Identification and prediction of distress trajectories in the first year after a breast cancer diagnosis.
OBJECTIVE
In this article, we aim to (a) identify distinct trajectories of psychological distress in the first year after a breast cancer diagnosis in women treated with adjuvant therapy and (b) explore possible predictors of these trajectories, that is, demographic, medical, and personal characteristics.


METHODS
The 171 patients were assessed after diagnosis, after surgery, after adjuvant treatment, in the reentry phase, and in the (short-term) survivorship phase (2 and 6 months after the end of treatment, respectively).


METHODS
Psychological distress was assessed with the 12-item General Health Questionnaire.


RESULTS
There were four trajectories of distress: a group that experienced no distress (36.3%), a group that experienced distress only in the active treatment phase (33.3%), a group that experienced distress in the reentry and survivorship phase (15.2%), and a group that experienced chronic distress (15.2%). Personality and physical complaints resulting from adjuvant treatment could distinguish the distress trajectories. Mastery was the only unique predictor.


CONCLUSIONS
Most patients were not distressed in response to breast cancer or only temporarily so. Yet, a minority of patients became or remained distressed after the end of treatment.
Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Inge
I
Henselmans
Vicki S
VS
Helgeson
Howard
H
Seltman
Jakob
J
de Vries
Robbert
R
Sanderman
Adelita V
AV
Ranchor
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000523:psychology*; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology* / Q000532:radiotherapy / Q000601:surgery; D017024:Chemotherapy, Adjuvant / Q000523:psychology; D003131:Combined Modality Therapy / Q000523:psychology; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D055809:Illness Behavior; D007389:Internal-External Control; D008016:Life Change Events; D008408:Mastectomy / Q000523:psychology; D008875:Middle Aged; D009426:Netherlands; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics; D018714:Radiotherapy, Adjuvant / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000523:psychology*