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. 2009 Mar;28(2):147-56.
doi: 10.1037/a0013221.

Psychosocial adjustment among cancer survivors: findings from a national survey of health and well-being

Erin S Costanzo  1 , Carol D Ryff, Burton H Singer
Affiliations

Psychosocial adjustment among cancer survivors: findings from a national survey of health and well-being

Erin S Costanzo et al. Health Psychol. 2009 Mar.

Abstract

Objective: The current study examined whether cancer survivors showed impairment, resilience, or growth responses relative to a sociodemographically matched sample in four domains: mental health and mood, psychological well-being, social well-being, and spirituality. The impact of aging on psychosocial adjustment was also investigated.

Design: Participants were 398 cancer survivors who were participants in the MIDUS survey (Midlife in the United States) and 796 matched respondents with no cancer history. Psychosocial assessments were completed in 1995-1996 and 2004-2006.

Main outcome measures: Outcomes including self-report measures of mental health and mood, psychological well-being, social well-being, and spirituality.

Results: Findings indicated that cancer survivors demonstrated impairment relative to the comparison group in mental health, mood, and some aspects of psychological well-being. Longitudinal analyses spanning pre- and postdiagnosis clarified that while mental health declined after a cancer diagnosis, poorer functioning in other domains existed prior to diagnosis. However, survivors exhibited resilient social well-being, spirituality, and personal growth. Moreover, age appeared to confer resiliency; older survivors were more likely than younger adults to show psychosocial functioning equivalent to their peers.

Conclusion: While younger survivors may be at risk for disturbances in mental health and mood, cancer survivors show resilience in other important domains of psychosocial adjustment.

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Figures

Figure 1
Figure 1
Pre- to post-diagnosis changes psychosocial measures relative to the comparison group: (a) interaction between group and wave predicts depression, F(1, 619) = 6.10, p = .01; (b) main effects of group and wave on positive affect, F(1, 493) = 4.96, p = .03 and F(1, 489) = 4.49, p = .03, respectively; (c) main effects of group and wave on positive relations with others, F(1, 493) = 3.90, p = .049 and F(1, 489) = 18.00, p < .001, respectively.
Figure 2
Figure 2
Interactions between group and age at Wave 2 predict (a) depression, β = -.13, p = .001, (b) positive affect, β = .08, p = .03, and (c) social actualization, β = .09, p = .02.
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