Indian Journal of Positive Psychology

2013, 4(4), 510-513

2013 Indian Association of Health,

Research and Welfare

http://www.iahrw.com/index.php/home/journal_detail/19#list

A study of coping, psychological distress and subjective wellbeing

among breast cancer women
Neelam

Parinka Devi

Psychologist, B. P. S. Govt. Medical College

Khanpur Kalan, Sonepat, Haryana

Department of Psychology
Kurukshetra University, Kurukshetra, Haryana

Breast cancer among women is associated with a large number of psychological problems. The women suffering
from breast cancer underwent severe psychological distress, use various coping mechanisms to improve their
overall quality of life. The present investigation was planned to study psychological distress, coping resources and
subjective well-being among breast cancer women in comparison to normal women. The sample for the study
consisted of 200 women (100 Breast cancer and 100 normal). The sample was assessed with Subjective Wellbeing
Inventory, Coping Resources Index, and General Health Questionnaire-12 (GHQ-12). Data were processed for
Discriminant Analysis. When compared, results clearly demonstrated poor subjective well-being, high level of
psychological distress, and inappropriate coping among breast cancer women as compared to their normal
counterparts. Discriminant Analysis clearly revealed a linear combination of five aspects of subjective well-being
which account for considerable degree of variation between breast cancer and normal women groups.

Keywords: breast cancer, distress, coping, wellbeing

Breast cancer (BC) is the most frequent malignant disease among
women. According to American reports every third cancer is
diagnosed as BC. In 2002 the incidence rate and death rate for
invasive BC, were 124.9 and 25.5 per 100,000 women respectively
(US Cancer Statistics). There is extensive literature on the
psychological impact of cancer in breast cancer patients. Reviews of
existing research estimate that a third to half of women with breast
cancer experience psychological distress and that multiple
antecedent and concomitant factors influence psychological
functioning of patients over time (Knobf, 2007 and Institute of
Medicine, 2004). Psychological distress experienced by cancer
patients has been thoroughly studied throughout the various stages of
the disease. Interestingly, although several studies have shown that
cancer patients in general, breast cancer patients included, were more
depressed than the general population, a meta analytical review
showed that no significant differences were found in terms of anxiety
and overall psychological distress (Van't et al.,1997). In patients with
a prognosis of six months or less, prevalence of depression according
to the ICD-10 diagnostic criteria was 22% (Lloyd Williams &
Friedman, 2001), while studies that have focused on psychological
distress during the course of the disease have shown that
psychological distress increases significantly in the last two to three
months before death and especially in the last month of life (Hanson
et al., 2000., Hwang et al., 2003; & Akechi et al., 2004). Regarding
breast cancer in particular, up to one third of patients may suffer from
psychological morbidity during the year following an initial
operation (Lloyd Williams & Friedman, 2001, Helgeson et al., 2004
& Thewes, 2004); moreover, it is acknowledged that adverse effects
of adjuvant cancer treatments may also play a part in psychological
adjustment (Ferrell et al., 1996), with problems persisting in a
significant proportion of women up to several years following
treatment (Stanton et al., 2002; & Knobf, 2002). Furthermore,
several psychosocial and demographic variables have been
Correspondence should be sent to Neelam, Psychologist,
B. P. S. Govt. Medical College, Khanpur Kalan, Sonepat

identified as affecting psychological morbidity, such as age at

diagnosis (Cowley et al., 2000; Arora et al., 2001), marital status
(Ganz et al., 2003, 2004), health complaints after surgery unrelated
to cancer (18), and premorbid personality characteristics (Ganz et
al., 2003; Glaus et al., 2006). However, in the majority of studies
assessing psychopathology in women suffering from breast cancer,
either within group comparisons are made at different time points,
i.e. before and after the onset of the disease or during its progress
through different stages, or between the study group and a group of
patients suffering from another disease. Few studies have included a
control group of healthy women and usually their principal objective
was not to measure psychopathology (Stone et al., 2000; Carlson et
al., 2007). WOMEN with breast cancer feel diverse physical
concerns as well as emotional problems such as distress, anxiety, or
depression (Spiegel, 1997). As a way to reduce these problems and
increase their quality of life, women with breast cancer have been
found to rely on a diverse range of coping mechanisms, which are
known to reduce distress (e.g. Han et al., 2008).
The objective of the present study was to compare a group of
women suffering from breast cancer and a control group of healthy
women or women suffering from benign breast diseases in terms of
coping, psychogogical distress and subjective wellbeing. A further
aim was to identify potential risk factors for the development of
psychological morbidity, as its early detection and preventive
therapeutic interventions have been found in longitudinal studies to
improve outcome (Hanson et al., 2000).

Method
Participants
The sample used in the present study consisted of two groups of
subjects i.e. Clinical group Breast Cancer patients (N=100) and
normal controls (N=100). The sample was collected from PGIMS,
Rohtak and Rajiv Gandhi Cancer Institute and Research Centre,
New Delhi. After due permission from hospital authorities, the
patients who volunteered to participate, were included in the sample.