學術產出-Theses
Article View/Open
Publication Export
-
題名 初診斷乳癌患者創傷後成長與心理適應的關係之長期追蹤研究－從創傷後成長異質性變化軌跡的觀點探討
A Longitudinal Study of the Relationship between Posttraumatic Growth and Psychological Adjustment in Women Newly Diagnosed with Breast Cancer－Are There Distinct PTG Trajectories ?作者 王韋婷
Wang, Wei Ting貢獻者 許文耀
Hsu, Wen Yau
王韋婷
Wang, Wei Ting關鍵詞 創傷後成長
心理適應
因應策略
認知投入
自覺脆弱性
變化軌跡
乳癌
posttraumatic growth
psychological adjustment
coping strategies
cognitive engagement
perceived vulnerability
trajectory
breast cancer日期 2013 上傳時間 12-Aug-2014 14:05:37 (UTC+8) 摘要 本研究試圖釐清乳癌患者創傷後成長（PTG）與心理適應之間的關係，由於過去實徵資料顯示PTG與心理適應間的關係相當不一致，之所以如此，可能的原因是PTG具有異質性的變化軌跡，本研究從這樣觀點，認為探討乳癌患者的PTG與心理適應的關係必須先探討PTG異質性軌跡的可能性，因此衍生出本研究的三個主要研究問題：一、乳癌患者的PTG變化軌跡是否具有異質性？二、若第一項研究問題成立，則探討PTG不同軌跡組別在影響PTG的相關變項上是否具有差異，以瞭解不同PTG軌跡組別患者的特性，三、PTG不同軌跡組別與心理適應的關係為何？本研究採縱貫研究設計，參與者為359位初診斷乳癌患者，於手術後隔日（診斷後平均41天）、術後3個月、術後6個月、術後一年進行PTG、影響PTG的相關變項與心理適應（焦慮、憂鬱、正向情緒）的測量，其中，311人完成三點以上的測量，本研究利用群體軌跡模式（TRAJ）的分析方法，探討這311位乳癌患者的PTG變化軌跡數目。結果顯示可將PTG變化軌跡分出四組，分別為PTG下降組、PTG上升組、PTG中度維持組、PTG高度維持組（分別占全體樣本13.3%、11.5%、36.7%、38.4%）。本研究進而探討PTG四個軌跡組別在各種影響PTG的相關變項上的差異，靜態相關變項（背景及醫療變項、自尊與社會期許性、主觀癌症衝擊度）以卡方差異檢定及變異數分析來探討組別差異，動態相關變項（自覺脆弱性、因應方式、認知投入方式）則以『潛在成長模型（LGM）』來探討動態變項之初始值與改變程度在PTG四組上的差異。結果發現不同PTG組別在年紀、教育程度、自尊、自覺脆弱性、因應策略與認知投入方式上具有顯著差異，PTG高度維持組的患者年紀較輕、教育程度較高、自覺脆弱性較高，而其適應性因應策略的採用及認知投入（苦惱自責與深思反省）亦較多；反之，PTG下降組的患者年紀較大、教育程度較低、自覺脆弱性亦較低且隨時間減少，而其適應性策略的採用及認知投入都較低，並且隨時間降低。PTG中度維持組的年齡較輕、教育程度居中（高中畢業者較多），PTG上升組年齡較大、教育程度較低，這兩組的自尊都比PTG高度維持組低，在適應性因應與深思反省上，這兩組的分數都介在PTG高度維持組與PTG下降組之間，但PTG中度維持組比起PTG上升組採用較多的適應性因應，而PTG上升組則是隨著時間自覺脆弱性逐漸增加。上述結果支持PTG軌跡組別的區分是具有效度的。由於本研究假定探討PTG與心理沮喪間的關係需考慮樣本的異質性，不論是PTG或心理沮喪均可能存在異質性，因此本研究亦利用TRAJ分析心理沮喪是否具有不同的變化軌跡。研究結果得到乳癌患者的焦慮程度具有四種變化軌跡：低焦慮組、次焦慮組、中高焦慮組、高焦慮組（分別占全體樣本31.6%、41.9%、17.2%、9.2%）；憂鬱程度亦可區分為四組變化軌跡：低憂鬱組、中憂鬱組、憂鬱下降組、高憂鬱組（分別占全體樣本48.2%、26.0%、11.1%、14.7%）。接著利用雙軌跡模型探討PTG與心理沮喪之變化軌跡的關聯性，結果發現PTG下降組的患者焦慮程度最低，且PTG與焦慮的關聯性有類似曲線的關係；PTG與憂鬱雙軌跡模式則出現負向關聯的型態，PTG高度維持組與低憂鬱組關聯性最強。故，本研究假定探討PTG與心理沮喪間的關係需考慮PTG與心理適應軌跡的異質性，獲得初步的支持。本研究以LGM探討PTG四組在焦慮、憂鬱、正向情緒（PA）上的變化差異，結果與雙軌跡模式的發現是一致的：PTG下降組的焦慮程度最低，PTG高度維持組的憂鬱程度最低。而PA則與PTG軌跡的PTG程度有正相關。最後，本研究追蹤174位乳癌患者於術後兩年的心理適應狀況，以探討PTG組別的預測效度。在控制相關背景變項後，PTG高度維持組於術後兩年具有最佳的心理適應狀況。PTG中度維持組與PTG上升組則具有較高的焦慮與憂鬱程度。PTG下降組具有較低的焦慮程度，但憂鬱分數介於中間。另外，PTG高度維持組的PA顯著的比其他三組來得高。總結而言，研究結果支持本研究的假設—乳癌患者的PTG具有不同變化軌跡，且背景變項、自尊、因應方式、認知投入、自覺脆弱性較能夠區分不同PTG軌跡組別之乳癌患者，而PTG不同軌跡組別的心理適應也具有差異。本研究認為乳癌患者面對疾病的方式有很大差異，PTG下降組的患者具有『不投入』的特性，因此PTG很低，也較少心理沮喪；排除PTG下降組的患者之後，PTG與心理沮喪之相關支持『PTG具有正向適應的特性』之假設，因為PTG與焦慮、憂鬱都具有負相關，與PA具有正相關。PTG高度維持組則是心理投入最多的一組乳癌患者，且手術兩年後，心理適應狀況最佳，面對癌症，他們表現出奮鬥迎戰的精神。本研究亦發現，適度的焦慮是必要的，但憂鬱會阻礙PTG的產生。本研究於討論中，針對研究結果在理論與臨床應用上的意涵進行探討，並提出對未來研究的建議。
Objectives: Empirical studies of the relationship between posttraumatic growth (PTG) and psychological adjustment have revealed a fairly inconclusive picture. After reviewing theories and empirical studies regarding the relationship between PTG and psychological adjustment, the current study argues that the inconsistent findings are likely due to the heterogeneity of the PTG experience over time. In this regard, individuals with different PTG trajectories vary in the level of adjustment and have distinct psychological characteristics. The first aim of this study is to identify different trajectories of PTG. The second aim of this study focuses on the validity of the categorization of PTG trajectory groups. That is, whether different trajectory groups of PTG are different in demographic and medical variables, cancer impact, self-esteem, social desirability (static PTG correlates), and coping styles, cognitive engagement, and perceived vulnerability (time-varying PTG correlates). The third aim of this study is to test whether PTG trajectory groups predicts psychological adjustment.Methods: Participants were Taiwanese women newly diagnosed with breast cancer. Measures of PTG, PTG correlates and adjustment outcomes, including anxiety, depression, and positive affect (PA) , were assessed at 1 day and 3, 6, and 12 months after surgery. Of the 359 women who consented to participate at baseline, 311 completed the measures at least three times and were included in the analyses. A group-based trajectory model (TRAJ) was used to identify subpopulations of individuals who shared homogenous PTG change patterns. Moreover, “dummy variables as covariate Latent Growth Curve Models (LGM)” were applied to test time-varying correlates. Then, we explored the relationship between PTG and psychological adjustment by dual trajectory model and LGM. Last, we determined whether the PTG trajectory groups predicted psychological adjustment at 24 months after surgery. Results: The patients were categorized into the following four groups, which showed very different patterns of PTG change over the first year after breast cancer surgery: stable high (38.4%), middle stable (36.7%), low increasing (11.5%), and sharp decreasing (13.3%). These four groups were different at static and time-varying correlates. Especially, the higher the PTG level, the more adaptive coping strategies, cognitive engagement, and perceived vulnerability. Of noted, these groups had difference on neither medical variables nor cancer severity.We also found four distinct trajectories for either anxiety or depression. They were low anxiety, mild anxiety, moderate anxiety, and high anxiety groups and low depression, mild depression, depression decreasing, and high depression groups. Dual trajectory models showed that the sharp decreasing PTG group had the lowest anxiety level, while the high stable PTG group had the lowest depression level. Curvilinear relationship was found between PTG