published_or_final_version / Social Work and Social Administration / Doctoral / Doctor of Philosophy

Breast cancer statistics in the United States are staggering. As the number of women diagnosed grows, so does the number of women who are writing about their experiences. This thesis is a multi-textual work which includes both the stories of women with breast cancer as well as the thesis author's personal journal entries. Women's experiences are used to examine and critique current institutional and cultural responses to breast cancer. Experience literature reveals that efforts against breast cancer in the United States are emerging from two distinct ideologies which are identified as Cure and Prevention in this work. This thesis address the most prevalent issues within Cure and Prevention, and analyzes how these mindsets are shaped by definitions and expectations of femininity. The following pages elucidate how engendered values and socialization play out through the Cure and Prevention paradigms. Ultimately, the Prevention model will be shown as the one that most resolutely addresses the issue of breast cancer. Women's experiences and expertise are critical for understanding the ramifications of Cure and Prevention responses to breast cancer; women are informing and bridging misunderstandings between Cure and Prevention thinking. / Graduation date: 1997

A descriptive study was conducted with the purpose of refining the Sexual Adjustment Questionnaire (SAQ) and further establishing reliability and validity. Twelve women receiving treatment for breast cancer and 22 women who were at least three months post-treatment for breast cancer voluntarily participated in the research study. Each was administered the Sexual Adjustment Questionnaire. Findings of the study revealed that the SAQ in its entirety was internally consistent. Repatterning of sexual behavior subsequent to having breast cancer did not occur in either group of women. Both the women receiving cancer treatment and those post-treatment experienced a noticeable change in their sexual behavior since having cancer.

This study utilized a self-reported survey design to obtain information from 47 Latinas to determine their breast cancer knowledge levels and compliance with early detection methods.

Indiana University-Purdue University Indianapolis (IUPUI) / Long-term psychosocial consequences of breast cancer are increasingly more important to study as survivors are living longer. However, the survivors do not experience cancer alone; their significant others often suffer just as much if not more than the survivors themselves. In this dissertation, we explore some long-term consequences of cancer within the context of the Social Cognitive Processing Theory (SCPT). SCPT proposes that an individual must be able to discuss their feelings in order to cognitively process a traumatic event, such as cancer. If discussions are hindered, in particular by a significant other, then one will be unable to work through his/her concerns, leading to poor psychological outcomes, such as depression and fear of recurrence. The purpose of this dissertation is to use SCPT to identify causal mechanisms of depressive symptoms and fear of recurrence using a large sample of young breast cancer survivors and their partners. For one paper, we also included a large set of older participants for comparison. This dissertation is divided into three distinct articles. Each article tests long-term consequences of breast cancer and its treatment on breast cancer survivors and their partners using SCPT to explain relationships. First we examine the hypothesized predictors of younger breast cancer survivors’ depressive symptoms including the partner variable of depressive symptoms. The second article addresses the partners by predicting their depressive symptoms using SCPT. The third and final article seeks to identify the relationship of predictors and FOR on both survivors and their partners again using SCPT. For survivors, structural equation modeling analyses found significant direct and indirect paths between depressive symptoms and theoretical variables, including social constraints (stb=.266, p<.001) and intrusive thoughts (stb=.453, p<.001). In partners, cognitive processing variables (intrusive thoughts and cognitive avoidance) mediated the relationship between social constraints and depressive symptoms (F(5,498)= 19.385, R2=.163, p<.001). And finally, cognitive processing mediated the relationship between social constraints and fear of recurrence both for survivors [F(3,213)= 47.541, R2=.401, p<.001] and partners [F(3,215)= 27.917, R2=.280, p<.001). The evidence from these studies supports the use of SCPT in predicting depressive symptoms and fear of recurrence in both long-term survivors and partners.