Posttraumatic Growth and Psychological and Behavioural Adjustment in Thyroid Cancer Survivors

Ms Rachel Costa (). Posttraumatic Growth and Psychological and Behavioural Adjustment in Thyroid Cancer Survivors Professional Doctorate, School of Psychology, The University of Queensland.

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Author Ms Rachel Costa
Thesis Title Posttraumatic Growth and Psychological and Behavioural Adjustment in Thyroid Cancer Survivors
School, Centre or Institute School of Psychology
Institution The University of Queensland
Thesis type Professional Doctorate
Supervisor Dr Kenneth Pakenham
Total pages 215
Abstract/Summary The objectives of the current research were two fold, firstly to expand the current knowledge and understanding of psychological functioning of thyroid cancer patients, especially with regard to positive psychological states including posttraumatic growth (PTG), and secondly to extend the understanding of PTG in relation to psychological adjustment in cancer more broadly by addressing methodological and conceptual criticisms of previous research. Two studies derived from the one research methodology were conducted: Study 1 documented a comprehensive psychosocial profile of thyroid cancer patients and Study 2 examined relations between PTG and adjustment. In Study 2 it was predicted that greater PTG would be related to increases in all of the positive adjustment indicators including positive affect, positive health behaviour changes and higher order adjustment (purpose in life, self-acceptance, spiritual wellbeing and wisdom). Self-reported health behaviour change was also examined as a source of validity for PTG and partner reports of participants’ PTG and health behaviour change were investigated as potential sources of external validity for these measures. Participants for both studies were 154 out-patients (mean age = 50.96 years, SD = 14.43) being treated for thyroid cancer at a large, tertiary, metropolitan hospital, and 34 partners. Most thyroid cancer participants were female (n = 108). Results of Study 1 provided a psychosocial profile of thyroid cancer patients that is more comprehensive than has previously been performed and that included both positive and negative psychological sequelae in response to the experience of cancer. The majority of participants fell within the normal range for depression (91.6%), while over a third (38.3%) were in the clinical range for anxiety and almost half (44.4%) met criteria for DSM-IV trauma. In comparison with prior research on thyroid cancer patients, participants of the present study revealed similar levels of anxiety and similar or lower levels of depression. Overall stress and trauma associated with the cancer experience was lower for participants of the present research than that reported in previous breast cancer research. Positive adjustment indicators including PTG, purpose in life, self-acceptance, and spiritual wellbeing were reported at similar levels to that of previous research involving cancer patients, and positive affect was relatively high compared with community norms. A number of sociodemographic factors including, age, sex, income and marital status and only one illness variable, cancer stage, was significantly related to psychological adjustment outcomes. Results for Study 2 supported predictions. After controlling for relevant sociodemographic variables and cancer-related stress, PTG predicted positive affect and two out of four of the higher order adjustment outcomes, spiritual wellbeing and wisdom but not purpose in life and self-acceptance, as well as positive health-related lifestyle changes. PTG was not significantly related to anxiety or depression. Measures of health behaviour change provided some validation for PTG supporting the contention that PTG reflects veridical growth. The present research provided a comprehensive profile of psychological functioning in thyroid cancer patients in comparison to other research samples of participants with thyroid and other cancer types, as well as identifying sociodemographic and illness-related variables that were relevant to psychological adjustment. In addition, the adaptive significance of PTG was demonstrated and there was some support for PTG reflecting veridical change. The present research provided support for a number of the theoretical contentions associated with PTG including that PTG may coexist with distress, that PTG is more likely to reflect positive adjustment outcomes, and that a broader definition of adjustment is warranted in the context of PTG. The present research also extended the understanding of PTG in the adjustment to cancer by identifying aspects of higher order adjustment associated with PTG and by demonstrating the validity and efficacy of a measure of PTG that accounts for both positive and negative changes in a cancer population. Finally, some important clinical implications are outlined for screening and psychological follow-up of thyroid cancer patients and considerations for the clinical application of PTG are offered, followed by directions for future research.
Keyword Posttraumatic Growth
Psychological Adjustment

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Created: Wed, 28 Oct 2009, 17:09:01 EST by Ms Rachel Costa