This study investigated whether loneliness and cognitive processing explain the influence of negative (social constraints) and positive (emotional support) relationship qualities on cancer survivors’ distress. Participants were 195 cancer survivors who had undergone hematopoietic stem cell transplantation. Path analysis supported the hypothesis that loneliness and cognitive processing would mediate the association between social constraints and distress. Only loneliness mediated the association between emotional support and distress – an indirect effect significant only when support came from family and friends rather than a partner. Findings suggest that addressing social constraints may enhance cancer survivors’ adjustment.
AndrykowskiMACordovaMJHannDMJacobsenPBFieldsKKPhillipsG (1999) Patients’ psychosocial concerns following stem cell transplantation. Bone Marrow Transplantation24: 1121–1129.
2.
BentlerPM (1992) EQS Structural Equations Program Manual. Los Angeles, CA: BMDP Statistical Software.
3.
BoerHElvingWJLSeydelER (1998) Psychosocial factors and mental health in cancer patients: Opportunities for health promotion. Psychology, Health, and Medicine3: 71–79.
4.
CacioppoJTHawkleyLCThistedRA (2010) Perceived social isolation makes me sad: 5-year cross-lagged analyses of loneliness and depressive symptomatology in the Chicago Health, Aging, and Social Relations Study. Psychology and Aging25: 453–463.
5.
ChouCPBentlerPM (1990) Model modification in covariance structure modeling: A comparison among likelihood ratio, Lagrange multiplier, and Wald tests. Multivariate Behavioral Research25: 115–136.
6.
CohenMZLeyCTarzianAJ (2001) Isolation in blood and marrow transplantation. Western Journal of Nursing Research23: 592–609.
7.
CopelanEA (2006) Hematopoietic stem-cell transplantation. New England Journal of Medicine354: 1813–1826.
8.
CordovaMJCunninghamLLCarlsonCRAndrykowskiMA (2001) Social constraints, cognitive processing, and adjustment to breast cancer. Journal of Consulting and Clinical Psychology69: 706–711.
9.
CordovaMJWalserRNeffJRuzekJI (2005) Predictors of emotional adjustment following traumatic injury: Personal, social, and material resources. Prehospital and Disaster Medicine20: 7–13.
10.
DerogatisLR (1993) Brief Symptom Inventory: Administration, Scoring, and Procedures Manual. Minneapolis, MN: National Computer Systems.
11.
FifeBLMonahanPOAbonourRWoodLLStumpTE (2009) Adaptation of family caregivers during the acute phase of adult BMT. Bone Marrow Transplantation43: 959–966.
12.
HawkleyLCCacioppoJT (2010) Loneliness matters: A theoretical and empirical review of consequences and mechanisms. Annals of Behavioral Medicine40: 218–227.
13.
HelgesonVSCohenS (1996) Social support and adjustment to cancer: Reconciling descriptive, correlational, and intervention research. Health Psychology15: 135–148.
14.
HjermstadMJLogeJHEvensenSAKvaloySOFayersPMKaasaS (1999) The course of anxiety and depression during the first year after allogeneic or autologous stem cell transplantation. Bone Marrow Transplantation24: 1219–1228.
15.
HorowitzM (1986) Stress-response syndromes: A review of posttraumatic and adjustment disorders. Hospital and Community Psychiatry37: 241–249.
16.
HorowitzMWilnerNAlvarezW (1979) Impact of Event Scale: A measure of subjective stress. Psychosomatic Medicine41: 209–218.
17.
HouseJSKahnRL (1985) Measures and concepts of social support. In: CohenSSymeL (eds) Social Support and Health. Orlando, FL: Academic Press, pp. 83–108.
18.
HuLBentlerPM (1999) Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling6: 1–55.
19.
Jenks KettmannJDAltmaierEM (2008) Social support and depression among bone marrow transplant patients. Journal of Health Psychology13: 39–46.
20.
JoshuaTVRizzoJDZhangMJ. (2010) Access to hematopoietic stem cell transplantation: Effect of race and sex. Cancer116: 3469–3476.
21.
LeeSJFaircloughDParsonsSK. (2001) Recovery after stem-cell transplantation for hematologic diseases. Journal of Clinical Oncology19: 242–252.
22.
LeporeSJ (2001) A social-cognitive processing model of emotional adjustment to cancer. In: BaumAAndersenBL (eds) Psychosocial Interventions for Cancer. Washington, DC: American Psychological Association, pp. 99–118.
23.
LeporeSJCoyneJC (2006) Psychological interventions for distress in cancer patients: A review of reviews. Annals of Behavioral Medicine32: 85–92.
24.
LeporeSJHelgesonVS (1998) Social constraints, intrusive thoughts, and mental health after prostate cancer. Journal of Social and Clinical Psychology17: 89–106.
25.
LeporeSJItuartePHG (1999) Optimism about cancer enhances mood by reducing negative social interactions. Cancer Research, Therapy, and Control8: 165–174.
26.
LeporeSJRevensonTA (2007) Social constraints on disclosure and adjustment to cancer. Social and Personality Psychology Compass1: 313–333.
