Psychiatry Investig.  2018 Aug;15(8):805-810. 10.30773/pi.2018.06.07.

Avoidant Insecure Attachment as a Predictive Factor for Psychological Distress in Patients with Early Breast Cancer: A Preliminary 1-Year Follow-Up Study

• Lee SS
• Rim HD
• Won SH
• Woo J

• KMID: 2419370
• DOI: http://doi.org/10.30773/pi.2018.06.07

Abstract

OBJECTIVE
To identify attachment insecurity as an associative factor with unresolved psychological distress 1 year after surgery in the early breast cancer (BC) population.
METHODS
One-hundred fourteen participants completed the Hospital Anxiety and Depression Scale (HADS) and the Experiences in Close Relationship (ECR-M36) questionnaire within 1 week (baseline) and at 1-year post-surgery (follow-up). Participants were categorized into the distress and the non-distress groups based on a HADS-total score cut-off of 15. Logistic regression analysis revealed predictive factors of distress at follow-up.
RESULTS
At baseline, 53 (46.5%) participants were found to be in the distress group. The degree of distress decreased over 1 year (p= 0.003); however, 43 (37.7%) showed significant remaining distress at follow-up. Baseline scores of the ECR-M36 avoidance [odds ratio (OR)=1.045, 95% confidence interval (CI)=1.002-1.090] and HADS-total (OR=1.138, 95% CI=1.043-1.241) were predictors of distress at follow-up.
CONCLUSION
A substantial proportion of early BC patients suffer distress even one-year after surgery. Avoidant attachment appeared to be an influential factor on distress in early BC patients. Moreover, the finding that initial distress level could predict one at 1-year post-operation warrant a screening and management of distress along with BC treatment.

Keyword

Distress; Breast cancer; Follow-up; Attachment; Predictors

MeSH Terms

Anxiety
Breast Neoplasms*
Breast*
Depression
Follow-Up Studies*
Humans
Logistic Models
Mass Screening