Publication Date




Embargo Period


Degree Type


Degree Name

Master of Science (MS)


Psychology (Arts and Sciences)

Date of Defense


First Committee Member

Michael H. Antoni

Second Committee Member

Youngmee Kim

Third Committee Member

Suzanne Lechner


Women vary widely in their ability to adapt psychologically and physiologically to the stressors of diagnosis and treatment for breast cancer, and such adaptation may depend on a number of cognitive and cultural individual difference factors. Research has found that women differ in the degree to which they identify with their ethnic group and in the type of strategies they use for coping. These differences have been associated with differences in various aspects of quality of life, psychosocial and physiological adaptation in particular, in women with early stage breast cancer. However, research has yet to clarify the roles of ethnicity, with a focus on individual difference factors such as cognitive and cultural factors, in the psychosocial and physiological adaptation to breast cancer. Thus, the current study had 3 aims: Specific Aim 1: To test whether Hispanic and NH White women differ in adaptation after surgery for breast cancer through assessments of quality of life, general distress, intrusive thoughts, and serum cortisol levels. It was hypothesized that Hispanic women would have poorer quality of life, greater distress, and greater levels of cortisol than NH White women. Specific Aim 2: To test the interaction of ethnic group (Hispanic versus NH White) and ethnic identity on adaptation to breast cancer. It was hypothesized that ethnic group would interact with ethnic identity to predict adaptation such that in Hispanic women greater ethnic identity would be associated with better psychological and physiological adaptation, whereas in NH White women those with greater and lower ethnic identity would not differ in their adaptation to breast cancer. Exploratory Aim: To test the interaction of ethnic group (Hispanic versus NH White) and emotionally expressive coping on adapting to breast cancer. It was hypothesized that ethnic group would interact with emotionally expressive coping to predict adaptation. In total, 362 women (38% Hispanic, 62% non-Hispanic White) who recently underwent surgery for non-metastatic breast cancer provided valid data. They provided an afternoon blood sample and completed self-report questionnaires including the Affects Balance Scale (ABS), a measure of mood states to indicate general distress; the Physical Well-Being and Emotional Well-Being subscales of the Functional Assessment of Cancer Therapy – Breast (FACT-B); the Impact of Events Scale (IES) Intrusive Thoughts subscale, a measure of cancer-specific distress; the Multigroup Ethnic Identity Scale (MEIM), an indicator of ethnic identity; and the Emotional Approach Coping Scale (EAC), which measures emotional expression. Multiple regression analysis was used. Findings showed no ethnic group differences in adaptation to breast cancer, and no significant ethnic group by ethnic identity or ethnic group by emotionally expressive coping interaction effects on psychological or physiological outcomes in this cohort of women undergoing primary treatment for non-metastatic breast cancer. These results were discrepant with those of prior studies, which have reported ethnic differences in adaptation to breast cancer, a positive association between ethnic identity and well-being in minorities, and ethnic differences in benefits associated with certain coping strategies. These differences point to a need to examine under what conditions ethnic disparities in adaptation to breast cancer exist. Further research to identify sociocultural factors that play significant roles in Hispanic women’s adjustment to breast cancer is needed.


breast cancer; ethnicity; ethnic identity