In the United States, approximately two million new cancer diagnoses will emerge in 2020, and more than 16 million persons are cancer survivors. Poor mental health is a significant concern among individuals with current or remitted cancer. Approximately 15%-25% of persons in the cancer population experience depression, perhaps attributable to the physical burden of illness and recovery (e.g., treatment side effects), and threat of mortality. Risk for distress may vary relative to the cohesiveness of one’s sense of self across time. Self-continuity, or perceived congruence of how one views their past, current, and future self (e.g., personality; values) may be disrupted by the illness experience but, when present, may promote psychosocial adjustment throughout the illness trajectory. Specifically, stable self-concept may promote engagement in adaptive coping mechanisms (e.g., problem-solving; seeking support), whereas self-discontinuity may deleteriously impact coping (e.g., interpersonal dysfunction; emotion dysregulation). In turn, it is well-established that effective coping is linked to less psychological distress. However, the role of self-continuity in this process has not been previously examined in the context of chronic illness.
At the bivariate level, we hypothesized that self-continuity would be positively associated with adaptive coping and negatively related to depressive symptoms, with opposite patterns of correlations for self-discontinuity. At the multivariate level, we hypothesized that adaptive coping would mediate the associations between self-perception type and depressive symptoms; self-continuity would be associated with adaptive coping and, sequentially, to fewer depressive symptoms. Conversely, self-discontinuity would be linked to poorer coping and, in turn, to more depressive symptoms.
Our U.S. national sample of persons with current or remitted cancer was recruited online (N=235). Most were female (n=152; 64.4%) and White (n=216; 91.5%). Participants completed self-reported measures including the Self-Continuity Scale and Multidimensional Health Profile-Psychological (coping and depression subscales). Bivariate correlations and mediation analyses, per Hayes (2013), were conducted, covarying age, sex, and ethnicity.
At the bivariate level, all variables were significantly (pt=-2.6289, SE=.3389, pt=-1.4125, SE=.3124, p=.159, CI [-1.0579, .1755]), indicating mediation. Coping was also a significant mediator of the relation between self-discontinuity and depressive symptoms; the total effect was significant (t=5.15, SE=.3098, p=.000, CI [.9849, 2.208]), and the direct effect reduced in significance when coping was added to the model (t=3.5539, SE=.2997, p
In our sample of persons with or recovering from cancer, self-continuity was associated with better coping and, in turn, to fewer depressive symptoms. Conversely, self-discontinuity was linked to poorer coping and consequent depression. To stabilize temporal self-perception, intervention strategies such as cognitive defusion (e.g., “leaves on a stream” mindfulness) or distress tolerance skills (e.g., sensory grounding) may promote acceptance of uncontrollable situations or inner experiences that threaten self-concept. Encouraging self-continuity (e.g., via nostalgia journaling) and adaptive coping (e.g., problem solving, relaxation may have beneficial effects on mental health throughout the diagnosis, treatment and survivorship phases of the cancer experience.
| Identifer | oai:union.ndltd.org:ETSU/oai:dc.etsu.edu:asrf-1588 |
| Date | 05 May 2020 |
| Creators | Penpek, Stephanie, Treaster, Morgan, Sirois, Fuschia, Hirsch, Jameson |
| Publisher | Digital Commons @ East Tennessee State University |
| Source Sets | East Tennessee State University |
| Detected Language | English |
| Type | text |
| Source | Appalachian Student Research Forum |
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