This study examined relations between behavioral and characterological self-blame attributions for breast cancer and psychological distress in the year following a diagnosis. One hundred fifteen women with newly diagnosed breast cancer participated. First, we predicted that both forms of self-blame would be associated with distress shortly after diagnosis (i.e., at 4 months). Second, we predicted that only characterological self-blame would be related to distress at 7 and 12 months post-diagnosis because behavioral self-blame would enhance perceptions of control, thereby protecting against distress. Results supported the first hypothesis; both forms of self-blame were related to symptoms of anxiety and depression at 4 months post-diagnosis. Findings did not support the second hypothesis because both forms of self-blame continued to be related to distress at 7 and 12 months post-diagnosis. Furthermore, perceptions of control did not mediate the self-blame/distress relation. Implications for social cognitive processes in adaptation to breast cancer are discussed.
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There were 25 participants who fell into this category, with missing data accounting for 6.0% of all variables. Before data substitution, we compared the group with complete data to the group with missing data. No significant differences emerged between the groups on the constructs of interest (i.e., self-blame, perceptions of control, symptoms of anxiety and depression) or the demographic variables. Where missing data occurred, we transformed the two available raw data scores to z-scores. The average of the two z-scores was used for the third time point, the missing variable. This average z-score was then transformed back to a raw score and substituted for the missing variable. We then compared, across all variables, the group for whom we had complete data and the group for whom we substituted transformed average z-scores. No significant differences emerged.
Participants enrolled in the study shortly after breast cancer diagnoses and were randomly assigned to an immediate intervention or wait list group. However, data (interviews and self-administered questionnaires) were not collected until a set number of women comprised one of the two groups (i.e., intervention or wait list). That is, we did not begin data collection until a woman's randomly assigned group was comprised of 7 other women.
Data transformations were utilized for normality purposes. Squared transformations were calculated for appraisals of control over recovery at Times 1 and 2, and for appraisals of control over recurrence at Time 1. Log transformations were calculated for symptoms of anxiety at Times 1, 2, and 3, and for behavioral and characterological self-blame. Square root transformations were calculated for symptoms of depression at Times 1, 2, and 3. All analyses reported reflect data with these transformations.
REFERENCES
Abramson, L. Y., Seligman, M. E. P., and Teasdale, J. D. (1978). Learned helplessness in humans: Critique and reformulation. J. Abnor. Psychol. 87: 49–74.
Baron, R. M., and Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. J. Pers. Soc. Psychol. 51: 1173–1182.
Beck, A. T., and Steer, R. A. (1990). Beck Anxiety Inventory Manual, Psychological Corporation, San Antonio, TX.
Beck, A. T., Steer, R. A., and Brown, G. K. (1996). Beck Depression Inventory Manual (2nd edn.). The Psychological Corporation, San Antonio, TX.
Cohen, J., and Cohen, P. (1983). Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences (2nd edn.). Lawrence Erlbaum Associates, Hillsdale, NJ.
Compas, B. E., Stoll, M. F., Thomsen, A. H., Oppedisano, G., Epping-Jordan, J. E., and Krag, D. N. (1999). Adjustment to breast cancer: Age-related differences in coping and emotional distress. Breast Can. Res. Treat. 54: 199–203.
Glinder, J., Beckjord, E., Langrock, A., and Compas, B. E. (2004). Perceived Control and Adjustment to Breast Cancer. Manuscript submitted for publication.
Glinder, J. G., and Compas, B. E. (1999). Self-blame attributions in women with newly diagnosed breast cancer: A prospective study of psychological adjustment. Health Psychol. 18: 475–481.
Gotay, C. C. (1985). Why me? Attributions and adjustment by cancer patients and their mates at two stages in the disease process. Soc. Sci. Med. 20: 825–831.
Houldin, A. D., Jacobsen, B., and Lowery, B. J. (1996). Self-blame and adjustment to breast cancer. Oncol. Nurs. Forum 23: 75–79.
Janoff-Bulman, R. (1979). Characterological versus behavioral self-blame: Inquiries into depression and rape. J. Person. Soc. Psychol. 37: 1798–1809.
Janoff-Bulman, R. (1992). Shattered Assumptions: Towards a New Psychology of Trauma, Free Press, New York.
Janoff-Bulman, R., and Wortman, C. B. (1977). Attributions of blame and coping in the “real world”: Severe accident victims react to their lot. J. Person. Soc. Psychol. 35: 351–363.
Lazarus, R. S., and Folkman, S. (1986). Cognitive theories of stress and the issue of circularity, In Appley, M. H., and Trumbull, R. (Eds.), Dynamics of Stress: Physiological, Psychological, and Social Perspectives. The Plenum Series on Stress and Coping, Plenum Press, New York, pp. 63–80.
Lowery, B. J., Jacobsen, B. S., and DuCette, J. (1993). Causal attribution, control, and adjustment to breast cancer. J. Psychosoc. Oncol. 10: 37–53.
Malcarne, V. L., Compas, B. E., Epping-Jordan, J. E., and Howell, D. C. (1995). Cognitive factors in adjustment to cancer: Attributions of self-blame and perceptions of control. J. Behav. Med. 18: 401–417.
Newsom, J. T., Knapp, J. E., and Schulz, R. (1996). Longitudinal analysis of specific domains of internal control and depressive symptoms in patients with recurrent cancer. Health Psychol. 15: 323–331.
Smith, C. A., Haynes, K. N., Lazarus, R. S., and Pope, L. K. (1993). In search of the “hot” cognitions: Attributions, appraisals, and their relation to emotion. J. Person. Soc. Psychol. 65: 916–929.
Smith, C. A., and Kirby, L. D. (2001). Affect and cognition appraisal processes. In Forgas J. P. (Ed.), Handbook of Affect and Social Cognition, Lawrence Erlbaum Associates, Mahwah, NJ, pp. 75–92.
Taylor, S. E. (1983). Adjustment to threatening events: A theory of cognitive adaptation. Am. Psychol. 38: 1161–1173.
Taylor, S. E., Lichtman, R. R., and Wood, J. V. (1984). Attributions, beliefs about control, and adjustment to breast cancer. J. Person. Soc. Psychol. 46: 489–502.
Timko, C., and Janoff-Bulman, R. (1985). Attributions, vulnerability, and psychological adjustment: The case of breast cancer. Health Psychol. 4: 521–544.
ACKNOWLEDGMENTS
This research was supported by grant R01CA67936 from the National Cancer Institute to Bruce E. Compas, and preparation of this manuscript was supported by NIMH Training Grant T32-MH18921 and NICHD Grant P30HD15052 to Vanderbilt University.
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Bennett, K.K., Compas, B.E., Beckjord, E. et al. Self-Blame and Distress Among Women with Newly Diagnosed Breast Cancer. J Behav Med 28, 313–323 (2005). https://doi.org/10.1007/s10865-005-9000-0
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DOI: https://doi.org/10.1007/s10865-005-9000-0