and anxiety, whereas negative correlation was found between PTG and depression. Differences in the level of adjustment at 24 months and the patterns of the correlations across time were found among these latent subgroups. The high stable PTG group had the least psychological distress and the highest PA. The sharp decreasing PTG group had a rather low level of anxiety but medium level of depression. The middle stable and low increasing groups showed the highest level of distress and a rather low level of PA.Conclusions: This study was the first longitudinal examination of PTG trajectories and their different levels of psychological adjustment. The findings support our argument that identifying distinct PTG trajectories can better understand the nature of the relationship between PTG and psychological adjustment. Further theoretical and practical implications for each PTG trajectories are discussed.參考文獻 周嘉娸（2008）。憂鬱反芻對工作記憶容量的影響之初探。（未出版碩士論文）。國立臺灣大學，臺北市。涂珮瓊（2013）。初診斷乳癌患者的心理沮喪變化軌跡與資源變化, 因應風格之關係探討。（未出版博士論文）。國立政治大學，臺北市。陳佩英、史麗珠、王正旭、賴裕和、張獻崑、陳美玲（1999）。疼痛對癌症病人焦慮與憂鬱之影響。台灣醫學，3，379-382。陳坤虎（2001）。青少年自我認同與父母管教態度及自尊之關係。（未出版碩士論文）。國立臺灣大學，臺北市。蔡美珠（1986）。齊克果存在概念。臺北市：水牛出版社。衛生福利部國民健康署（n.d.）。100年癌症登記年報。未出版之統計數據。2013/4/16取自http://tcr.cph.ntu.edu.tw/main.php?Page=A5Affleck, G., & Tennen, H. (1996). Construing benefits from adversity: Adaptotional significance and disposltional underpinnings. Journal of Personality, 64(4), 899-922. Affleck, G., Tennen, H., Croog, S., & Levine, S. (1987). Causal attribution, perceived benefits, and morbidity after a heart attack: an 8-year study. Journal of consulting and clinical psychology, 55(1), 29-35. Aldwin, C. M. (1994). Stress, coping, and development: An integrative approach. New York, NY: Guilford Press.Algoe, S. B., & Stanton, A. L. (2009). Is benefit finding good for individuals with chronic disease? In C. L. Park, S. C. Lechner, M. H. Antoni & A. L. Stanton (Eds.), Medical Illness and Positive Life Change: Can Crisis Lead to Personal Transformation? (pp. 173-193). Washington, DC: APA.Allison, P. J., Guichard, C., & Gilain, L. (2000). A prospective investigation of dispositional optimism as a predictor of health-related quality of life in head and neck cancer patients. Quality of Life Research, 9(8), 951-960. Antoni, M. H., Carver, C. S., & Lechner, S. C. (2009). Enhancing positive adaptation: Example intervention during treatment for breast cancer. In C. L. Park, S. C. Lechner, M. H. Antoni & A. L. Stanton (Eds.), Medical illness and positive life change: Can crisis lead to personal transformation? (pp. 197-214). Washington, DC: APA.Antoni, M. H., Lechner, S., Diaz, A., Vargas, S., Holley, H., Phillips, K., . . . Blomberg, B. (2009). Cognitive behavioral stress management effects on psychosocial and physiological adaptation in women undergoing treatment for breast cancer. Brain, behavior, and immunity, 23(5), 580-591. Antoni, M. H., Lehman, J. M., Klibourn, K. M., Boyers, A. E., Culver, J. L., Alferi, S. M., . . . Harris, S. D. (2001). Cognitive-behavioral stress management intervention decreases the prevalence of depression and enhances benefit finding among women under treatment for early-stage breast cancer. Health Psychology, 20(1), 20-32. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.Baum, A., & Posluszny, D. M. (2000). Traumatic stress as a target for intervention with cancer patients. In A. Baum & B. L. Anderson (Eds.), Psychosocial Interventions for Cancer. Washington, DC: APA.Bellizzi, K. M., & Blank, T. O. (2006). Predicting posttraumatic growth in breast cancer survivors. Health psychology, 25(1), 47-56. Bellizzi, K. M., Miller, M. F., Arora, N. K., & Rowland, J. H. (2007). Positive and negative life changes experienced by survivors of non-Hodgkin’s lymphoma. Annals of Behavioral Medicine, 34(2), 188-199. Bonanno, G. A. (2004). Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? American psychologist, 59(1), 20-28. Bonanno, G. A., Kennedy, P., Galatzer-Levy, I. R., Lude, P., & Elfström, M. L. (2012). Trajectories of resilience, depression, and anxiety following spinal cord injury. Rehabilitation Psychology, 57(3), 236-247. Boot, J. S., Holcombe, C., & Salmon, P. (2010). Positive adjustment to breast cancer: development of a disease‐specific measure and comparison of women diagnosed from 2 weeks to 5 years. Psycho‐Oncology, 19(11), 1187-1194. Bower, J. E., Kemeny, M. E., Taylor, S. E., & Fahey, J. L. (1998). Cognitive processing, discovery of meaning, CD4 decline, and AIDS-related mortality among bereaved HIV-seropositive men. Journal of consulting and clinical psychology, 66(6), 979-986. Bower, J. E., Meyerowitz, B. E., Bernaards, C. A., Rowland, J. H., Ganz, P. A., & Desmond, K. A. (2005). Perceptions of positive meaning and vulnerability following breast cancer: Predictors and outcomes among long-term breast cancer survivors. Annals of Behavioral Medicine, 29(3), 236-245. Bradburn, N. M. (1969). The Structure of Psychological Well-being: Aldine: Chicago.Brame, R., Nagin, D. S., & Wasserman, L. (2006). Exploring some analytical characteristics of finite mixture models. Journal of Quantitative Criminology, 22(1), 31-59. Brannick, M. T. (1995). Critical comments on applying covariance structure modeling. Journal of Organizational Behavior, 16(3), 201-213. Brennan, J. (2001). Adjustment to cancer—coping or personal transition? Psycho‐Oncology, 10(1), 1-18. Browall, M., Ahlberg, K., Karlsson, P., Danielson, E., Persson, L.