title: The impact of social and personal resources on psychological distress in women at risk for hereditary breast cancer.
abstract: OBJECTIVE
  The objectives of the present study were to (1) evaluate whether social and personal resources were independently related to psychological distress and (2) examine the interrelationships of social and personal resources in women at risk for hereditary breast cancer.
  
  
  METHODS
  General and breast cancer specific distress, family communication regarding hereditary breast cancer, perceived social support, self-esteem, self-concept, and demographics were assessed in 222 high-risk women, having opted either for regular surveillance or prophylactic surgery.
  
  
  RESULTS
  Structural equation modeling showed that (1) both personal and social resources were independently associated with psychological distress and (2) the associations between social resources and psychological distress were partially mediated by personal resources. Support from family and friends was associated with a higher level of self-esteem, which in turn was associated with less general distress. Furthermore, communication regarding cancer within the nuclear family was associated with decreased feelings of stigmatization, which in turn was associated with less general and breast cancer specific distress. Moreover, open communication within the family was associated with a reduced sense of vulnerability.
  
  
  CONCLUSIONS
  Health workers involved in the care of high-risk women should carefully monitor women's personal and social resources, and if compromised refer them for appropriate support.
authors.affiliation: Department of Medical Psychology and Psychotherapy, Erasmus Medical Centre, Rotterdam, The Netherlands. m.denheijer@erasmusmc.nl
authors.forename: Mariska
authors.initials: M
authors.lastname: den Heijer
authors.forename: Joël
authors.initials: J
authors.lastname: Vos
authors.forename: Caroline
authors.initials: C
authors.lastname: Seynaeve
authors.forename: Kathleen
authors.initials: K
authors.lastname: Vanheusden
authors.forename: Hugo J
authors.initials: HJ
authors.lastname: Duivenvoorden
authors.forename: Madeleine
authors.initials: M
authors.lastname: Tilanus-Linthorst
authors.forename: Marian B E
authors.initials: MB
authors.lastname: Menke-Pluymers
authors.forename: Aad
authors.initials: A
authors.lastname: Tibben
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000235:genetics / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012649:Self Concept; D012944:Social Support; D012959:Socioeconomic Factors; D018454:Spouses / Q000523:psychology; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires