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Gepubliceerd in:

01-12-2010

Affective differentiation in breast cancer patients

Auteurs: Kimberly B. Dasch, Lawrence H. Cohen, Amber Belcher, Jean-Philippe Laurenceau, Jeff Kendall, Scott Siegel, Brendt Parrish, Elana Graber

Gepubliceerd in: Journal of Behavioral Medicine | Uitgave 6/2010

Abstract

Fifty-three breast cancer patients completed an Internet-based diary measuring daily negative affect and positive affect and daily negative and positive events for seven consecutive evenings shortly after surgery. The authors used Hierarchical Linear Modeling (Raudenbush and Bryk in Hierarchical linear models: applications and data analysis methods. Sage, Thousand Oaks, CA, 2002) to examine moderators of affective differentiation, or the daily relationship between the patients’ negative affect and positive affect. Strong affective differentiation is characterized by the relative independence of negative and positive affect. There were no significant Level 1 (within-subject) moderators of affective differentiation. However, at Level 2 (between-subject), as predicted, increased age was associated with stronger affective differentiation, as was greater use of planning to cope with breast cancer. Also as predicted, increased anxiety and greater use of behavioral disengagement and denial coping were associated with weaker affective differentiation. The results suggest the value of the affective differentiation construct, and a daily diary methodology, for research on the daily lives of breast cancer patients.

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We repeated all analyses with exact time of diary completion as a level 1 control variable, but its inclusion did not affect the results. In addition, we dummy coded time of diary completion, with 4 p.m.–6.59 p.m. as the reference time period, and 7.00 p.m.–7.59 p.m.; 8.00 p.m.–9.59 p.m.; and 10.00 p.m.–2.00 a.m. as the other time periods. We then repeated all analyses with statistical control of these three dummy coded level 1 variables (time periods). All results remained the same, with one exception: The coping strategy of Acceptance emerged as a significant moderator of affective differentiation, whereas originally it was a near-significant moderator.

We also conducted analyses with each person’s average positive affect score as a level 2 control variable, but its inclusion did not affect the results.

Patients’ treatment status (yes/no for radiation or chemotherapy) during their participation in the study was a significant moderator of affective differentiation, γ₁₁ = − .368, p < .001, such that those who were receiving treatment had weaker affective differentiation than those who were not. This pattern was obtained even with the statistical control of anxiety, γ₁₁ = −.319, p = .002. Educational background, working status, and number of days since surgery were also examined as potential moderators, but none of these variables significantly moderated affective differentiation, with or without anxiety as a control.

Without controlling for initial anxiety, age, planning, behavioral disengagement, denial, humor, and seeking medical advice continued to serve as significant moderators of affective differentiation, and acceptance was a significant (rather than near-significant) moderator. Religion became a non-significant moderator and substance use was a near-significant moderator (p < .10). When both anxiety and treatment status (yes/no for radiation or chemotherapy) were included in the models, age, planning, behavioral disengagement, denial, humor, religion, substance use, and seeking medical advice were all significant moderators of affective differentiation, and acceptance was a near-significant moderator of affective differentiation.

For exploratory purposes, we also tested the moderating effects of a number of initial individual difference variables not reported in the text, specifically, neuroticism and extraversion (both measured with the NEO Five Factor Inventory; Costa and McCrae 1992), depression (with the Hospital Anxiety and Depression Scale; Zigmond and Snaith 1983), and mood clarity (with the Mood Clarity Subscale of the Trait Meta-Mood Scale; Salovey et al. 1995). Depression, γ₁₁ = − .053, p = .001, and neuroticism, γ₁₁ = − .026, p < .001, were significant moderators of affective differentiation, with higher scores on both variables associated with weaker affective differentiation. Extraversion was also a significant moderator of affective differentiation, γ₁₁ = .015, p = .031, with higher extraversion scores associated with stronger affective differentiation. Mood clarity was not a significant moderator of affective differentiation, γ₁₁ = .060, p = .414.

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Titel: Affective differentiation in breast cancer patients
Auteurs: Kimberly B. Dasch
Lawrence H. Cohen
Amber Belcher
Jean-Philippe Laurenceau
Jeff Kendall
Scott Siegel
Brendt Parrish
Elana Graber
Publicatiedatum: 01-12-2010
Uitgeverij: Springer US
Gepubliceerd in: Journal of Behavioral Medicine / Uitgave 6/2010
Print ISSN: 0160-7715
Elektronisch ISSN: 1573-3521
DOI: https://doi.org/10.1007/s10865-010-9274-8

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