-O., & Gaston-Johansson, F. (2008). Health-related quality of life during adjuvant treatment for breast cancer among postmenopausal women. European Journal of Oncology Nursing, 12(3), 180-189. Brunet, J., McDonough, M. H., Hadd, V., Crocker, P. R., & Sabiston, C. M. (2010). The Posttraumatic Growth Inventory: An examination of the factor structure and invariance among breast cancer survivors. Psycho‐Oncology, 19(8), 830-838. Butler, L. D., Blasey, C. M., Garlan, R. W., McCaslin, S. E., Azarow, J., Chen, X.-H., . . . Hastings, T. A. (2005). Posttraumatic growth following the terrorist attacks of September 11, 2001: Cognitive, coping, and trauma symptom predictors in an internet convenience sample. Traumatology, 11(4), 247-267. Calhoun, L. G., & Tedeschi, R. G. (1999). Facilitating posttraumatic growth: A clinician`s guide. Mahwah, NJ: Erlbaum.Calhoun, L. G., & Tedeschi, R. G. (2006). The foundations of posttraumatic growth: An expanded framework. In L. G. Calhoun & R. G. Tedeschi (Eds.), Handbook of Posttraumatic Growth: Research and Practice (pp. 3-23). Mahwah, NJ: Lawrence Erlbaum.Carpenter, J. S., Brockopp, D. Y., & Andrykowski, M. A. (1999). Self‐transformation as a factor in the self‐esteem and well‐being of breast cancer survivors. Journal of Advanced Nursing, 29(6), 1402-1411. Carver, C. S. (1997). You want to measure coping but your protocol’too long: Consider the brief cope. International Journal of Behavioral Medicine, 4(1), 92-100. Carver, C. S., & Antoni, M. H. (2004). Finding benefit in breast cancer during the year after diagnosis predicts better adjustment 5 to 8 years after diagnosis. Health Psychology, 23, 595-598. Carver, C. S., Lechner, S. C., & Antoni, M. H. (2009). Callenges in studying positive change after adversity : Illusions form research on breast cancer. In C. L. Park, S. C. Lechner, M. H. Antoni & A. L. Stanton (Eds.), Medical illness and positive life change: Can crisis lead to personal transformation? (pp. 51-62). Washington, DC: APA.Carver, C. S., Pozo, C., Harris, S. D., Noriega, V., Scheier, M. F., Robinson, D. S., . . . Clark, K. C. (1993). How coping mediates the effect of optimism on distress: a study of women with early stage breast cancer. Journal of Personality and social psychology, 65(2), 375-390. Carver, C. S., Scheier, M. F., & Weintraub, J. K. (1989). Assessing coping strategies: A theoretically based approach. Journal of Personality and Social Psychology, 56(2), 267-283. Cella, D. F., & Tross, S. (1986). Psychological adjustment to survival from Hodgkin`s disease. Journal of Consulting and Clinical Psychology, 54(5), 616-622. Cheng, C., Wong, W.-m., & Tsang, K. W. (2006). Perception of benefits and costs during SARS outbreak: An 18-month prospective study. Journal of consulting and clinical psychology, 74(5), 870-879. Cheung, G. W., & Rensvold, R. B. (2002). Evaluating goodness-of-fit indexes for testing measurement invariance. Structural Equation Modeling, 9(2), 233-255. Christopher, M. (2004). A broader view of trauma: A biopsychosocial-evolutionary view of the role of the traumatic stress response in the emergence of pathology and/or growth. Clinical Psychology Review, 24(1), 75-98. Cohen, J. (1983). The Cost of dichotomization. Applied Psychological Measurement, 7(3), 249-253. Cohen, L. H., Hettler, T. R., & Pane, N. (1998). Assessment of posttraumatic growth. In R. G. Tedeschi, C. L. Park & L. G. Calhoun (Eds.), Posttraumatic growth: Positive changes in the aftermath of crisis (pp. 23-42). Mahwah, NJ, USA: Lawrence Erlbaum Associates.Conway, M., Csank, P. A., Holm, S. L., & Blake, C. K. (2000). On assessing individual differences in rumination on sadness. Journal of personality assessment, 75(3), 404-425. Cordova, M. J., Cunningham, L. L., Carlson, C. R., & Andrykowski, M. A. (2001). Posttraumatic growth following breast cancer: a controlled comparison study. Health Psychology, 20(3), 176-185. Cordova, M. J., Giese-Davis, J., Golant, M., Kronenwetter, C., Chang, V., & Spiegel, D. (2007). Breast cancer as trauma: Posttraumatic stress and posttraumatic growth. Journal of Clinical Psychology in Medical Settings, 14(4), 308-319. Coward, D. (1991). Self-transcendence and emotional well-being in women with advanced breast cancer. Paper presented at the Oncology Nursing Forum.Crowne, D. P., & Marlowe, D. (1960). A new scale of social desirability independent of psychopathology. Journal of consulting psychology, 24(4), 349-354. Cruess, D. G., Antoni, M. H., McGregor, B. A., Kilbourn, K. M., Boyers, A. E., Alferi, S. M., . . . Kumar, M. (2000). Cognitive-behavioral stress management reduces serum cortisol by enhancing benefit finding among women being treated for early stage breast cancer. Psychosomatic Medicine, 62(3), 304-308. Curbow, B., Somerfield, M. R., Baker, F., Wingard, J. R., & Legro, M. W. (1993). Personal changes, dispositional optimism, and psychological adjustment to bone marrow transplantation. Journal of Behavioral Medicine, 16(5), 423-443. Danoff-Burg, S., & Revenson, T. A. (2005). Benefit-finding among patients with rheumatoid arthritis: Positive effects on interpersonal relationships. Journal of Behavioral Medicine, 28(1), 91-103. Davis, C. G., & Nolen-Hoeksema, S. (2001). Loss and Meaning How Do People Make Sense of Loss? American Behavioral Scientist, 44(5), 726-741. Davis, C. G., Nolen-Hoeksema, S., & Larson, J. (1998). Making sense of loss and benefiting from the experience: two construals of meaning. Journal of Personality and Social Psychology, 75(2), 561-574. Dolbeault, S., Szporn, A., & Holland, J. (1999). Psycho-oncology: Where have we been? Where are we going? European Journal of