The influence of cognitive-behavioral stress management, optimism, and coping on positive growth in women with breast cancer

Date of Award




Degree Name

Doctor of Philosophy (Ph.D.)



First Committee Member

Michael H. Antoni - Committee Chair


There is evidence that some people experience positive growth, or "positive contributions," resulting from traumatic events. This study examined the roles of cognitive-behavioral stress management (CBSM) intervention, coping, and dispositional optimism on the perception of positive contributions as a result of having had breast cancer. The sample was comprised of 125 women with Stages 0, 1 and 11 breast cancer who were randomized to either a 10-week CBSM group intervention or a control group that received a one-day seminar after the 10-week intervention had completed. The first assessment was completed approximately 4--10 weeks after breast cancer surgery and the second was completed at the end of the 10-week intervention.In general, the women in this study were found to endorse high levels of positive contributions, dispositional optimism, and adaptive coping. The CBSM intervention, however, did not influence perceptions of positive contributions. In addition, it was found that there were few differences between the intervention subjects and control subjects on measures of coping, either longitudinally or cross-sectionally. Differences between the two groups in coping suggested that intervention subjects tended to use less avoidant coping strategies, such as substance use and self-distraction. Optimism did not predict positive contributions cross-sectionally or longitudinally.Despite these null findings, there were associations between coping and positive contributions that provided insight into factors associated with positive growth. Women who endorsed using higher levels of acceptance, active coping, positive reframing, religious coping, planning, and use of friends for emotional support had significantly higher levels of positive contributions than women who had lower levels of these coping strategies and higher levels of self-distraction and substance use.Exploratory analyses also found a measure of emotional processing to be predictive of positive contributions. Specifically, the quality of examining one's feelings was associated with positive growth cross-sectionally and longitudinally. As in the coping analyses, there were no significant differences between intervention subjects and control subjects on this variable.Overall, this research clearly shows associations between adaptive coping and positive growth. Future research should focus on how psychological interventions can enhance positive growth, how ethnic differences influence positive growth, and how group process variables are involved in perceptions of growth.


Women's Studies; Psychology, Clinical

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