title: On the positive relation between received social support and negative affect: a test of the triage and self-esteem threat models in women with breast cancer.
abstract: OBJECTIVE
  There is a seemingly paradoxical positive relation between received social support and psychological distress in cancer patients. This study evaluates two models that explain this positive relation: (a) the triage model, which argues that more distressed people receive more support and (b) the self-esteem threat model, which argues that receiving support increases distress by undermining self-esteem.
  
  
  METHODS
  Longitudinal survey data were collected from 71 women treated for breast cancer at 3- (T1) and 18-months (T2) post-diagnosis.
  
  
  RESULTS
  Analyses did not disconfirm either model. Consistent with the triage model, there was a marginally significant (p=0.052) positive relation between T1 negative affect and T2 received support, controlling for T1-received support. Consistent with the self-esteem threat model, a significant positive relation between T1 received support and T2 negative affect, controlling for T1 negative affect, appeared to be mediated by T2 self-esteem.
  
  
  CONCLUSIONS
  These findings suggest that people with cancer who are most distressed may receive the most social support, but the conveyance of support can have negative consequences for self-esteem and affect.
authors.affiliation: Department of PublicHealth, Temple University, Philadelphia, PA 19122, USA. slepore@temple.edu
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Lepore
authors.forename: Debra B
authors.initials: DB
authors.lastname: Glaser
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Roberts
mesh_terms: D000339:Affect; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011584:Psychology; D012649:Self Concept; D012944:Social Support; D011795:Surveys and Questionnaires