title: What Factors Affect the Insomnia Symptom Trajectories in Women With Nonmetastatic Breast Cancer?
abstract: This study sought to identify the trajectories of insomnia symptoms in Chinese women with nonmetastatic breast cancer and further determine the effects of sociodemographic, disease, and psychological variables on different insomnia symptoms.
  
  
  
  A total of 287 female breast cancer patients were recruited to complete measures of cognitive emotion regulation strategies, perceived social support, and insomnia symptoms at six time points from the week after diagnosis to four months after surgery.
  
  
  
  Four distinct classes of insomnia symptom trajectories were identified using growth mixture modeling and were named low sustained class (n = 128, 44.60%), high sustained class (n = 33, 11.50%), moderate sustained class (n = 64, 22.30%), and decreasing class (n = 62, 21.60%). Patients in these trajectory classes differed in demographic characteristics (age, education, employment, and monthly income), pathologic stage, and psychological characteristics (perceived social support and cognitive emotion regulation strategies). Patients with less than nine years of education (adjusted odds ratio = 2.61-4.10) or higher levels of self-blame (adjusted odds ratio = 1.80-2.14) are most likely to belong to the high sustained, moderate sustained, and decreasing classes.
  
  
  
  Four latent trajectories may be a reliable and valuable approach in analyzing insomnia symptoms in breast cancer patients. Heterogeneity should be considered to allow more attention to be paid on patients in high and moderate sustained class. Education and cognitive emotion regulation strategies are important factors for the onset and development of insomnia symptoms.
authors: School of Humanities & Social Sciences, Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China; Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China.
authors: Yuping
authors: Y
authors: Wang
authors: Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China; Medical Psychological Institute of Central South University, Changsha, Hunan, P.R. China. Electronic address: xiongzhaozhu@163.com.
authors: Xiongzhao
authors: X
authors: Zhu
authors: Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China.
authors: Lingyan
authors: L
authors: Li
authors: Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China.
authors: Jinyao
authors: J
authors: Yi
authors: The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China.
authors: Jincai
authors: J
authors: He
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000150:complications* / Q000523:psychology / Q000601:surgery; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D008962:Models, Theoretical; D016017:Odds Ratio; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D012944:Social Support; D012959:Socioeconomic Factors
keywords: Breast cancer; cognitive emotion regulation strategy; growth mixture modeling; insomnia symptom; perceived social support