title: Attachment style and respiratory sinus arrhythmia predict post-treatment quality of life in breast cancer survivors.
abstract: OBJECTIVE
  Breast cancer is the most frequent malignant tumor among women in the industrialized world. The vast majority of these tumors can now be successfully treated. A subset of breast cancer survivors report quality of life (QOL) difficulties well after treatment is completed. The current study examined how individual differences in attachment style and self-regulatory capacity (as indexed by respiratory sinus arrhythmia (RSA)) were associated QOL among post-treatment breast cancer survivors.
  
  
  METHODS
  Women who had completed treatment for stage 0-IIIA breast cancer within the past 2 years participated in the study (N=96). RSA was assessed using electrocardiography data that was continuously measured non-invasively for 10 min. Attachment orientation was measured using a modified version of the Experiences in Close Relationships Scale and overall QOL by the Functional Assessment of Cancer Therapy-Breast scale.
  
  
  RESULTS
  Breast cancer survivors with more attachment anxiety reported poorer QOL than those with less attachment anxiety. Women who were more avoidantly attached also reported poorer QOL compared with those who were less avoidantly attached. Furthermore, attachment avoidance interacted with RSA to predict QOL such that those with higher attachment avoidance were only vulnerable to poorer QOL if they also had lower self-regulatory capacity, as indexed by lower RSA.
  
  
  CONCLUSIONS
  A better understanding of how attachment style and RSA contribute to breast cancer survivors QOL will help identify people at risk for QOL problems after treatment completion.
authors.affiliation: Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Fagundes
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Jaremka
authors.forename: William B
authors.initials: WB
authors.lastname: Malarkey
authors.forename: Janice K
authors.initials: JK
authors.lastname: Kiecolt-Glaser
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000209:etiology / Q000523:psychology*; D001943:Breast Neoplasms / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009769:Object Attachment; D011237:Predictive Value of Tests; D011788:Quality of Life; D065809:Respiratory Sinus Arrhythmia / Q000502:physiology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*
keywords: attachment theory; cancer survivorship; psycho-oncology; quality of life; respiratory sinus arrhythmia; self-regulation