and contrary to expectations, the loss of functional capacity does not predict a decrease in wellbeing. We discuss the differential weight of medical and psychosocial variables on health-related quality of life. Results emphasize the importance of interventions aimed at improving emotional state through improved relationships during cancer treatments.Downloads
References
Ando, N., Iwamitsu, Y., Kuranami, M., Okazaki, S., Nakatani, Y., Yamamoto, K., Watanabe, M. y Miyaoka, H. (2011). Predictors of psychosocial distress after diagnosis in breast cancer patientes and patients with benign breast problems. Psychosomatics, 52(1), 56-64.
Ato, M., López, J.J. y Benavente, A. (2013). Un sistema de clasificación de los diseños de investigación en psicología. Anales de Psicología, 29(3), 1038-1059.
Badía, X., Gutiérrez, F., Wiklund, I. y Alonso, J. (1996). Validity and reliability of the Spanish Psychological General Well-Being Index. Quality of Life Research, 5, 101-108.
Badr, H., Basen-Engquist, K., Taylor, C.L.C. y de Moor, C. (2006). Mood states associated with transitory physical symptoms among breast and ovarian cancer survivors. Journal of Behavioral Medicine, 29, 461-475.
Baldwin, M.W., Keelan, J.P.R., Fehr, B., Enns, V. y Koh-Rangarajoo, E. (1996). Social-cognitive conceptualization of attachment working models: Availability and accessibility effects. Journal of Personality and Social Psychology, 71, 94-109.
Bartholomew, K. y Horowitz, L.M. (1991). Attachment styles among young adults: a test of a four-category model. Journal of Personality and Social Psychology, 61(2), 226-44.
Bazzazian, S. y Besharat, M.A. (2012). An explanatory model of adjustment to type I diabetes based on attachment, coping, and self-regulation theories. Psychology, Health & Medicine, 17(1), 47-58.
Bowlby, J. (1988). A secure base: Parent-child attachment and healthy human development. New York: Basic.
Cerezo, M.V., Ortiz-Tallo, M. y Cardenal, V. (2009). Expresión de emociones y bienestar en un grupo de mujeres con cáncer de mama: una intervención psicológica. Revista Latinoamericana de Psicología, 41(1), 131-140.
Chida, Y., Hamer, M., Wardle, J. y Steptoe, A. (2008). Do stress-related psychosocial factors contribute to cancer incidence and survival? Nature Clinical Practice Oncology, 5, 466-475.
Cicero, V., Lo Coco, G., Gullo, S. y Lo Verso, G. (2009). The role of attachment dimensions and perceived social support in predicting adjustment to cancer. Psycho-Oncology, 18(10), 1045-1052.
Collins, N.L. y Read, S.J. (1994). Cognitive representations of attachment: The structure and function of working models. En K. Bartholomew y D. Perlman (Eds.), Advances in personal relationships (Vol. 5, pp. 53-90). London: Kingsley.
Duijts, S.F.A., Zeegers, M.P.A. y Borne, B.V. (2003). The association between stressful life events and breast cancer risk: a meta-analysis. International Journal of Cancer, 107, 1023-1029.
Dupuy, H.J. (1984). The psychological general well-being (PGWB) index. En N.K. Wegner, M.E. Mattson y C.P. Fuberg (Eds.), Assessment of quality of life in clinical trials of cardiovascular therapies (pp. 170-183). New York: Le Jacq.
Ezama, E., Alonso, Y. y Fontanil, Y. (2010). Pacientes, síntomas, trastornos, organicidad y psicopatología. International Journal of Psychology and Psychological Therapy, 10(2), 293-314.
Fillion, L., Kohn, P., Gagnon, P., Van Wijka, M. y Cunningham A. (2001). The inventory of recent life experiences for cancer patients (IRLE-C): A decontaminated measure of cancer-based hassles. Psyhology and Health, 16(4), 443-459.
Fontanil, Y. Ezama, E. y Alonso, Y. (2013). Validation of the scale of preferences and expectations in close interpersonal relationships (EPERIC). Psicothema, 25(2), 275-281.
Gould, J. (2011). Attachment theory and psychotherapy integration: An introduction and review of the literature. Journal of Psychotherapy Integration, 21(3), 221-231.
Grossmann, K.E., Grossmann, K. y Waters, E. (2005). Attachment from Infancy to Adulthood. New York: Guilford Press.
Hall, D.L., Armstrong, J., Cabral, N. y Kim, Y. (2012). Individual and dyadic effects of adult attachment on quality of life among colorectal cancer care recipients and their caregivers. Psycho-Oncology, 21(supl. I), 67.
Havighurst, R.J. (1972). Developmental task and education. New York: David Mc Kay.
Hernández, M., Cruzado, J.A., Prado, M.C., Rodríguez, E., Hernández, C., González, M.A. y Martín, J.C. (2012). Salud mental y malestar emocional en pacientes con cáncer. Psicooncología, 9(2-3), 299-316.