Cancer, 35(11), 1554-1558. Dunn, L. B., Cooper, B. A., Neuhaus, J., West, C., Paul, S., Aouizerat, B., . . . Miaskowski, C. (2011). Identification of distinct depressive symptom trajectories in women following surgery for breast cancer. Health psychology, 30(6), 683-692.Ehlers, A., & Steil, R. (1995). Maintenance of intrusive memories in posttraumatic stress disorder: A cognitive approach. Behavioural and Cognitive Psychotherapy, 23, 217-217. Epping-Jordan, J. E., Compas, B. E., Osowiecki, D. M., Oppedisano, G., Gerhardt, C., Primo, K., & Krag, D. N. (1999). Psychological adjustment in breast cancer: processes of emotional distress. Health Psychology, 18(4), 315-326. Folkman, S., & Moskowitz, J. T. (2000). Positive affect and the other side of coping. American psychologist, 55(6), 647-654. Frazier, P., Conlon, A., & Glaser, T. (2001). Positive and negative life changes following sexual assault. Journal of Consulting and Clinical Psychology, 69(6), 1048-1055. Frazier, P., Tashiro, T., Berman, M., Steger, M., & Long, J. (2004). Correlates of levels and patterns of positive life changes following sexual assault. Journal of Consulting and Clinical Psychology, 72(1), 19-30. Fromm, K., Andrykowski, M. A., & Hunt, J. (1996). Positive and negative psychosocial sequelae of bone marrow transplantation: implications for quality of life assessment. Journal of behavioral medicine, 19(3), 221-240. Grubaugh, A. L., & Resick, P. A. (2007). Posttraumatic growth in treatment-seeking female assault victims. Psychiatric Quarterly, 78(2), 145-155. Gueorguieva, R., & Krystal, J. H. (2004). Move over anova: Progress in analyzing repeated-measures data andits reflection in papers published in the archives of general psychiatry. Archives of general psychiatry, 61(3), 310-317. Harper, K., Felicity, W., Schmidt, J. E., Beacham, A. O., Salsman, J. M., Averill, A. J., . . . Andrykowski, M. A. (2007). The role of social cognitive processing theory and optimism in positive psychosocial and physical behavior change after cancer diagnosis and treatment. Psycho‐Oncology, 16(1), 79-91. Heim, E., Valach, L., & Schaffner, L. (1997). Coping and psychosocial adaptation: longitudinal effects over time and stages in breast cancer. Psychosomatic Medicine, 59(4), 408-418. Helgeson, V. S., Reynolds, K. A., & Tomich, P. L. (2006). A meta-analytic review of benefit finding and growth. Journal of Consulting and Clinical Psychology, 74(5), 797-816. Helgeson, V. S., Snyder, P., & Seltman, H. (2004). Psychological and physical adjustment to breast cancer over 4 years: identifying distinct trajectories of change. Health Psychology, 23(1), 3-15. Henselmans, I., Helgeson, V. S., Seltman, H., de Vries, J., Sanderman, R., & Ranchor, A. V. (2010). Identification and prediction of distress trajectories in the first year after a breast cancer diagnosis. Health Psychology, 29(2), 160-168. Ho, S. M., Chan, C. L., & Ho, R. T. (2004). Posttraumatic growth in Chinese cancer survivors. Psycho‐Oncology, 13(6), 377-389. Hobfoll, S. E., Hall, B. J., Canetti‐Nisim, D., Galea, S., Johnson, R. J., & Palmieri, P. A. (2007). Refining our understanding of traumatic growth in the face of terrorism: Moving from meaning cognitions to doing what is meaningful. Applied Psychology, 56(3), 345-366. Hou, W. K., Law, C. C., Yin, J., & Fu, Y. T. (2010). Resource loss, resource gain, and psychological resilience and dysfunction following cancer diagnosis: a growth mixture modeling approach. Health Psychology, 29(5), 484-495. Hu, L., & Bentler, P. M. (1998). Fit indices in covariance structure modeling: Sensitivity to underparameterized model misspecification. Psychological Methods, 3(4), 424-453. Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1-55. Jöreskog, K., & Sörbom, D. (2004). LISREL 8.7 Computer Software Lincolnwood. IL: Scientific Software International, Inc.Janoff-Bulman, R. (1992). Shattered assumptions: Towards a new psychology of trauma. New York: Free Press.Jim, H. S., Richardson, S. A., Golden-Kreutz, D. M., & Andersen, B. L. (2006). Strategies used in coping with a cancer diagnosis predict meaning in life for survivors. Health Psychology, 25(6), 753-761. Jones, B. L., Nagin, D. S., & Roeder, K. (2001). A SAS procedure based on mixture models for estimating developmental trajectories. Sociological Methods & Research, 29(3), 374-393. Joseph, S., & Linley, P. A. (2005). Positive adjustment to threatening events: An organismic valuing theory of growth through adversity. Review of general psychology, 9(3), 262-280. Joseph, S., & Linley, P. A. (2006). Growth following adversity: Theoretical perspectives and implications for clinical practice. Clinical psychology review, 26(8), 1041-1053. Kangas, M., Henry, J. L., & Bryant, R. A. (2002). Posttraumatic stress disorder following cancer: A conceptual and empirical review. Clinical psychology review, 22(4), 499-524. Karanci, A. N., & Erkam, A. (2007). Variables related to stress‐related growth among Turkish breast cancer patients. Stress and Health, 23(5), 315-322. Katz, R. C., Flasher, L., Cacciapaglia, H., & Nelson, S. (2001). The psychosocial impact of cancer and lupus: A cross validation study that extends the generality of “benefit-finding” in patients with chronic disease. Journal of Behavioral Medicine, 24(6), 561-571. Keltner, D., & Gross, J. J. (1999). Functional accounts of emotions. Cognition & Emotion, 13(5), 467-480. Kinsinger, D. P., Penedo, F. J., Antoni, M. H., Dahn, J. R., Lechner, S., & Schneiderman, N. (2006). Psychosocial and sociodemographic correlates of benefit‐finding in men treated for localized prostate cancer. Psycho‐Oncology, 15(11), 954-961. Kleim, B., & Ehlers, A. (2009). Evidence for a curvilinear relationship between posttraumatic growth and posttrauma depression and PTSD in assault survivors. Journal of traumatic stress, 22(1), 45-52. Kuner, S., Orsborn, C., Quigley, L., & Stroup, K. （李巧雲譯；1999/2002）。