27.
ManneSLOstroffJWinkelGGranaGFoxK (2005) Partner unsupportive responses, avoidant coping, and distress among women with early stage breast cancer: Patient and partner perspectives. Health Psychology24: 635–641.
28.
ManneSLRubinSEdelsonM. (2007) Coping and communication-enhancing intervention versus supportive counseling for women diagnosed with gynecological cancers. Journal of Consulting and Clinical Psychology75: 615–628.
29.
MasiCMChenHYHawkleyLCCacioppoJT (2011) A meta-analysis of interventions to reduce loneliness. Personality and Social Psychology Review15: 219–266.
30.
MosherCEReddWHRiniCMBurkhalterJEDuHamelKN (2009) Physical, psychological, and social sequelae following hematopoietic stem cell transplantation: A review of the literature. Psycho-Oncology18: 113–127.
31.
MosherCEDuhamelKNRiniCCornerGLamJReddWH (2011) Quality of life concerns and depression among hematopoietic stem cell transplant survivors. Supportive Care in Cancer19: 1357–1365.
32.
NewsomJTRookKSNishishibaMSorkinDHMahanTL (2005) Understanding the relative importance of positive and negative social exchanges: Examining specific domains and appraisals. Journals of Gerontology: Psychological Sciences60: P304–P312.
33.
PinquartMFrohlichCSilbereisenRK (2007) Cancer patients’ perceptions of positive and negative illness-related changes. Journal of Health Psychology12: 907–921.
34.
PorterLSKeefeFJBaucomDH. (2009) Partner-assisted emotional disclosure for patients with gastrointestinal cancer: Results from a randomized controlled trial. Cancer115(18 Suppl): 4326–4338.
35.
PreacherKJHayesAF (2008) Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavioral Research Methods40: 879–891.
36.
RiniCDunkel SchetterC (2010) The effectiveness of social support transactions in intimate relationships. In: DavilaJSullivanK (eds) Support Processes in Intimate Relationships. New York: Oxford, pp. 26–67.
37.
RiniCManneSDuHamelK. (2008) Social support from family and friends as a buffer of low spousal support among mothers of critically ill children: A multilevel modeling approach. Health Psychology27: 593–603.
38.
RiniCReddWHAustinJ. (2011) Effectiveness of partner social support predicts enduring psychological distress after hematopoietic stem cell transplantation. Journal of Consulting and Clinical Psychology79: 64–74.
39.
RookKS (1987) Social support versus companionship: Effects on life stress, loneliness, and evaluations by others. Journal of Personality and Social Psychology52: 1132–1147.
40.
RusiewiczADuHamelKNBurkhalterJ. (2008) Psychological distress in long-term survivors of hematopoietic stem cell transplantation. Psycho-Oncology17: 329–337.
41.
RussellDW (1996) UCLA Loneliness Scale (Version 3): Reliability, validity, and factor structure. Journal of Personality Assessment66: 20–40.
42.
SalsmanJMSegerstromSCBrechtingEHCarlsonCRAndrykowskiMA (2009) Posttraumatic growth and PTSD symptomatology among colorectal cancer survivors: A 3-month longitudinal examination of cognitive processing. Psycho-Oncology18: 30–41.
43.
SatorraABentlerPM (1988) Scaling corrections for chi-square statistics in covariance structure analysis. Journal of the American Statistical Association1: 308–313.
44.
ShroutPEBolgerN (2002) Mediation in experimental and nonexperimental studies: new procedures and recommendations. Psychological Methods7: 422–445.
45.
SyrjalaKLKurlandBFAbramsJRSandersJEHeimanJR (2008) Sexual function changes during the 5 years after high-dose treatment and hematopoietic cell transplantation for malignancy, with case-matched controls at 5 years. Blood111: 989–996.
46.
SyrjalaKLLangerSLAbramsJR. (2004) Recovery and long-term function after hematopoietic cell transplantation for leukemia or lymphoma. Journal of the American Medical Association291: 2335–2343.
47.
ThoitsPA (1985) Social support and psychological well-being: Theoretical possibilities. In: SarasonIGSarasonBR (eds) Social Support: Theory, Research, and Applications. Dordrecht, The Netherlands: Martinus Nijhoff, pp. 51–72.
WeiMRussellDWZakalikRA (2005) Adult attachment, social self-efficacy, self-disclosure, loneliness, and subsequent depression for freshman college students: A longitudinal study. Journal of Counseling Psychology52: 602–614.
50.
WingardJRHuangICSobocinskiKA. (2010) Factors associated with self-reported physical and mental health after hematopoietic cell transplantation. Biology of Blood and Marrow Transplantation16: 1682–1692.
51.
ZaboraJBrintzenhofeSzocKCurbowBHookerCPiantadosiS (2001) The prevalence of psychological distress by cancer site. Psycho-Oncology10: 19–28.
52.
ZakowskiSGRamatiAMortonCJohnsonPFlaniganR (2004) Written emotional disclosure buffers the effects of social constraints on distress among cancer patients. Health Psychology23: 555–563.
