A longitudinal investigation of coping and posttraumatic growth in breast cancer survivors.

This study supported several predictions for coping and distress during chemotherapy (Time 1), and coping, perceived stress, and posttraumatic growth two years later (Time 2) in women with breast cancer. At T1, the emotion-focused coping strategies of disengagement, denial, self-blame, and venting were positively related to physical and psychological distress. In addition, the cognitive strategies of religion, positive reframing, and acceptance together accounted for a significant amount of the variance in fatigue and distressed mood. Positive reframing and acceptance negatively related to chemotherapy distress, while using religion positively related. However, using religion at chemotherapy (T1) related to more posttraumatic growth at two-year follow-up (T2). Furthermore, at two-year follow-up, (1) using religion, positive reframing, and acceptance accounted for forty-six percent (46%) of the variance in posttraumatic growth; (2) positive reframing related to more posttraumatic growth; (3) instrumental and emotional support related to more posttraumatic growth; (4) acceptance related to less perceived stress; (5) self-blame related to more perceived stress; and (6) posttraumatic growth marginally related to lower perceived stress. These findings support the current theoretical model that posttraumatic growth is adaptive, that it results from cognitively processing trauma, and that coping may moderate this growth.