title: Attachment, emotion regulation, and adaptation to breast cancer: assessment of a mediational hypothesis.
abstract: OBJECTIVE
  This study examines the links between attachment, adaptation to breast cancer, and the mediating role played by emotional regulation processes.
  
  
  METHODS
  Participants were 127 women with breast cancer recruited in two public hospitals of Porto and at the Portuguese Cancer League. Women completed measures of attachment, quality of life, and emotion regulation. Path models were used to examine the associations between the constructs and to test the mediational hypotheses.
  
  
  RESULTS
  Significant associations were found between attachment and adaptation. Dimensions of emotion regulation totally or partially mediated the associations between attachment and adaptation outcomes. Attachment security effects on interpersonal relations were totally mediated by communicating emotions. Also, attachment anxiety effect on physical well-being was totally mediated by rumination. Attachment avoidance effects on psychological outcomes were totally mediated by emotional control and partially mediated by communicating emotions for the case of interpersonal relations.
  
  
  CONCLUSIONS
  This study highlights the importance of addressing emotional regulation jointly with attachment to deepen the comprehension of the relational processes implicated in adaptation to breast cancer. Results supported a mediational hypothesis, presenting emotional regulation processes as relevant dimensions for the understanding of attachment associations with adaptation to breast cancer.
authors.affiliation: Faculty of Psychology and Educational Sciences, University of Porto, Psychology Center, Porto, Portugal.
authors.forename: Marisa
authors.initials: M
authors.lastname: Ávila
authors.affiliation: Faculty of Psychology and Educational Sciences, University of Porto, Psychology Center, Porto, Portugal.
authors.forename: Tânia
authors.initials: T
authors.lastname: Brandão
authors.affiliation: Faculty of Psychology and Educational Sciences, University of Porto, Psychology Center, Porto, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Teixeira
authors.affiliation: Faculty of Psychology and Educational Sciences, University of Porto, Psychology Center, Porto, Portugal.
authors.forename: Joaquim Luis
authors.initials: JL
authors.lastname: Coimbra
authors.affiliation: Faculty of Psychology and Educational Sciences, University of Porto, Psychology Center, Porto, Portugal.
authors.forename: Paula Mena
authors.initials: PM
authors.lastname: Matos
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology; D001943:Breast Neoplasms / Q000523:psychology* / Q000628:therapy; D003142:Communication; D056348:Emotional Intelligence; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008875:Middle Aged; D009769:Object Attachment; D011788:Quality of Life
keywords: adaptation; attachment; breast cancer; emotion regulation; oncology