別為癌症哭泣—四個女子抗癌的療傷心聲（Speak the Language of healing）。台北：商訊文化。Lam, W. W., Bonanno, G. A., Mancini, A. D., Ho, S., Chan, M., Hung, W. K., . . . Fielding, R. (2010). Trajectories of psychological distress among Chinese women diagnosed with breast cancer. Psycho‐Oncology, 19(10), 1044-1051. Lechner, S. C., & Antoni, M. H. (2004). Posttraumatic growth and group-based interventions for persons dealing with cancer: What have we learned so far? Psychological Inquiry, 15(1), 35-41. Lechner, S. C., Carver, C. S., Antoni, M. H., Weaver, K. E., & Phillips, K. M. (2006). Curvilinear associations between benefit finding and psychosocial adjustment to breast cancer. Journal of Consulting and Clinical Psychology, 74(5), 828-840. Lechner, S. C., Zakowski, S. G., Antoni, M. H., Greenhawt, M., Block, K., & Block, P. (2003). Do sociodemographic and disease‐related variables influence benefit‐finding in cancer patients? Psycho‐Oncology, 12(5), 491-499. Lehman, D. R., Davis, C. G., DeLongis, A., Wortman, C. B., Bluck, S., Mandel, D. R., & Ellard, J. H. (1993). Positive and negative life changes following bereavement and their relations to adjustment. Journal of Social and Clinical Psychology, 12(1), 90-112. Lelorain, S., Bonnaud-Antignac, A., & Florin, A. (2010). Long term posttraumatic growth after breast cancer: prevalence, predictors and relationships with psychological health. Journal of Clinical Psychology in Medical Settings, 17(1), 14-22. Linley, P. A., & Joseph, S. (2004). Positive change following trauma and adversity: A review. Journal of Traumatic Stress, 17(1), 11-21. Low, C. A., Stanton, A. L., Bower, J. E., & Gyllenhammer, L. (2010). A randomized controlled trial of emotionally expressive writing for women with metastatic breast cancer. Health Psychology, 29(4), 460-466. Maercker, A., & Zoellner, T. (2004). The Janus face of self-perceived growth: Toward a two-component model of posttraumatic growth. Psychological Inquiry, 15(1), 41-48. Manne, S., Ostroff, J., Winkel, G., Goldstein, L., Fox, K., & Grana, G. (2004). Posttraumatic growth after breast cancer: Patient, partner, and couple perspectives. Psychosomatic Medicine, 66(3), 442-454. Matthews, E. E., & Cook, P. F. (2009). Relationships among optimism, well‐being, self‐transcendence, coping, and social support in women during treatment for breast cancer. Psycho‐Oncology, 18(7), 716-726. Maxwell, S. E., & Delaney, H. D. (1993). Bivariate median splits and spurious statistical significance. Psychological bulletin, 113(1), 181-190. McDonald, R. P., & Ho, M. H. R. (2002). Principles and practice in reporting structural equation analyses. Psychological Methods, 7(1), 64-82. McGregor, B. A., Antoni, M. H., Boyers, A., Alferi, S. M., Blomberg, B. B., & Carver, C. S. (2004). Cognitive–behavioral stress management increases benefit finding and immune function among women with early-stage breast cancer. Journal of psychosomatic research, 56(1), 1-8. McMillen, C., Zuravin, S., & Rideout, G. (1995). Perceived benefit from child sexual abuse. Journal of Consulting and Clinical Psychology, 63(6), 1037-1043. Milam, J. (2004). Posttraumatic Growth Among HIV/AIDS Patients. Journal of Applied Social Psychology, 34(11), 2353-2376. Milam, J. (2006). Posttraumatic growth and HIV disease progression. Journal of consulting and clinical psychology, 74(5), 817-827. Millar, K., Purushotham, A. D., McLatchie, E., George, W. D., & Murray, G. D. (2005). A 1-year prospective study of individual variation in distress, and illness perceptions, after treatment for breast cancer. Journal of Psychosomatic Research, 58(4), 335-342. Mineka, S., & Sutton, S. K. (1992). Cognitive biases and the emotional disorders. Psychological Science, 3(1), 65-69. Morris, B. A., Shakespeare-Finch, J. E., & Scott, J. L. (2007). Coping processes and dimensions of posttraumatic growth. The Australasian Journal of Disaster and Trauma Studies, 2007(1), 1-12. Moskowitz, J. T., & Epel, E. S. (2006). Benefit finding and diurnal cortisol slope in maternal caregivers: A moderating role for positive emotion. The Journal of Positive Psychology, 1(2), 83-91. Nagin, D. S. (2005). Group-Based Modeling of Development. Cambridge, MA: Harvard University Press.Nagin, D. S., & Tremblay, R. E. (2001). Parental and early childhood predictors of persistent physical aggression in boys from kindergarten to high school. Archives of General psychiatry, 58(4), 389-394. Nolen-Hoeksema, S., & Davis, C. G. (2004). Theoretical and methodological issues in the assessment and interpretation of posttraumatic growth. Psychological Inquiry, 15(1), 60-64. Nolen-Hoeksema, S., & Morrow, J. (1991). A prospective study of depression and posttraumatic stress symptoms after a natural disaster: the 1989 Loma Prieta Earthquake. Journal of personality and social psychology, 61(1), 115-121. O`Leary, V. E., Alday, C. S., & Ickovics, J. R. (1998). Models of life change and posttraumatic growth. In R. G. Tedeschi, C. L. Park & L. G. Calhoun (Eds.), Posttraumatic growth: Positive changes in the aftermath of crisis (pp. 127-151). Mahwah, NJ, USA: Lawrence Erlbaum Associates.Pakenham, K. I. (2005). Benefit finding in multiple sclerosis and associations with