Posttraumatic Growth in a Cognitive Behavioral Couple Intervention for Women with Early Stage Breast Cancer Public Deposited

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  • March 20, 2019
Creator
  • Wiesenthal, Naomi
    • Affiliation: College of Arts and Sciences, Department of Psychology and Neuroscience
Abstract
  • Breast cancer patients and their partners often report positive functioning they attribute to cancer - termed posttraumatic growth. This study attempts to understand the nature of that growth in the couple context. Specifically, is growth a more individual or relational phenomenon? Do happier marriages promote growth? Does individual growth promote marital adjustment? Individual-based interventions with breast cancer populations have enhanced posttraumatic growth, but because partners also suffer and may be involved in the growth process, this study evaluates a couple-based cognitive behavioral intervention incorporating efforts to promote growth. Prior couple-based interventions with cancer populations have improved psychological, relationship, and sexual functioning, but this is the first intervention aimed at enhancing posttraumatic growth. In addition, this study seeks to understand the role of gender in growth and the trajectory of growth over time. Participants were 36 heterosexual couples in which the wife was diagnosed with Stage I, II, or IIIa breast cancer. Twenty-three couples were randomized to intervention and 13, to the treatment-as-usual control condition. Pretest and posttest assessments included Benefit Finding (Antoni et al., 2001), the Posttraumatic Growth Inventory (Tedeschi & Calhoun, 1996), and the Dyadic Adjustment Scale - Short Form (Sharpley & Rogers, 1984). Data were analyzed using multilevel modeling, with time nested within individual, and individuals within couples. Intraclass correlation coefficients revealed that although somewhat relational in nature, posttraumatic growth remains a predominantly individual phenomenon. Further, relationship quality does not enhance growth, nor does growth facilitate happier relationships. Despite strong gains in other domains, treatment did not enhance posttraumatic growth, nor did couples in the treatment condition develop a more similar perspective on growth in the cancer experience. In addition, posttraumatic growth was not more relational in nature for treatment than for control couples. Consistent with hypotheses, women initially reported greater growth than men. Over time, in the control condition, men experienced an increase in growth, approaching women's level. In the treatment condition, however, this convergence did not occur. Thus, contrary to expectations, couples did not come to a shared experience of meaning in the cancer experience, regardless of relationship quality, nor did the couple-based intervention appear to facilitate growth.
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  • In Copyright
Advisor
  • Baucom, Donald
Degree
  • Doctor of Philosophy
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2006
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