Structural Equation Modeling of Cancer Adaptation and Mentalization: The Mediating Role of dissociative experiences in Breast Cancer Patients
Subject Areas :
Fatemeh Shahamat Dehsorkh
1
*
,
Bahar Sabri Zam
2
*
1 - Psychology, Department of Psychology, Faculty of humanities, Khayyam University, Mashhad, Iran
2 - Department of Psychology, Faculty of Humanities, Khayyam University, Mashhad, Iran.
Keywords: Breast cancer, dissociation experiences, psychological adjustment, mentalization,
Abstract :
Psychological factors play an important role in psychological adjustment to breast cancer. One of the important factors is the ability to mentalize mental issues. The aim of this study was to model the structural equations of psychological adjustment and mentalization and the mediating role of analytical experiences in breast cancer patients. Research Method: Descriptive-correlation is a structural equation model. The study population includes all statistics of women with breast cancer referred to Reza Medical Center in Mashhad in the first six months of 1400. Using the sampling method in 190 patients Breast cancer were selected. For the measurements of the study, the abbreviated form of mental adjustment (MAC), the conclusion of reflective action and the analysis of analytical experiences were used. All research data were used by Pearson correlation coefficient, and LISREL and SPSS statistical software were used for modeling. The findings showed that there is a significant relationship between mind building and psychological adjustment, and between analytical experiences and psychological adjustment, and between mentalization and analytical experiences in women with breast cancer, but the experiences of mediating analysis Meaning is between two variables. is not. Discussion and Conclusion: It can be stated that mentalization has a significant effect on psychological adjustment to cancer in patients. To better understand the indirect effects of experiences, psychological adjustment and mentalization are needed to consider disease progression and length of treatment.
حسینی، سید رحمان؛ اژه‌ای، جواد؛ غلامعلی لواسانی، مسعود؛ و خلیلی، شیوا. (1396). بررسی اثربخشی مشاورۀ گروهی مبتنی بر نظریۀ انتخاب و واقعیت درمانگری بر افزایش سازگاری اجتماعی و خود- تنظیمی در نوجوانان. مجله روان‌شناسی، 2(21)، 132-118.
زاهد، سعیده؛ نژادحمدی، ندا؛ عربزاده، مهدی؛ رحیمی، ریحانه؛ و چراغی، فرشته. (1401). تأثیر آموزش مدیریت اضطراب امتحان بر ذهن‌آگاهی، انعطاف‌پذیری روانشناختی و تاب‌آوری در دانش‌آموزان دارای اضطراب امتحان. مجله روان‌شناسی، 4(26)، 395-386.
فتح الهی‌انویق، محرم؛ خادمی، علی؛ اعتمادی نیا، مهین؛ و شاکر دولق، علی. (1399). مدل‌یابی سازگاری روانی زنان با سرطان براساس تأثیر علی طرح‌واره‌های ناسازگار اولیه با درنظر گرفتن نقش سبک‌های اِسناد علی به‌عنوان متغیر واسطه‌ای. مجله مطالعات علوم پزشکی، 31(11)، 823-835.
کارگربرزی، حمید؛ کربلایی محمدمیگونی، احمد؛ برماس، حامد؛ و تقی‌لو، صادق. (1397). ویژگی‌های روان‌سنجی مقیاس تجارب تجزیه‌ای و همبستگی آن با افکار خودکشی و صفات بیمارگون شخصیت در بیماران افسرده. فصلنامه اندازه‌گیری تربیتی، 9(34)، 115-131.
کاوه‌فارسانی، ذبیح الله؛ نظری‌فر، محسن؛ و محمودی نجف‌آبادی، فاطمه. (1402). ارزیابی الگوی رابطه بین ذهن‌آگاهی و کیفیت رابطه زناشویی با میانجی‌گری باورهای لذت‌بری و قدردانی. مجله روان‌شناسی، 1(27)، 9-1.
American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders. https://doi.org/10.1176/appi.books.9780890425787
Antoni, M. H., Diaz, A., Taub, C., Fisher, H., Carver, C. S., Lippman, M., Hudson, B., & Blomberg, B. B. (2019). Abstract # 2061 Brief stress management interventions after surgery improve psychological adaptation and immune cell signaling in breast cancer patients. Brain, Behavior, and Immunity, 76, e6. https://doi.org/10.1016/J.BBI.2018.11.189
Ballespí, S., Vives, J., Debbané, M., Sharp, C., & Barrantes-Vidal, N. (2018). Beyond diagnosis: Mentalization and mental health from a transdiagnostic point of view in adolescents from non-clinical population. Psychiatry Research, 270, 755–763. https://doi.org/10.1016/J.PSYCHRES.2018.10.048
Board, P. S. and P. C. E. (2022). Adjustment to Cancer: Anxiety and Distress (PDQ®). PDQ Cancer Information Summaries. https://www.ncbi.nlm.nih.gov/books/NBK65960/
Bromberg, P. M. (2013). Standing in the Spaces. Https://Doi.Org/10.1080/00107530.1996.10746334, 32(4), 509–535. https://doi.org/10.1080/00107530.1996.10746334
Brown, R. J. (2008). Different Types of “Dissociation” Have Different Psychological Mechanisms. Http://Dx.Doi.Org/10.1300/J229v07n04_02, 7(4), 7–28. https://doi.org/10.1300/J229V07N04_02
Butler, L. D. (2006). Normative dissociation. Psychiatric Clinics of North America, 29(1), 45–62. https://doi.org/10.1016/J.PSC.2005.10.004
Cardeña, E., & Carlson, E. (2011). Acute stress disorder revisited. Annual Review of Clinical Psychology, 7, 245–267. https://doi.org/10.1146/ANNUREV-CLINPSY-032210-104502
Chou, C.-P., & Bentler, P. M. (1995). Estimates and tests in structural equation modeling. In R. H. Hoyle (Ed.), Structural equation modeling: Concepts, issues, and applications (pp. 37–55). Sage Publications, Inc.
Cieślak, M., Kozaka, J., Golińska, P. B., & Bidzan, M. (2022). Mentalization and Its Relation to Life Satisfaction and the Level of Mental Adjustment to Illness in Women with Breast Cancer-A Pilot Study. International Journal of Environmental Research and Public Health, 19(16). https://doi.org/10.3390/IJERPH191610323
Cruz, R. A., Peterson, A. P., Fagan, C., Black, W., & Cooper, L. (2020). Evaluation of the brief adjustment scale-6 (BASE-6): A measure of general psychological adjustment for measurement-based care. Psychological Services, 17(3), 332–342. https://doi.org/10.1037/SER0000366
Dekker, J., & de Groot, V. (2018). Psychological adjustment to chronic disease and rehabilitation–an exploration. Disability and Rehabilitation, 40(1), 116–120. https://doi.org/10.1080/09638288.2016.1247469
Drogar, E., Fathi-Ashtiani, A., & ashrafi, E. (2020). Validation and Reliability of the Persian Version of the Mentalization Questionnaire. Journal of Clinical Psychology, 12(1), 1-12. doi: 10.22075/jcp.2020.18897.1745 [Persian]
Duman, M., Durgun Ozan, Y., & Doǧan Yüksekol, Ö. (2021). Relationship between the religious attitudes of women with gynecologic cancer and mental adjustment to cancer. Palliative & Supportive Care, 19(1), 62–68. https://doi.org/10.1017/S1478951520000619
Ensink, K., Bégin, M., Normandin, L., Godbout, N., & Fonagy, P. (2017). Mentalization and dissociation in the context of trauma: Implications for child psychopathology. Journal of Trauma and Dissociation, 18(1), 11–30. https://doi.org/10.1080/15299732.2016.1172536
Ensink, K., Fonagy, P., Berthelot, N., Normandin, L., & Bernazzani, O. (2015). Response: Behind the closed doors of mentalizing. A commentary on “Another step closer to measuring the ghosts in the nursery: Preliminary validation of the Trauma Reflective Functioning Scale.” Frontiers in Psychology, 6(JUN). https://doi.org/10.3389/FPSYG.2015.00697
Foa, E. B., & Hearst-Ikeda, D. (1996). Emotional Dissociation in Response to Trauma. Handbook of Dissociation, 207–224. https://doi.org/10.1007/978-1-4899-0310-5_10
Folkman, S., & Lazarus, R. S. (1980). An analysis of coping in a middle-aged community sample. Journal of health and social behavior, 219-239.