positive and negative outcomes. Health Psychology, 24(2), 123-132. Park, C. L. (2009). Overview of theoretical perspectives. In C. L. Park, S. C. Lechner, M. H. Antoni & A. L. Stanton (Eds.), Medical Illness and Positive Life Change: Can Crisis Lead to Personal Transformation? (pp. 11-30). Washington, DC: APA.Park, C. L., Cohen, L. H., & Murch, R. L. (1996). Assessment and Prediction of Stress‐Related Growth. Journal of personality, 64(1), 71-105. Park, C. L., & Fenster, J. R. (2004). Stress-related growth: Predictors of occurrence and correlates with psychological adjustment. Journal of Social and Clinical Psychology, 23(2), 195-215. Park, C. L., & Folkman, S. (1997). Meaning in the context of stress and coping. Review of General Psychology, 1(2), 115-144. Park, C. L., & Helgeson, V. S. (2006). Introduction to the special section: Growth following highly stressful life events- Current status and future directions. Journal of Consulting and Clinical Psychology, 74(5), 791-796. Parkes, C. M. (1988). Bereavement as a psychosocial transition: Processes of adaptation to change. Journal of Social Issues, 44(3), 53-65. Pat‐Horenczyk, R., & Brom, D. (2007). The Multiple Faces of Post‐Traumatic Growth. Applied Psychology, 56(3), 379-385. Paul, T. (1952). The Courage to be: Yale University Press.Prati, G., & Pietrantoni, L. (2009). Optimism, social support, and coping strategies as factors contributing to posttraumatic growth: A meta-analysis. Journal of Loss and Trauma, 14(5), 364-388. Ransom, S., Sheldon, K. M., & Jacobsen, P. B. (2008). Actual change and inaccurate recall contribute to posttraumatic growth following radiotherapy. Journal of consulting and clinical psychology, 76(5), 811-819. Reynolds, W. M. (1982). Development of reliable and valid short forms of the Marlowe‐Crowne Social Desirability Scale. Journal of clinical psychology, 38(1), 119-125. Rieker, P. P., Fitzgerald, E. M., Kalish, L. A., Richie, J. P., Lederman, G. S., Edbril, S. D., & Garnick, M. B. (1989). Psychosocial factors, curative therapies, and behavioral outcomes. A comparison of testis cancer survivors and a control group of healthy men. Cancer, 64(11), 2399-2407. Rini, C., Manne, S., DuHamel, K. N., Austin, J., Ostroff, J., Boulad, F., . . . Mee, L. (2004). Mothers’ perceptions of benefit following pediatric stem cell transplantation: A longitudinal investigation of the roles of optimism, medical risk, and sociodemographic resources. Annals of behavioral medicine, 28(2), 132-141. Riskind, J. H., Williams, N. L., & Joiner, T. E. (2006). The looming cognitive style: A cognitive vulnerability for anxiety disorders. Journal of Social and Clinical Psychology, 25(7), 779-801. Robinette, R. L. (1991). The relationship between the Marlowe‐Crowne form C and the validity scales of the MMPI. Journal of Clinical Psychology, 47(3), 396-399.Robinson, J. P., Shaver, P. R., & Wrightsman, L. S. （楊宜音、張志學譯；1990/1998）。性格與社會心理測量總覽。台北：遠流出版社。Rollo, M. (1953). The Meaning of Anxiety. The Journal of Nervous and Mental Disease, 118(3), 280-281. Rosenberg, M. (1965). Society and the adolescent self-image. Princeton, N J: Princeton Univ. Press.Ross, M., & Wilson, A. E. (2002). It feels like yesterday: self-esteem, valence of personal past experiences, and judgments of subjective distance. Journal of personality and social psychology, 82(5), 792-803. Salsman, J. M., Segerstrom, S. C., Brechting, E. H., Carlson, C. R., & Andrykowski, M. A. (2009). Posttraumatic growth and PTSD symptomatology among colorectal cancer survivors: a 3‐month longitudinal examination of cognitive processing. Psycho‐Oncology, 18(1), 30-41. Sawyer, A., Ayers, S., & Field, A. P. (2010). Posttraumatic growth and adjustment among individuals with cancer or HIV/AIDS: A meta-analysis. Clinical Psychology Review, 30(4), 436-447. Schaefer, J. A., & Moos, R. H. (1992). Life crises and personal growth. In B. N. Carpenter (Ed.), Personal Coping: Theory, Research, and Application (pp. 149-170). Westport, CT: Praeger.Schroevers, M. J., Kraaij, V., & Garnefski, N. (2011). Cancer patients` experience of positive and negative changes due to the illness: relationships with psychological well‐being, coping, and goal reengagement. Psycho‐Oncology, 20(2), 165-172. Schroevers, M. J., & Teo, I. (2008). The report of posttraumatic growth in Malaysian cancer patients: Relationships with psychological distress and coping strategies. Psycho‐Oncology, 17(12), 1239-1246. Schulz, U., & Mohamed, N. E. (2004). Turning the tide: benefit finding after cancer surgery. Social science & medicine, 59(3), 653-662. Schwarzer, R., Luszczynska, A., Boehmer, S., Taubert, S., & Knoll, N. (2006). Changes in finding benefit after cancer surgery and the prediction of well-being one year later. Social Science & Medicine, 63(6), 1614-1624. Scrignaro, M., Barni, S., & Magrin, M. E. (2011). The combined contribution of social support and coping strategies in predicting post‐traumatic growth: a longitudinal study on cancer patients. Psycho‐Oncology, 20(8), 823-831. Sears, S. R., Stanton, A. L., & Danoff-Burg, S. (2003). The yellow brick road and the emerald city: benefit finding, positive reappraisal coping and posttraumatic growth in women with early-stage breast cancer. Health Psychology, 22(5), 487-497. Shakespeare-Finch, J., & Lurie-Beck, J. (2014). A meta-analytic clarification of the relationship between posttraumatic growth and symptoms of posttraumatic distress disorder. Journal of anxiety disorders, 28(2), 223-229. Shapiro, J. P., McCue, K., Heyman, E. N., Dey, T., & Haller, H. S. (2010). Coping-related