Dissertation Abstract

The Role of Social Support in Adjustment to Breast Cancer: The Importance of Support Congruency.

Advances in medical treatment have improved the rate of survival for women diagnosed with early stage breast cancer, so understanding how to facilitate their psychological adjustment is important. This study examined emotional support from a personal supporter during and after treatment for cancer. Support was conceptualized as four types that included whether support was wanted and whether it was received: positive congruent support (wanted, received), null support (not wanted, not received), support omission (wanted, not received), and support commission (not wanted, received). Congruent support was defined as matched wanting and receiving of support (positive congruent and null support).

The participants in the study were 101 women who had been treated for breast cancer in the year preceding their participation in the study. The women completed a questionnaire that included medical and demographic questions, a Social Support Survey, the Cancer Rehabilitation Evaluation System (CARES), Rosenberg Self-Esteem Scale (RSE), and the Profile of Mood States (POMS). Sixty-five women completed a single questionnaire either during adjuvant treatment (chemotherapy or radiation therapy) or following the end of treatment; an additional 36 women completed the questionnaires during both phases.

Surprisingly, there was little effect of support on psychosocial adjustment during the in-treatment period, perhaps because medical support available during this phase was a larger proportion of total available support. In contrast, in the post-treatment period, multiple effects of support on psychosocial adjustment (psychosocial functioning, self-esteem, and mood) were found. Over 37% of the variance in CARES and 15% of the variance in POMS was explained by the four types of support. Support commissions had a significant unique effect on CARES with greater amounts of support commissions associated with greater psychological distress. Support omissions had a significant unique effect on POMS with greater amounts of support omissions associated with worse mood in the women. Age was also found to be an important factor. Older women reported fewer support commissions, which enhanced their level of psychosocial functioning. The level of support remained relatively constant from the in-treatment to post-treatment period, although the impact of support was much stronger in the post-treatment period.

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