Benefit-finding doesn't always mean improved lives for breast cancer patients

Finding the good in the bad isn't always good when facing a breast cancer diagnosis, according to a study in the January issue of Health Psychology (Vol. 23, No. 1). Women in more severe stages of breast cancer who perceive more benefits following their diagnosis tend to face a poorer quality of life--including worse mental functioning--compared with women who do not perceive benefits from their diagnoses, the study suggests.

 In the study, researchers interviewed 364 women diagnosed with Stage I, II or III breast cancer at four, seven and 13 months after their diagnoses to assess their quality of life and whether they reported experiencing benefits from their diagnoses. The women rated the extent that their attitudes and behaviors had changed since their diagnoses, such as changes in their personal priorities, daily activities, family, world views and relationships. They also completed several batteries of tests and scales to help gauge their quality of life, mental and physical functioning and mood.

Women who perceived such benefits as closer relationships, greater appreciation of life and a change in life priorities were found to have poorer mental health, according to the study.

Why? Women who report benefits stemming from their diagnoses may be trying to reduce the threat of the diagnosis, in denial or reluctant to concede the severity of--or their own stress over--the diagnosis, suggests lead researcher Patricia L. Tomich, PhD, a postdoctoral researcher in the psychology department at Carnegie Mellon University.

Minorities, women with a low socioeconomic status and those in more severe stages of the disease--II and III--tended more often to report benefits from their diagnoses than other women in the study, found Tomich, who collaborated with co-author Vicki S. Helgeson, PhD, a psychology professor at Carnegie Mellon, on the study.

Tomich suggests these women may face hardships in their lives--such as discrimination or financial trouble--and therefore might have more experience than other women in construing something positive from a negative event. Also, women diagnosed with more severe stages of breast cancer may have found more benefits from their diagnoses because they have more critically examined their situation than women diagnosed with a less severe stage, Tomich says.

However, research findings in this emerging topic on the effects of finding benefits in traumas remain inconsistent, Tomich adds. Some studies have found that finding benefits in traumatic life events improves quality of life; other studies, like the present one, have shown it can have a negative impact, such as greater distress.

"We really need to do more research in this area to find out if people truly change," Tomich says. "Some researchers suggest that benefit-finding is illusory. We still need to determine if there is a true positive change or personal growth from the diagnosis, or do these women just think they have changed for the better?"

Another explanation for the discrepancy in previous research, Tomich says, is the timing of when benefits are assessed. In the current study, researchers interviewed women early on after their diagnoses.

"It's possible that when individuals are asked about benefits early in the coping process, benefits may be related to factors that may not be healthy, such as greater distress," Tomich says. "But benefits found later in the coping process may reflect more substantive life changes that have a more positive impact on quality of life."

--M. DITTMANN