variables associated with individual differences in adjustment to cancer. Journal of psychosocial oncology, 28(1), 1-22. Spiegel, D., Butler, L. D., Giese‐Davis, J., Koopman, C., Miller, E., DiMiceli, S., . . . Kraemer, H. C. (2007). Effects of supportive‐expressive group therapy on survival of patients with metastatic breast cancer. Cancer, 110(5), 1130-1138. Stanton, A. L., Bower, J. E., & Low, C. A. (2006). Posttraumatic Growth After Cancer. In L. G. Calhoun & R. G. Tedeschi (Eds.), Handbook of Posttraumatic Growth: Research and Practice (pp. 138–175). Mahwah, NJ: Lawrence Erlbaum.Stanton, A. L., & Snider, P. R. (1993). Coping with a breast cancer diagnosis: A prospective study. Health Psychology, 12(1), 16-23. Steenkamp, J. B. E. M., & Baumgartner, H. (1998). Assessing measurement invariance in cross-national consumer research. Journal of Consumer Research, 25(1), 78-107. Sumalla, E. C., Ochoa, C., & Blanco, I. (2009). Posttraumatic growth in cancer: reality or illusion? Clinical Psychology Review, 29(1), 24-33. Taku, K., Cann, A., Calhoun, L. G., & Tedeschi, R. G. (2008). The factor structure of the Posttraumatic Growth Inventory: A comparison of five models using confirmatory factor analysis. Journal of Traumatic Stress, 21(2), 158-164. Tallman, B. A., Altmaier, E., & Garcia, C. (2007). Finding benefit from cancer. Journal of Counseling Psychology, 54(4), 481-487. Taylor, S. E. (1983). Adjustment to threatening events. A theory of cognitive adaptation. American Psychologist, 38(11), 1161-1173. Taylor, S. E., & Armor, D. A. (1996). Positive illusions and coping with adversity. Journal of personality, 64(4), 873-898. Taylor, S. E., & Brown, J. D. (1988). Illusion and well-being: a social psychological perspective on mental health. Psychological bulletin, 103(2), 193-210. Taylor, S. E., Lichtman, R. R., & Wood, J. V. (1984). Attributions, beliefs about control, and adjustment to breast cancer. Journal of personality and social psychology, 46(3), 489-502. Tedeschi, R. G., & Calhoun, L. G. (1996). The Posttraumatic Growth Inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9(3), 455-471. Tedeschi, R. G., & Calhoun, L. G. (2004). Posttraumatic Growth: Conceptual Foundations and Empirical Evidence. Psychological Inquiry, 15(1), 1-18. Tedeschi, R. G., Park, C. L., & Calhoun, L. G. (1998). Posttraumatic growth: Positive changes in the aftermath of crisis: Psychology Press.Tennen, H., & Affleck, G. (2002). Benefit-finding and benefit-reminding. In C. R. Snyder & S. Lopez (Eds.), The handbook of positive psychology (pp. 584-597). New York: Oxford University Pres.Tennen, H., & Affleck, G. (2009). Assessing positive life change: In search of meticulous methods. In C. L. Park, S. C. Lechner, M. H. Antoni & A. L. Stanton (Eds.), Medical illness and positive life change: Can crisis lead to personal transformation? (pp. 31-50). Washington, DC: APA.Tennen, H., Affleck, G., Urrows, S., Higgins, P., & Mendola, R. (1992). Perceiving control, construing benefits, and daily processes in rheumatoid arthritis. Canadian Journal of Behavioural Science, 24(2), 186-203. Thornton, A. A., Owen, J. E., Kernstine, K., Koczywas, M., Grannis, F., Cristea, M., . . . Stanton, A. L. (2012). Predictors of finding benefit after lung cancer diagnosis. Psycho‐Oncology, 21(4), 365-373. Thornton, A. A., & Perez, M. A. (2006). Posttraumatic growth in prostate cancer survivors and their partners. Psycho‐Oncology, 15(4), 285-296. Thuné-Boyle, I. C., Myers, L. B., & Newman, S. P. (2006). The role of illness beliefs, treatment beliefs, and perceived severity of symptoms in explaining distress in cancer patients during chemotherapy treatment. Behavioral Medicine, 32(1), 19-29. Tomich, P. L., & Helgeson, V. S. (2002). Five years later: a cross‐sectional comparison of breast cancer survivors with healthy women. Psycho‐oncology, 11(2), 154-169. Tomich, P. L., & Helgeson, V. S. (2004). Is finding something good in the bad always good? Benefit finding among women with breast cancer. Health Psychology, 23(1), 16-23. Tomich, P. L., Helgeson, V. S., & Nowak Vache, E. J. (2005). Perceived growth and decline following breast cancer: a comparison to age‐matched controls 5‐years later. Psycho‐Oncology, 14(12), 1018-1029. Treynor, W., Gonzalez, R., & Nolen-Hoeksema, S. (2003). Rumination reconsidered: A psychometric analysis. Cognitive Therapy and Research, 27(3), 247-259. Urcuyo, K. R., Boyers, A. E., Carver, C. S., & Antoni, M. H. (2005). Finding benefit in breast cancer: Relations with personality, coping, and concurrent well-being. Psychology & Health, 20(2), 175-192. Vandenberg, R. J., & Lance, C. E. (2000). A review and synthesis of the measurement invariance literature: Suggestions, practices, and recommendations for organizational research. Organizational Research Methods, 3(1), 4-70. Watkins, E. R. (2008). Constructive and unconstructive repetitive thought. Psychological bulletin, 134(2), 163-206. Watson, M., Law, M. G., Santos, M. d., Greer, S., Baruch, J., & Bliss, J. (1994). The Mini-MAC: further development of the mental adjustment to cancer scale. Journal of Psychosocial Oncology, 12(3), 33-46. Westphal, M., & Bonanno, G. A. (2007). Posttraumatic growth and resilience to trauma: Different sides of the same coin or different coins? Applied Psychology, 56(3), 417-427. Widows, M. R., Jacobsen, P. B., Booth-Jones, M., & Fields, K. K. (2005). Predictors of posttraumatic growth following bone marrow transplantation for cancer. Health Psychology, 24(3), 266-273. Wilkinson, S., & Kitzinger, C. (2006). Surprise as an interactional achievement: Reaction tokens in conversation. Social psychology quarterly, 69(2), 150-182. Yalom, I. D., & Lieberman, M. A. (1991). Bereavement and heightened existential awareness. Psychiatry: Interpersonal and Biological Processes, 54, 334-345. Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361-370. Zoellner, T., & Maercker, A. (2006). Posttraumatic growth in clinical psychology—A critical review and introduction of a two component model. Clinical Psychology Review, 26(5), 626-653. 描述 博士
