Changes in psychological adjustment over the course of treatment for breast cancer: the predictive role of social sharing and social support.

BACKGROUND: Although research on social sharing suggests it could be an important factor in subsequent adjustment, it has rarely been examined in combination with the nature of the support received by patients. The goal of this study was to determine whether and to what extent social sharing concerning the disease and perceived social support after breast surgery explain psychological adjustment at the end of the treatment. METHODS: One hundred two participants were recruited consecutively at a large cancer care center (Gustave Roussy, France). After surgery (T1) and at the end of the adjuvant treatment (T2), patients responded to self-report questionnaires assessing psychological adjustment (depressive symptoms and cancer-related distress), social sharing concerning the illness, and perceived social support (generic and cancer specific). RESULTS: When the initial levels of adjustment were controlled for, hierarchical multiple regression models showed that greater instrumental support at T1 accounted for favorable changes in depressive symptoms at T2. In contrast, the perception of aversive attitudes in the environment and the avoidance of social sharing explained an increase in intrusive cancer-related thoughts. CONCLUSION: The results suggest a negative impact of aversive attitudes from the environment on adjustment during treatment. It also confirms the importance of practical aspects of social support after surgery. In line with Lepore theory, sharing about the illness in a supportive environment may be of primary importance in the cognitive processing of cancer and thus may promote adjustment. These results have original implications for the counseling of patients and their relatives.