Abstract
Women who are diagnosed with breast cancer are at high risk for experiencing affective distress; however, previous research suggests that older women may be less likely than younger women to experience extreme distress. Two issues remain unclear regarding age and affective distress: (a) the psychological processes that account for the association of age and distress, and (b) whether this association remains stable over the course of treatment and recovery from breast cancer. This study investigated symptoms of anxiety and depression in 80 women ages 36–80 years old with newly diagnosed breast cancer near the time of their diagnosis and at 3 and 6 months post‐diagnosis. Disease severity and coping style were also examined. Symptoms of anxiety/depression and age were negatively correlated near the time of diagnosis. Path analysis controlling for disease severity revealed that coping involving the ventilation of emotion fully mediated the effect of age on symptoms of anxiety and depression. However, the association of age with symptoms of anxiety/depression was no longer significant at 3 and 6 months post‐diagnosis, although emotional ventilation still predicted greater emotional distress at 6 months. These findings suggest that age is a salient factor to consider in the psychological adjustment of women with breast cancer near the time of initial diagnosis, with younger women exhibiting greater affective distress and a tendency to engage in less adaptive ways of coping. However, younger and older women do not differ in their adjustment over the subsequent course of their treatment and initial recovery. The use of emotional ventilation coping remains associated with poorer adjustment, independent of patients’ age.
Similar content being viewed by others
References
Nelson DV, Friedman LC, Baer PE, Lane M, Smith FE: Subtypes of psychosocial adjustment to breast cancer. J Behav Med 17(2): 127–141, 1994
Shag CAC, Ganz PA, Polinsky ML, Fred C, Hirji K, Peterson L: Characteristics of women at risk for psychological distress in the year after breast cancer. J Clin Oncol 11: 783–793, 1993
Glanz K, Lerman C: The psychosocial impact of breast cancer: A critical review. Annals Behav Med 14(3): 204–212, 1992
Yanick R, Ries LG, Yates JW: Breast cancer in aging women: A population-based study of contrasts in stage, surgery, and survival. Cancer 63: 976–981, 1989
Stanton AL, Snider PR: Coping with a breast cancer diagnosis: A prospective study. Health Psychol 12(1): 16–23, 1993
Northouse LL, Swain MA: Adjustment of patients and husbands to the initial impact of breast cancer. Nurs Res 36(4): 221–225, 1987
Vinokur AD, Threatt BA, Vinokur-Kaplan D, Satariano WA: The process of recovery from breast cancer for younger and older patients: Changes during the first year. Cancer 65: 1242–1254, 1990
Baltes RM, Baltes MM: Psychological perspectives on successful aging: The model of selective optimization with compensation. In: Baltes PB, Baltes MM (eds) Successful Aging. Cambridge University Press, New York, 1990, pp 1–35
Carver CS, Pozo C, Harris SD, Noriega V, Scheier MF, Robinson DS, Ketcham AS, Maffat FL, Clark KC: How coping mediates the effect of optimism on distress: A study of women with early stage breast cancer. J Pers Soc Psychol 65(2): 375–390, 1993
Dunkel-Schetter C, Feinstein LG, Taylor SE, Falke RL: Patterns of coping with cancer. Health Psychol 11(2): 79–87, 1992
Classen C, Koopman C, Angell K, et al.: Coping styles associated with psychological adjustment to breast cancer. Health Psychol 15: 434–437, 1996
Spiegel D, Bloom J, Yalom I: Group support for patients with metastatic cancer. Arch Gen Psychia 38: 527–533, 1981
Pennebaker JW, Beall SK: Confronting a traumatic event: Toward an understanding of inhibition and disease. J Abnorm Psychol 95(3): 274–281, 1986
Pennebaker JW, Colder M, Sharp LK: Accelerating the coping process. J Pers Soc Psychol 58(3): 528–537, 1990
Aldwin CM: Does age affect the stress and coping process? Implication of age differences in perceived control. J Gerontol 46: 174–180, 1991
McRae RR: Age differences in the use of coping mechanisms. J Gerontol 37(4): 454–460, 1982
McRae RR: Age differences and changes in the use of coping mechanisms. J Gerontol 44(6): 161–169, 1989
Felton BJ, Revenson RA: Age differences in coping with chronic illness. Psychol Aging 2(2): 164–170, 1987
Hilton BA: The relationship of uncertainty, control, commitment, and threat of recurrence to coping strategies used by women diagnosed with breast cancer. J Behav Med 12(1): 39–53, 1989
Dean C: Psychiatric morbidity following mastectomy: Preoperative predictors and types of illness. J Psychosom Res 31(3): 385–392, 1987
Greer S, Morris T: Psychological attributes of women who develop breast cancer: A controlled study. J Psychosom Res 19: 147–153, 1975
Hughes J: Emotional reactions to the diagnosis and treatment of early breast cancer. J Psychosom Res 26(2): 277–283, 1982
Hughson AVM, Cooper AF, McArdle CS, Smith DC: Psychosocial consequences of mastectomy: Levels of morbidity and associated factors. J Psychosom Res 32(4/5): 383–391, 1988
Hughson AVM, Cooper AF, McArdle CS, Smith DC: Psychosocial morbidity in patients awaiting breast biopsy. J Psychosom Res 32(2): 173–180, 1988
Morris T, Greer S, Pettingale KW, Watson M: Patterns of expressions of anger and their psychological correlates in women with breast cancer. J Psychosom Res 25(2): 111–117, 1981
Pettingale KW, Burgess C, Greer S: Psychological response to cancer diagnosis I: Correlations with prognostic variables. J Psychosom Res 32(3): 255–261, 1988
American Joint Committee on Cancer: Manual for Staging of Cancer, 4th edition. Lippincott, Philadelphia, 1992
Derogatis LR: The SCL-90RManual II: Administration, Scoring, and Procedures. Johns Hopkins, Baltimore, MD, 1977
Taylor SE, Lichtman RR, Wood JV, Bluming AZ, Dosik GM, Liebowitz RL: Illness-related and treatment-related factors in psychological adjustment to breast cancer. Cancer 55: 2506–2513, 1985
Tobin DL, Holroyd KA, Reynolds RV, Wigal JK: The hierarchical factor structure of the Coping Strategies Inventory. Cog Ther Res 13(4): 343–361, 1989
Mor V: Section IV: Psychosocial and survival issues. Natl Cancer Inst Monogr 16: 170, 1994
Baron RM, Kenny DA: The moderator-mediator variables distinction in social psychology research: Conceptual, strategic, and statistical considerations. J Pers Soc Psychol 51: 1173–1182, 1986
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Compas, B.E., Stoll, M.F., Thomsen, A.H. et al. Adjustment to breast cancer: age‐related differences in coping and emotional distress. Breast Cancer Res Treat 54, 195–203 (1999). https://doi.org/10.1023/A:1006164928474
Issue Date:
DOI: https://doi.org/10.1023/A:1006164928474