The aim of this study was to assess, in the immediate postsurgical period, the influence of attachment avoidance and anxiety on distress and body image disturbances in women facing breast cancer. Seventy-five women participated in the study 3 weeks after surgery. Questionnaires were used to assess study variables. To predict distress and body image disturbances, we controlled for several variables known to influence adjustment to the stress of breast cancer. The results of hierarchical regression analyses show that attachment explains the outcomes above and beyond other influential variables. Insecurely attached women are especially vulnerable to the stress of the disease.
AndoNIwamitsuYKuranamiM. (2011) Predictors of psychological distress after diagnosis in breast cancer patients and patients with benign breast problems. Psychosomatics52(1): 56–64. DOI: 10.1016/j.psym.2010.11.012.
2.
AroraNKFinney RuttenLJGustafsonDH. (2007) Perceived helpfulness and impact of social support provided by family, friends, and health care providers to women newly diagnosed with breast cancer. Psychooncology16(5): 474–486. DOI: 10.1002/pon.1084.
3.
AuerbachSKendallPCuttlerH. (1976) Anxiety, locus of control, type of preparatory information, and adjustment to dental surgery. Journal of Consulting and Clinical Psychology44(5): 809–818. DOI: 10.1037/0022-006X.44.5.809.
4.
AvisNECrawfordSManuelJ (2004) Psychosocial problems among younger women with breast cancer. Psychooncology13: 295–308. DOI: 10.1002/pon.744.
5.
BartholomewKHorowitzLM (1991) Attachment styles among young adults: A test of a four-category model. Journal of Personality and Social Psychology61(2): 226–244. DOI: 10.1037/0022-3514.61.2.226.
6.
BloomJRStewartSLChangS. (2004) Then and now: Quality of life of young breast cancer survivors. Psychooncology13(3): 147–160. DOI: 10.1002/pon.794.
7.
BowlbyJ (1969) Attachment and Loss: Attachment, vol. 1. New York: Basic Books.
8.
BurgessCCorneliusVLoveS. (2005) Depression and anxiety in women with early breast cancer: Five year observational cohort study. British Medical Journal330(7493): 702. DOI: 10.1136/bmj.38343.670868.D3.
9.
CashTFThériaultJAnnisNM (2004) Body image in an interpersonal context: Adult attachment, fear of intimacy and social anxiety. Journal of Social and Clinical Psychology23(1): 89–103. DOI: 10.1521/jscp.23.1.89.26987.
10.
CoyneJCPalmerSCShapiroPJ. (2004) Distress, psychiatric morbidity, and prescriptions for psychotropic medication in a breast cancer waiting room sample. General Hospital Psychiatry26(2): 121–128. DOI: 10.1016/j.genhosppsych.2003.08.012.
DiamondLMHicksAMOtter-HendersonK (2006) Physiological evidence for repressive coping among avoidantly attached adults. Journal of Social and Personal Relationships23(2): 205–229. DOI: 10.1177/0265407506062470.
13.
FobairPStewartSLChangS. (2006) Body image and sexual problems in young women with breast cancer. Psychooncology15(7): 579–594. DOI: 10.1002/pon.991.
14.
FraleyRWallerNBrennanK (2000) An item response theory analysis of self-report measures of adult attachment. Journal of Personality and Social Psychology78: 350–365. DOI: 10.1037/0022-3514.78.2.350.
15.
GoldbergJAScottRNDavidsonPM. (1992) Psychological morbidity in the first year after breast surgery. European Journal of Surgical Oncology18: 327–331.
16.
Goldschmidt MertzBBistrupPEJohansenC. (2012) Psychological distress among women with newly diagnosed breast cancer. European Journal of Oncology Nursing16(4): 439–443. DOI: 10.1016/j.ejon.2011.10.001.
17.
HärtlKJanniWKästnerR. (2003) Impact of medical and demographic factors on long-term quality of life and body image of breast cancer patients. Annals of Oncology14(7): 1064–1071. DOI: 10.1093/annonc/mdg289.
18.
HazanCShaverP (1987) Romantic love conceptualized as an attachment process. Journal of Personality and Social Psychology52: 511–524. DOI: 10.1037/0022-3514.52.3.511.
19.
HegelMTMooreCPCollinsED. (2006) Distress, psychiatric syndromes, and impairment of function in women with newly diagnosed breast cancer. Cancer107(12): 2924–2931. DOI: 10.1002/cncr.22335.
20.
