Mixed Psychological Changes Following Mastectomy: Unique Predictors and Heterogeneity of Post-traumatic Growth and Post-traumatic Depreciation

Objectives: Post-traumatic growth (PTG) is a promising construct, however it fails to include the full range of experiences and feelings, i.e. the negative, as well as the positive, life changes (the so-called post-traumatic depreciation; PTD). In the absence of studies on PTG and PTD in cancer patients, we investigated (1) coping strategies and support effectiveness as predictors of PTG and PTD in post-mastectomy women, (2) homogeneous classes with different intensity of PTG and PTD symptoms, and (3) correlates of class membership. Methods: Coping strategies (Brief COPE), support effectiveness (SSE-Q), PTG (PTGI), and PTD (negatively reworded items of PTGI) were measured in 84 post-mastectomy women (mean age = 62.27, SD = 8.38). Multiple regression, two-step cluster, and multinomial logistic regression were applied. Results: PTG and PTD had unique predictors: time since diagnosis and positive emotion-focused coping predicted PTG (R2=.24), while negative emotion-focused and avoidance-focused coping and low support effectiveness were linked to PTD (R2=.14). Four groups of PTG × PTD symptoms were identified: PTG (52.4%), No perceived change (17.9%), Mixed perceived change (15.5%), and PTD (14.3%). Higher emotion- and avoidance-focused coping was characteristic for the PTD group (R2=.41). Conclusions: Our findings shed light on the coexistence and unique predictors of PTG and PTD after mastectomy, indicating heterogeneity in PTG and PTD levels among post-mastectomy women.