The Mediating Role of Avoidant Coping in the Relationships between Physical, Psychological, and Social Wellbeing and Distress in Breast Cancer Survivors
Open accessAbstract
Objective: Many breast cancer survivors (BCSs) recover from the negative sequelae of cancer treatment. However, some report persistent and disruptive distress well into disease‐free survivorship. More information is needed on the predictors of distress in this growing population of BCS, including the role of avoidant coping, or attempts to avoid thoughts, feelings, and reminders of cancer, in mediating the relationship between distress and psychological, physical, and social domains of well‐being. Methods: In a large cross‐sectional study, BCS ( n = 1,127), who were 3 to 8 years post‐diagnosis, completed a survey assessing demographic characteristics, medical history, distress (anxiety and depressive symptoms), avoidant coping, and physical (fatigue), psychological (fear of recurrence, attention, body image), and social (social support from a partner, social constraints from a partner) well‐being. Multiple mediation analyses were conducted to determine if avoidant coping mediated the relationship between each distress variable (anxiety and depressive symptoms) and each well‐being (fear of recurrence, attention, body image, fatigue, social support, and social constraints) variable. Results: In all six mediation models, avoidant coping significantly ( p < 0 . 001) mediated the relationship between each well‐being variable (fear of recurrence, attention, body image, fatigue, social support, and social constraints) and each distress indicator (depression and anxiety). Avoidant coping mediated 19%–54% of the effects of the contributing factors on the distress variables. Conclusions: Avoidant coping may indicate risk for, or presence of, distress among BCS. Interventions to reduce distress may benefit from addressing avoidant coping styles.
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The adoption of passive or avoidant coping strategies has a negative impact on breast cancer survivors' quality of life, influencing psychological distress and depression.
“Other studies showed that the adoption of passive or avoidant coping strategies could have a negative impact on breast cancer survivors’ quality of life [62,63] influencing psychological distress [64,65], and depression [66].”
From The Role of Emotion-Related Abilities in the Quality of Life of Breast Cancer Survivors: A Systematic Review (2022) · cites this paper as [64]
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BackgroundMethodInfluential
- Authors
- Cohee, A., Johns, S. A., Alwine, J. S., Talib, T., Monahan, P. O., Stump, T. E., Cella, D., & Champion, V. L.
- Affiliations
- Indiana University Indianapolis (US)
- Regenstrief Institute (US)
- Northwestern University (US)
- Corresponding author
- Cohee, Andrea
- ORCID
- Venue
- Psycho-Oncology
- Publisher
- Wiley
- Published
- 2021-03-31
- Volume
- 30
- Issue
- 7
- Pages
- 1129-1136
- ISSN
- 1057-9249 (ISSN-L)
- 1099-1611
- PMC
- PMC8411351
- OpenAlex
- W3137746355
- Semantic Scholar
- 8585d8be4cdad37195d8aeef981a9aa5c102cdb5
- Cited by
- 39
- References
- 36
- Citations by year
- 2026: 10 · 2025: 9 · 2024: 8 · 2023: 6 · 2022: 6
- FWCI
- 1.82
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psycho-Oncology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- IUScholarWorks (Indiana University) (submittedVersion)
- Funders
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Keywords
- breast cancer survivors, avoidance coping, psychological distress, anxiety, depression, fear of recurrence, body image, fatigue, social support, social constraints, mediation, well-being
- MeSH terms
- Cancer Survivors, Adaptation, Psychological, Breast Neoplasms, Cross-Sectional Studies, Depression, Female, Humans, Neoplasm Recurrence, Local, Stress, Psychological
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