Social Support and Psychological Distress in Cancer: Stress as a Mediator

Authors' Affiliations

Morgan K. Treaster1, B.A., Fuschia Sirois2, Ph.D., Martin Offenbächer3, Ph.D., Loren Touissant4, Ph.D., Niko Kohls5, Ph.D., Eberhard Nöfer5, Ph.D., & Jameson K. Hirsch1, Ph.D. 1. Department of Psychology, College of Arts & Sciences, East Tennessee State University, Johnson City, Tennessee; 2. Department of Psychology, University of Sheffield, Sheffield, United Kingdom; 3. Institute of General Medicine, University Hospital, Munich, Germany; 4. Department of Psychology, Luther College, Decorah, Iowa; 5. Department of Integrated Health Promotion, Coburg University, Coburg, Germany

Location

Ballroom

Start Date

4-5-2018 8:00 AM

End Date

4-5-2018 12:00 PM

Poster Number

54

Name of Project's Faculty Sponsor

Jameson K. Hirsch

Faculty Sponsor's Department

Department of Psychology

Classification of First Author

Graduate Student-Master’s

Type

Poster: Competitive

Project's Category

Social and Behavioral Sciences

Abstract or Artist's Statement

Cancer affects nearly 15 million Americans, and is the second leading cause of death in the U.S. Persons with cancer, including those in recovery, are at increased risk for mental health difficulties; 15% - 25% experience clinically significant depressive symptoms and approximately 12% meet criteria for an anxiety disorder. Poor mental health may be due to heightened levels of stress related to the illness experience, such as uncertainty about the course of disease or adapting to functional impairments (e.g., cleaning, walking) and illness symptoms (e.g., pain). Lack of predictability regarding symptoms and physical limitations may lead to negative mood states, such as fear, worry, or sadness. However, not all persons living with or recovering from cancer, experience psychological distress, perhaps due to individual-level factors, such as social support. An available network of persons (e.g., friends, family) who can provide emotional (e.g., empathy), instrumental (e.g., health advice), or tangible (e.g., assistance with chores) support may lower levels of perceived stress and, in turn, may reduce the likelihood of experiencing psychological distress. Based on this, we examined the linkage between social support and symptoms of psychopathology, and the mediating role of perceived stress.

At the bivariate level, we hypothesized that social support would be negatively related to stress and symptoms of depression and anxiety, and that stress would be positively related to both depressive and anxiety symptoms. At the multivariate level, we hypothesized that stress would mediate the relations between social support and symptoms of anxiety and depression, such that higher levels of social support would be associated with lower levels of perceived stress and, in turn, to fewer symptoms of depression and anxiety.

Our sample of persons living with, or in remission from, cancer (N = 236) was primarily White (91.5%; n = 216) and female (64.4%; n = 152). Participants completed self-report measures including the Modified Social Support Survey, Perceived Stress Scale, and Multidimensional Health Profile – Psychosocial Functioning. Bivariate correlations and multivariate analyses, per Hayes (2013), were conducted covarying age, sex, and ethnicity. In bivariate correlations, all variables were significantly related to one another in the hypothesized directions (p < .01). In serial mediation analyses, the total effect of social support on depressive symptoms was significant (t = -5.22, p < .001), and the direct effect was nonsignificant when stress was added to the model (t = -1.72, p = .09), indicating mediation. In the second model, stress also mediated the relation between social support and anxiety symptoms; the total effect was significant (t = -4.56, p < .001), and the direct effect was nonsignificant (t = -1.73, p = .09).

Supporting hypotheses, our results suggest that to the extent one has available social support, illness-related stress may be lessened and, in turn, cancer-affected persons may experience fewer symptoms of depression and anxiety. Therapeutic interventions focused on enhancing one’s social support network (e.g., cancer support groups) or lowering perceived stress (e.g., Mindfulness Based Stress Reduction) may reduce experiences of psychological distress among persons living with, or in remission from, cancer.

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Apr 5th, 8:00 AM Apr 5th, 12:00 PM

Social Support and Psychological Distress in Cancer: Stress as a Mediator

Ballroom

Cancer affects nearly 15 million Americans, and is the second leading cause of death in the U.S. Persons with cancer, including those in recovery, are at increased risk for mental health difficulties; 15% - 25% experience clinically significant depressive symptoms and approximately 12% meet criteria for an anxiety disorder. Poor mental health may be due to heightened levels of stress related to the illness experience, such as uncertainty about the course of disease or adapting to functional impairments (e.g., cleaning, walking) and illness symptoms (e.g., pain). Lack of predictability regarding symptoms and physical limitations may lead to negative mood states, such as fear, worry, or sadness. However, not all persons living with or recovering from cancer, experience psychological distress, perhaps due to individual-level factors, such as social support. An available network of persons (e.g., friends, family) who can provide emotional (e.g., empathy), instrumental (e.g., health advice), or tangible (e.g., assistance with chores) support may lower levels of perceived stress and, in turn, may reduce the likelihood of experiencing psychological distress. Based on this, we examined the linkage between social support and symptoms of psychopathology, and the mediating role of perceived stress.

At the bivariate level, we hypothesized that social support would be negatively related to stress and symptoms of depression and anxiety, and that stress would be positively related to both depressive and anxiety symptoms. At the multivariate level, we hypothesized that stress would mediate the relations between social support and symptoms of anxiety and depression, such that higher levels of social support would be associated with lower levels of perceived stress and, in turn, to fewer symptoms of depression and anxiety.

Our sample of persons living with, or in remission from, cancer (N = 236) was primarily White (91.5%; n = 216) and female (64.4%; n = 152). Participants completed self-report measures including the Modified Social Support Survey, Perceived Stress Scale, and Multidimensional Health Profile – Psychosocial Functioning. Bivariate correlations and multivariate analyses, per Hayes (2013), were conducted covarying age, sex, and ethnicity. In bivariate correlations, all variables were significantly related to one another in the hypothesized directions (p < .01). In serial mediation analyses, the total effect of social support on depressive symptoms was significant (t = -5.22, p < .001), and the direct effect was nonsignificant when stress was added to the model (t = -1.72, p = .09), indicating mediation. In the second model, stress also mediated the relation between social support and anxiety symptoms; the total effect was significant (t = -4.56, p < .001), and the direct effect was nonsignificant (t = -1.73, p = .09).

Supporting hypotheses, our results suggest that to the extent one has available social support, illness-related stress may be lessened and, in turn, cancer-affected persons may experience fewer symptoms of depression and anxiety. Therapeutic interventions focused on enhancing one’s social support network (e.g., cancer support groups) or lowering perceived stress (e.g., Mindfulness Based Stress Reduction) may reduce experiences of psychological distress among persons living with, or in remission from, cancer.