title: Factors associated with depressive symptoms in young long-term breast cancer survivors.
abstract: Long-term breast cancer survivors frequently report distress (i.e., depressive symptoms) that impacts their quality of life. Previous studies have found that negative social interactions ("social constraints") from partners contribute to long-term, unresolved cycling of intrusive thoughts and cognitive avoidance, resulting in psychological distress. However, these relationships have not been tested in long-term breast cancer survivors. Furthermore, the effect of partners' depressive symptoms on the survivors' depressive symptoms has not been tested within the context of these relationships. Therefore, the purpose of this study was to test relationships between breast cancer survivors' depressive symptoms and (1) social constraints, cognitive avoidance, and intrusive thoughts, and (2) partners' depressive symptoms.
  
  
  
  Data were from a cross-sectional descriptive study of breast cancer survivors (N = 222) 3-8 years post-diagnosis and their partners, who completed surveys assessing demographic characteristics, social constraints, intrusive thoughts, cognitive avoidance, and depressive symptoms. Structural equation modeling confirmatory path analyses were conducted to determine significant relationships between survivors' depressive symptoms and all other variables.
  
  
  
  Our model fits the data well. Breast cancer survivors' depressive symptoms were predicted by social constraints and intrusive thoughts. The relationship between survivors' depressive symptoms and partners' depressive symptoms was close but not significant.
  
  
  
  As hypothesized, depressive symptoms were predicted by social constraints and intrusive thoughts. Further research is needed to understand the possible relationship between survivors' long-term depressive symptoms and cognitive avoidance and partners' depressive symptoms. Our findings highlight the negative impact of social constraints from partners on psychological outcomes in long-term breast cancer survivors.
authors.affiliation: Indiana University School of Nursing, 1111 Middle Drive, NU 317, Indianapolis, IN, 46202, USA. aamaners@iu.edu.
authors.forename: Andrea A
authors.identifier: 0000-0001-7928-6491
authors.initials: AA
authors.lastname: Cohee
authors.affiliation: Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Timothy
authors.initials: T
authors.lastname: Stump
authors.affiliation: Department of Psychology, Purdue University School of Science, Indianapolis, IN, USA.
authors.forename: Rebecca N
authors.initials: RN
authors.lastname: Adams
authors.affiliation: Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Shelley A
authors.initials: SA
authors.lastname: Johns
authors.affiliation: Indiana University School of Nursing, 1111 Middle Drive, NU 317, Indianapolis, IN, 46202, USA.
authors.forename: Diane
authors.initials: D
authors.lastname: Von Ah
authors.affiliation: Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Zoppi
authors.affiliation: Indiana University School of Nursing, 1111 Middle Drive, NU 317, Indianapolis, IN, 46202, USA.
authors.forename: Betsy
authors.initials: B
authors.lastname: Fife
authors.affiliation: Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Patrick O
authors.initials: PO
authors.lastname: Monahan
authors.affiliation: Northwestern University, Chicago, IL, USA.
authors.forename: David
authors.initials: D
authors.lastname: Cella
authors.affiliation: Indiana University School of Nursing, 1111 Middle Drive, NU 317, Indianapolis, IN, 46202, USA.
authors.forename: Victoria L
authors.initials: VL
authors.lastname: Champion
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000401:mortality / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D018434:Sickness Impact Profile; D017741:Survivors / Q000523:psychology*
keywords: Breast cancer survivors; Depressive symptoms; Social cognitive processing; Social constraints