Identification and prediction of distress trajectories in the first year after a breast cancer diagnosis

Health Psychol. 2010 Mar;29(2):160-8. doi: 10.1037/a0017806.


Objective: In this article, we aim to (a) identify distinct trajectories of psychological distress in the first year after a breast cancer diagnosis in women treated with adjuvant therapy and (b) explore possible predictors of these trajectories, that is, demographic, medical, and personal characteristics.

Method: The 171 patients were assessed after diagnosis, after surgery, after adjuvant treatment, in the reentry phase, and in the (short-term) survivorship phase (2 and 6 months after the end of treatment, respectively).

Main outcome measure: Psychological distress was assessed with the 12-item General Health Questionnaire.

Results: There were four trajectories of distress: a group that experienced no distress (36.3%), a group that experienced distress only in the active treatment phase (33.3%), a group that experienced distress in the reentry and survivorship phase (15.2%), and a group that experienced chronic distress (15.2%). Personality and physical complaints resulting from adjuvant treatment could distinguish the distress trajectories. Mastery was the only unique predictor.

Conclusion: Most patients were not distressed in response to breast cancer or only temporarily so. Yet, a minority of patients became or remained distressed after the end of treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Aged
  • Anxiety Disorders / diagnosis*
  • Anxiety Disorders / psychology*
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / psychology*
  • Breast Neoplasms / radiotherapy
  • Breast Neoplasms / surgery
  • Chemotherapy, Adjuvant / psychology
  • Combined Modality Therapy / psychology
  • Depressive Disorder / diagnosis*
  • Depressive Disorder / psychology*
  • Female
  • Follow-Up Studies
  • Humans
  • Illness Behavior*
  • Internal-External Control
  • Life Change Events
  • Mastectomy / psychology
  • Middle Aged
  • Netherlands
  • Personality Inventory / statistics & numerical data
  • Psychometrics
  • Radiotherapy, Adjuvant / psychology
  • Stress Disorders, Post-Traumatic / diagnosis*
  • Stress Disorders, Post-Traumatic / psychology*