HelmsRLO’HeaELCorsoM (2008) Body image issues in women with breast cancer. Psychology, Health & Medicine13(3): 313–325. DOI: 10.1080/13548500701405509.
21.
HopwoodPFletcherILeeA. (2001) A body image scale for use with cancer patients. European Journal of Cancer37(2): 189–197. DOI: 10.1016/S0959-8049(00)00353-1.
22.
KayserKScottJ (2008) Helping Couples Cope with Women’s Cancers. New York: Springer.
23.
KimYCarverCS (2007) Frequency and difficulty in caregiving among spouses of individuals with cancer: Effects of adult attachment and gender. Psychooncology16(8): 714–723. DOI: 10.1002/pon.1110.
24.
KornblithABPowellMReganMM. (2007) Long-term psychosocial adjustment of older vs younger survivors of breast and endometrial cancer. Psychooncology16(10): 895–903. DOI: 10.1002/pon.1146.
25.
LeungJPachanaNAMcLaughlinD (2014) Social support and health-related quality of life in women with breast cancer: A longitudinal study. Psychooncology23: 1014–1020. DOI: 10.1002/pon.3523.
26.
McKinleyNMRandaLA (2005) Adult attachment and body satisfaction: An exploration of general and specific relationship differences. Body Image2(3): 209–218. DOI: 10.1016/j.bodyim.2005.04.003.
27.
ManciniADBonnanoGAClarkAE (2011) Stepping off the hedonic treadmill: Individual differences in response to major life events. Journal of Individual Differences32(3): 144–152. DOI: 10.1027/1614-0001/a000047.
28.
MaunderRGLanceeWJNolanRP. (2006) The relationship of attachment insecurity to subjective stress and autonomic function during standardized acute stress in healthy adults. Journal of Psychosomatic Research60(3): 283–290. DOI: 10.1016/j.jpsychores.2005.08.013.
29.
MikulincerMFlorianV (1998) The relationship between adult attachment styles and emotional and cognitive reactions to stressful events. In: SimpsonJRholesW (eds) Attachment Theory and Close Relationships. New York: Guilford Press, pp. 143–165.
30.
MikulincerMShaverPR (2007) Attachment in Adulthood: Structure, Dynamics and Change. New York: Guilford Press.
31.
MikulincerMShaverPR (2008) Adult attachment and affect regulation. In: CassidyJShaverPR (eds) Handbook of Attachment (2nd edn). New York: Guilford Press, pp. 503–531.
32.
NordinKBerglundGGlimeliusB. (2001) Predicting anxiety and depression among cancer patients: A clinical model. European Journal of Cancer37(3): 376–384. DOI: 10.1016/S0959-8049(00)00398-1.
PetronisVMCarverCSAntoniMH. (2003) Investment in body image and psychosocial well-being among women treated for early stage breast cancer: Partial replication and extension. Psychology & Health18(1): 1–13. DOI: 10.1080/0887044021000020941.
35.
ReichMLesurAPerdrizet-ChevallierC (2008) Depression, quality of life and breast cancer: A review of the literature. Breast Cancer Research and Treatment110(1): 9–17. DOI: 10.1007/s10549-007-9706-5.
36.
RodinGWalshAZimmermannC. (2007) The contribution of attachment security and social support to depressive symptoms in patients with metastatic cancer. Psychooncology16(12): 1080–1091. DOI: 10.1002/pon.1186.
37.
SarasonIGSarasonBRShearinEN. (1987) A brief measure of social support: Practical and theoretical implications. Journal of Social and Personal Relationships4(4): 497–510. DOI: 10.1177/0265407587044007.
38.
SchmidtSNachtigallCWuethrich-MartoneO. (2002) Attachment and coping with chronic disease. Journal of Psychosomatic Research53(3): 763–773. DOI: 10.1016/S0022-3999(02)00335-5.
39.
SchoverL (1994) Sexuality and body image in younger women with breast cancer. Journal of the National Cancer Institute: Monographs16(1): 177–182.
ShimozumaKGanzPPetersenL. (1999) Quality of life in the first year after breast cancer surgery: Rehabilitation needs and patterns of recovery. Breast Cancer Research and Treatment56(1): 45–57. DOI: 10.1023/a:1006214830854.
42.
TiggemannM (2004) Body image across the adult life span: Stability and change. Body Image1(1): 29–41. DOI: 10.1016/S1740-1445(03)00002-0.
43.
UchinoB (2004) Social Support and Physical Health: Understanding the Health Consequences of Relationships. New Haven, CT: Yale University Press.
