title: Optimism and depression: a new look at social support as a mediator among women at risk for breast cancer.
abstract: OBJECTIVE
  Breast cancer risk is a chronic stressor associated with depression. Optimism is associated with lower levels of depression among breast cancer survivors. However, to our knowledge, no studies have explored the relationship between optimism and depression among women at risk for breast cancer. We hypothesized that women at risk for breast cancer who have higher levels of optimism would report lower levels of depression and that social support would mediate this relationship.
  
  
  METHODS
  Participants (N = 199) with elevated distress were recruited from the community and completed self-report measures of depression, optimism, and social support. Participants were grouped based on their family history of breast cancer. Path analysis was used to examine the cross-sectional relationship between optimism, social support, and depressive symptoms in each group.
  
  
  RESULTS
  Results indicated that the variance in depressive symptoms was partially explained through direct paths from optimism and social support among women with a family history of breast cancer. The indirect path from optimism to depressive symptoms via social support was significant (β = -.053; 90% CI = -.099 to -.011, p = .037) in this group. However, among individuals without a family history of breast cancer, the indirect path from optimism to depressive symptoms via social support was not significant.
  
  
  CONCLUSIONS
  These results suggest that social support partially mediates the relationship between optimism and depression among women at risk for breast cancer. Social support may be an important intervention target to reduce depression among women at risk for breast cancer.
authors.affiliation: Clinical Psychology, Seattle Pacific University, Seattle, WA, USA.|Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: Melissa J
authors.initials: MJ
authors.lastname: Garner
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: Bonnie A
authors.initials: BA
authors.lastname: McGregor
authors.affiliation: Clinical Psychology, Seattle Pacific University, Seattle, WA, USA.|Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: Karly M
authors.initials: KM
authors.lastname: Murphy
authors.affiliation: Clinical Psychology, Seattle Pacific University, Seattle, WA, USA.
authors.forename: Alex L
authors.initials: AL
authors.lastname: Koenig
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: Emily D
authors.initials: ED
authors.lastname: Dolan
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: Denise
authors.initials: D
authors.lastname: Albano
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000235:genetics / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D000067656:Optimism; D012306:Risk; D012944:Social Support
keywords: breast cancer; depression; oncology; optimism; social support