Resource loss, resource gain, and psychological resilience and dysfunction following cancer diagnosis: a growth mixture modeling approach

Health Psychol. 2010 Sep;29(5):484-495. doi: 10.1037/a0020809.


Objective: This study investigated trajectories of psychological distress and their relationships with change in psychosocial resources in the year following cancer diagnosis.

Design: Chinese colorectal cancer (CRC) patients (n = 234) were assessed within 12 weeks of diagnosis (T1) and again at 3-month (T2) and 12-month (T3) follow-ups. Growth mixture modeling was used to analyze the longitudinal data.

Main outcome measures: Psychological distress was measured at the three time-points using Hospital Anxiety and Depression Scale (HADS).

Results: Growth mixture models identified four classes: chronic distress (7-9%), delayed distress (10-13%), recovery (13-16%), and resilient (65-67%). People in chronic distress were more likely to demonstrate loss in physical functioning and social relational quality than those in delayed distress, and loss in physical functioning, optimism, and hope than those in recovery, but more likely to demonstrate stability/gain in optimistic personalities than those in delayed distress and resilient. People in resilient were more likely to report stability/gain in optimistic personalities than those in delayed distress but not those in recovery.

Conclusion: Understanding differential outcome trajectories and associated change in coping resources has implications for developing ongoing psychological services for cancer patients during the diagnosis and treatment process.

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Aged
  • Aged, 80 and over
  • Asian People
  • China
  • Colorectal Neoplasms / diagnosis*
  • Colorectal Neoplasms / ethnology
  • Colorectal Neoplasms / psychology*
  • Depression / psychology*
  • Female
  • Follow-Up Studies
  • Humans
  • Life Change Events
  • Male
  • Middle Aged
  • Models, Psychological
  • Personality
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Resilience, Psychological*
  • Social Support
  • Socioeconomic Factors
  • Stress, Psychological / psychology*
  • Time Factors