Fonagy, P. (2006). The mentalization-focused approach to social development. In: Allen, G., & Fonagy, P. (2006) Handbook of mentalization-based treatment (pp. 53-100). Chichester: John Wiley & Sons. doi:10.1002/9780470712986.
Fonagy, P., & Bateman, A. W. (2016). Adversity, attachment, and mentalizing. Comprehensive Psychiatry, 64, 59–66. https://doi.org/10.1016/J.COMPPSYCH.2015.11.006
Fonagy, P., Luyten, P., Allison, E., & Campbell, C. (2018). Reconciling Psychoanalytic Ideas with Attachment Theory. و In: Shaver, P and Cassidy, J, (Eds.) Handbook of Attachment. و Guilford Press: New York, NY, United States. (2018) و (In Press).
Gibson, L. E., Reeves, L. E., Cooper, S., Olino, T. M., & Ellman, L. M. (2019). Traumatic life event exposure and psychotic-like experiences: A multiple mediation model of cognitive-based mechanisms. Schizophrenia Research, 205, 15–22. https://doi.org/10.1016/J.SCHRES.2018.02.005
Groarke, A. M., Curtis, R., Groarke, J. M., Hogan, M. J., Gibbons, A., & Kerin, M. (2017). Post-traumatic growth in breast cancer: how and when do distress and stress contribute? Psycho-Oncology, 26(7), 967–974. https://doi.org/10.1002/PON.4243
Halford, J., & Brown, T. (2009). Cognitive–behavioral therapy as an adjunctive treatment in chronic physical illness. Advances in Psychiatric Treatment, 15(4), 306–317. https://doi.org/10.1192/APT.BP.107.003731
Handeland, T. B., & Kristiansen, V. R. (2017). Certain and Uncertain Reflective Functioning in Mothers with Substance Use Disorder: Investigating the Associations between Reflective Functioning, Trauma and Executive Functions. https://www.duo.uio.no/handle/10852/59725
Hayden, M. C., Müllauer, P. K., Beyer, K. J. P., Gaugeler, R., Senft, B., Dehoust, M. C., & Andreas, S. (2021). Increasing Mentalization to Reduce Maladaptive Defense in Patients with Mental Disorders. Frontiers in Psychiatry, 12, 637915. https://doi.org/10.3389/FPSYT.2021.637915
Katznelson, H. (2014). Reflective functioning: A review. Clinical Psychology Review, 34(2), 107–117. https://doi.org/10.1016/J.CPR.2013.12.003
Kline, R. B. (2015). Principles and Practice of Structural Equation Modeling. Guilford Publications.
Luyten, P., & Fonagy, P. (2015). The Neurobiology of Mentalizing. Personality Disorders: Theory, Research, and Treatment, 6(4), 366–379. https://doi.org/10.1037/PER0000117
Marchetti, M., Russo, L., Giaccherini, C., Gamba, S., & Falanga, A. (2022). Hemostatic system activation in breast cancer: Searching for new biomarkers for cancer risk prediction and outcomes. Thrombosis Research, 213, S46–S50. https://doi.org/10.1016/J.THROMRES.2022.01.019
Matthews, H. K., Bertoli, C., & de Bruin, R. A. M. (2022). Cell cycle control in cancer. Nature Reviews. Molecular Cell Biology, 23(1), 74–88. https://doi.org/10.1038/S41580-021-00404-3
Morgan, C., & Gayer-Anderson, C. (2016). Childhood adversities and psychosis: evidence, challenges, implications. World Psychiatry, 15(2), 93–102. https://doi.org/10.1002/WPS.20330
Neustadter, E. S., Fotopoulou, A., Steinfeld, M., & Fineberg, S. K. (2021). Mentalization and embodied selfhood in borderline personality disorder. Journal of Consciousness Studies: Controversies in Science & the Humanities, 28(3–4), 126. /pmc/articles/PMC7612160/
Nijenhuis, E. R. S., & van der Hart, O. (2011). Dissociation in Trauma: A New Definition and Comparison with Previous Formulations. Http://Dx.Doi.Org/10.1080/15299732.2011.570592, 12(4), 416–445. https://doi.org/10.1080/15299732.2011.570592