Hunter, M.J., Davis, P.J. y Tunstall, J.R. (2006). The influence of attachment and emotional support in end-stage cancer. Psycho-Oncology, 15, 431-444.
Huntsinger, E.T. y Luecken, L.J. (2004). Attachment relationships and health behavior: The mediational role of self-esteem. Psychology y Health, 19(4), 515-26.
Kim, Y, Carver, C.S., Deci, E.L. y Kasser, T. (2008). Adult attachment and psychological well-being in cancer caregivers: The mediational role of spouses' motives for caregiving. Health Psychology, 27, 144-154.
Kohn, P.M. y Macdonald, J.E. (1992). The survey of recent life experiences: A decontamitated hassles scale for adults. Journal of Behavioral Medicine, 15(2), 221-236.
Lo, C., Lin, J., Gagliese, L., Zimmermann, C., Mikulincer, M. y Rodin, G. (2010). Age and depression in patients with metastatic cancer: The protective effects of attachment security and spiritual wellbeing. Ageing y Society, 30, 325-336.
Lo, C., Walsh, A., Mikulincer, M., Gagliese, L., Zimmermann C. y Rodin, G. (2009). Measuring attachment security in patients with advanced cancer: Psychometric properties of a modified and brief Experiences in Close Relationships scale. Psycho-Oncology, 18, 490-499.
Maunder, R.G. y Hunter, J.J. (2008). Attachment relationships as determinants of physical health. Journal of the American Academy of Psychoanalysis y Dynamic Psychiatry, 36, 11-32.
McWilliams, L.A. y Bailey, S.J. (2010). Associations between adult attachment ratings and health conditions: Evidence from the National Comorbidity Survey Replication. Health Psychology, 29(4), 446-453.
Mikulincer, M. y Shaver, P.R. (2007). Attachment in adulthood: Dynamics, structure, and change. New York: Guilford.
Porter, L.S., Keefe, F.J., Davis, D., Rumble, M. Scipio, C. y Garst, J. (2012). Attachment styles in patients with lung cancer and their spouses: Associations with patient and spouse adjustment. Supportive Care in Cancer, 20(10), 2459-2466.
Sánchez-Cánovas, J. (1994). El bienestar psicológico subjetivo. Escalas de evaluación. Boletín de Psicología, 43, 23-45.
Sandín, B., Chorot, P., Lostao, L., Joiner, T.E., Santed, M.A. y Valiente, R.M. (1999). Escalas PANAS de afecto positivo y negativo: validación factorial y convergencia transcultural. Psicothema, 11(19), 37-51.
Sandín, B., Chorot, P. y Santed, M.A. (1999). Escala SRLE de Kohn-Macdonald 1992. En B. Sandín (Ed.), El estrés psicosocial: Conceptos y consecuencias clínicas. Madrid: UNED-FUE.
Schmidt, S., Blank, T. Bellizzi, K. y Park, C. (2012). The relationship of coping strategies, social support, and attachment style with posttraumatic growth in cancer survivors. Journal of Health Psychology, 17, 1033-1040.
Snyder, C.F., Garrett-Mayer, E., Brahmer, J.R., Carducci, M.A., Pili, R., Stearns, V., Wolff, A.C., Dy, S.M. y Wu, A.W. (2008). Symptoms, supportive care needs, and function in cancer patients: How are they related? Quality of Life Research, 17, 665-677.
Tan, A., Zimmermann, C. y Rodin, G. (2005). Interpersonal processes in palliative care: An attachment perspective on the patient-clinician relationship. Palliative Medicine, 19, 143-150.
Toledo, M., Barreto, M.P., Pascual, A. y Ferrero, J. (1993). Adaptación del Cuestionario de Calidad de Vida de la E.O.R.T.C. para cáncer de mama. Revista de Psicología de la Salud, 5(2), 29-45.
Wallin, D.J. (2007). Attachment in psychotherapy. New York: Guilford Press.
Watson, D., Clarck, L.A. y Tellengen, A. (1998). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54, 1063-1070.
The works published in this journal are subject to the following terms:
1. The Publications Service of the University of Murcia (the publisher) retains the property rights (copyright) of published works, and encourages and enables the reuse of the same under the license specified in paragraph 2.
© Servicio de Publicaciones, Universidad de Murcia, 2022
2. The works are published in the online edition of the journal under a Creative Commons Reconocimiento-CompartirIgual 4.0 (legal text). You can copy, use, distribute, transmit and publicly display, provided that: i) you cite the author and the original source of publication (journal, editorial and URL of the work), ii) are not used for commercial purposes, iii ) mentions the existence and specifications of this license.
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
3. Conditions of self-archiving. Is allowed and encouraged the authors to disseminate electronically pre-print versions (version before being evaluated and sent to the journal) and / or post-print (version reviewed and accepted for publication) of their works before publication, as it encourages its earliest circulation and diffusion and thus a possible increase in its citation and scope between the academic community. RoMEO Color: Green.