Patou M, Moradi A, Allahyari A A, Payandeh M. Psychometric Properties of The Version of The Mini- Mental Adjustment to Cancer Scale (Mini-MAC) In Patients with Cancer. Rph 2015; 9 (1) :3-3. [Persian]
Payne, A., Kralj, A., Young, J., & Meiser-Stedman, R. (2019). The prevalence of intrusive memories in adult depression: A meta-analysis. Journal of Affective Disorders, 253, 193–202. https://doi.org/10.1016/J.JAD.2019.04.055
Peterson, A. P., Fagan, C., & Smith, R. (2015). Psychometric Evaluation of the Brief Adjustment Scale-6 (BASE-6): A New Measure of General Psychological Adjustment. https://digital.lib.washington.edu:443/researchworks/handle/1773/34153
Schimmenti, A. (2016). Dissociative experiences and dissociative minds: Exploring a nomological network of dissociative functioning. Journal of Trauma and Dissociation, 17(3), 338–361. https://doi.org/10.1080/15299732.2015.1108948
Shaw, C., Lo, C., Lanceley, A., Hales, S., & Rodin, G. (2020). The Assessment of Mentalization: Measures for the Patient, the Therapist and the Interaction. Journal of Contemporary Psychotherapy, 50(1), 57–65. https://doi.org/10.1007/S10879-019-09420-Z
Shin, G. I., Goldstein, L. H., & Pick, S. (2019). Evidence for subjective emotional numbing following induced acute dissociation. Behavior Research and Therapy, 119, 103407. https://doi.org/10.1016/J.BRAT.2019.05.004
Soffer-Dudek, N. (2014). Dissociation and dissociative mechanisms in panic disorder, obsessive–compulsive disorder, and depression: A review and heuristic framework. Psychology of Consciousness: Theory, Research, and Practice, 1(3), 243–270. https://doi.org/10.1037/CNS0000023
Stanton, A. L., Revenson, T. A., & Tennen, H. (2007). Health psychology: Psychological adjustment to chronic disease. Annual Review of Psychology, 58, 565–592. https://doi.org/10.1146/ANNUREV.PSYCH.58.110405.085615
Tschoeke, S., Steinert, T., & Bichescu-Burian, D. (2019). Causal connection between dissociation and ongoing interpersonal violence: A systematic review. Neuroscience & Biobehavioral Reviews, 107, 424–437. https://doi.org/10.1016/J.NEUBIOREV.2019.09.030
Walter, H., & Mohnke, S. (2015). Mentalizing and Psychopathology in Schizophrenia, Depression, and Social Anxiety. Brain Mapping: An Encyclopedic Reference, 3, 183–189. https://doi.org/10.1016/B978-0-12-397025-1.00176-7
Wilkinson, L., & Gathani, T. (2022). Understanding breast cancer as a global health concern. The British Journal of Radiology, 95(1130). https://doi.org/10.1259/BJR.20211033
Williams, J., Bucci, S., Berry, K., & Varese, F. (2018). Psychological mediators of the association between childhood adversities and psychosis: A systematic review. Clinical Psychology Review, 65, 175–196. https://doi.org/10.1016/J.CPR.2018.05.009
Yamasaki, S., Ando, S., Koike, S., Usami, S., Endo, K., French, P., Sasaki, T., Furukawa, T. A., Hasegawa-Hiraiwa, M., Kasai, K., & Nishida, A. (2016). Dissociation mediates the relationship between peer victimization and hallucinatory experiences among early adolescents. Schizophrenia Research: Cognition, 4, 18–23. https://doi.org/10.1016/J.SCOG.2016.04.001
Yildirim, M., & Solmaz, F. (2021). Testing a Turkish Adaption of the Brief Psychological Adjustment Scale and Assessing the Relation to Mental Health. Studies in Psychology, 41(1), 231–245. https://doi.org/10.26650/SP2020-0032