國立政治大學
心理學研究所
98752502
102資料來源 http://thesis.lib.nccu.edu.tw/record/#G0098752502 資料類型 thesis dc.contributor.advisor 許文耀 zh_TW dc.contributor.advisor Hsu, Wen Yau en_US dc.contributor.author (Authors) 王韋婷 zh_TW dc.contributor.author (Authors) Wang, Wei Ting en_US dc.creator (作者) 王韋婷 zh_TW dc.creator (作者) Wang, Wei Ting en_US dc.date (日期) 2013 en_US dc.date.accessioned 12-Aug-2014 14:05:37 (UTC+8) - dc.date.available 12-Aug-2014 14:05:37 (UTC+8) - dc.date.issued (上傳時間) 12-Aug-2014 14:05:37 (UTC+8) - dc.identifier (Other Identifiers) G0098752502 en_US dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/68549 - dc.description (描述) 博士 zh_TW dc.description (描述) 國立政治大學 zh_TW dc.description (描述) 心理學研究所 zh_TW dc.description (描述) 98752502 zh_TW dc.description (描述) 102 zh_TW dc.description.abstract (摘要) 本研究試圖釐清乳癌患者創傷後成長（PTG）與心理適應之間的關係，由於過去實徵資料顯示PTG與心理適應間的關係相當不一致，之所以如此，可能的原因是PTG具有異質性的變化軌跡，本研究從這樣觀點，認為探討乳癌患者的PTG與心理適應的關係必須先探討PTG異質性軌跡的可能性，因此衍生出本研究的三個主要研究問題：一、乳癌患者的PTG變化軌跡是否具有異質性？二、若第一項研究問題成立，則探討PTG不同軌跡組別在影響PTG的相關變項上是否具有差異，以瞭解不同PTG軌跡組別患者的特性，三、PTG不同軌跡組別與心理適應的關係為何？本研究採縱貫研究設計，參與者為359位初診斷乳癌患者，於手術後隔日（診斷後平均41天）、術後3個月、術後6個月、術後一年進行PTG、影響PTG的相關變項與心理適應（焦慮、憂鬱、正向情緒）的測量，其中，311人完成三點以上的測量，本研究利用群體軌跡模式（TRAJ）的分析方法，探討這311位乳癌患者的PTG變化軌跡數目。結果顯示可將PTG變化軌跡分出四組，分別為PTG下降組、PTG上升組、PTG中度維持組、PTG高度維持組（分別占全體樣本13.3%、11.5%、36.7%、38.4%）。本研究進而探討PTG四個軌跡組別在各種影響PTG的相關變項上的差異，靜態相關變項（背景及醫療變項、自尊與社會期許性、主觀癌症衝擊度）以卡方差異檢定及變異數分析來探討組別差異，動態相關變項（自覺脆弱性、因應方式、認知投入方式）則以『潛在成長模型（LGM）』來探討動態變項之初始值與改變程度在PTG四組上的差異。結果發現不同PTG組別在年紀、教育程度、自尊、自覺脆弱性、因應策略與認知投入方式上具有顯著差異，PTG高度維持組的患者年紀較輕、教育程度較高、自覺脆弱性較高，而其適應性因應策略的採用及認知投入（苦惱自責與深思反省）亦較多；反之，PTG下降組的患者年紀較大、教育程度較低、自覺脆弱性亦較低且隨時間減少，而其適應性策略的採用及認知投入都較低，並且隨時間降低。PTG中度維持組的年齡較輕、教育程度居中（高中畢業者較多），PTG上升組年齡較大、教育程度較低，這兩組的自尊都比PTG高度維持組低，在適應性因應與深思反省上，這兩組的分數都介在PTG高度維持組與PTG下降組之間，但PTG中度維持組比起PTG上升組採用較多的適應性因應，而PTG上升組則是隨著時間自覺脆弱性逐漸增加。上述結果支持PTG軌跡組別的區分是具有效度的。由於本研究假定探討PTG與心理沮喪間的關係需考慮樣本的異質性，不論是PTG或心理沮喪均可能存在異質性，因此本研究亦利用TRAJ分析心理沮喪是否具有不同的變化軌跡。研究結果得到乳癌患者的焦慮程度具有四種變化軌跡：低焦慮組、次焦慮組、中高焦慮組、高焦慮組（分別占全體樣本31.6%、41.9%、17.2%、9.2%）；憂鬱程度亦可區分為四組變化軌跡：低憂鬱組、中憂鬱組、憂鬱下降組、高憂鬱組（分別占全體樣本48.2%、26.0%、11.1%、14.7%）。接著利用雙軌跡模型探討PTG與心理沮喪之變化軌跡的關聯性，結果發現PTG下降組的患者焦慮程度最低，且PTG與焦慮的關聯性有類似曲線的關係；PTG與憂鬱雙軌跡模式則出現負向關聯的型態，PTG高度維持組與低憂鬱組關聯性最強。故，本研究假定探討PTG與心理沮喪間的關係需考慮PTG與心理適應軌跡的異質性，獲得初步的支持。本研究以LGM探討PTG四組在焦慮、憂鬱、正向情緒（PA）上的變化差異，結果與雙軌跡模式的發現是一致的：PTG下降組的焦慮程度最低，PTG高度維持組的憂鬱程度最低。而PA則與PTG軌跡的PTG程度有正相關。最後，本研究追蹤174位乳癌患者於術後兩年的心理適應狀況，以探討PTG組別的預測效度。在控制相關背景變項後，PTG高度維持組於術後兩年具有最佳的心理適應狀況。PTG中度維持組與PTG上升組則具有較高的焦慮與憂鬱程度。PTG下降組具有較低的焦慮程度，但憂鬱分數介於中間。另外，PTG高度維持組的PA顯著的比其他三組來得高。總結而言，研究結果支持本研究的假設—乳癌患者的PTG具有不同變化軌跡，且背景變項、自尊、因應方式、認知投入、自覺脆弱性較能夠區分不同PTG軌跡組別之乳癌患者，而PTG不同軌跡組別的心理適應也具有差異。本研究認為乳癌患者面對疾病的方式有很大差異，PTG下降組的患者具有『不投入』的特性，因此PTG很低，也較少心理沮喪；排除PTG下降組的患者之後，PTG與心理沮喪之相關支持『PTG具有正向適應的特性』之假設，因為PTG與焦慮、憂鬱都具有負相關，與PA具有正相關。PTG高度維持組則是心理投入最多的一組乳癌患者，且手術兩年後，心理適應狀況最佳，面對癌症，他們表現出奮鬥迎戰的精神。本研究亦發現，適度的焦慮是必要的，但憂鬱會阻礙PTG的產生。本研究於討論中，針對研究結果在理論與臨床應用上的意涵進行探討，並提出對未來研究的建議。 zh_TW dc.description.abstract (摘要) Objectives: Empirical studies of the relationship between posttraumatic growth (PTG) and psychological adjustment have revealed a fairly inconclusive picture. After reviewing theories and empirical studies regarding the relationship between PTG and psychological adjustment, the current study argues that the inconsistent findings are likely due to the heterogeneity of the PTG experience over time. In this regard, individuals with different PTG trajectories vary in the level of adjustment and have distinct psychological characteristics. The first aim of this study is to identify different trajectories of PTG. The second aim of this study focuses on the validity of the categorization of PTG trajectory groups. That is, whether different trajectory groups of PTG are different in demographic and medical variables, cancer impact, self-esteem, social desirability (static PTG correlates), and coping styles, cognitive engagement, and perceived vulnerability (time-varying PTG correlates). The third aim of this study is to test whether PTG trajectory groups predicts psychological adjustment.Methods: Participants were Taiwanese women newly diagnosed with breast cancer. Measures of PTG, PTG correlates and adjustment outcomes, including anxiety, depression, and positive affect (PA) , were assessed at 1 day and 3, 6, and 12 months after surgery. Of the 359 women who consented to participate at baseline, 311 completed the measures at least three times and were included in the analyses. A group-based trajectory model (TRAJ) was used to identify subpopulations of individuals who shared homogenous PTG change patterns. Moreover, “dummy variables as covariate Latent Growth Curve Models (LGM)” were applied to test time-varying correlates. Then, we explored the relationship between PTG and psychological adjustment by dual trajectory model and LGM. Last, we determined whether the PTG trajectory groups predicted psychological adjustment at 24 months after surgery. Results: The patients were categorized into the following four groups, which showed very different patterns of PTG change over the first year after breast cancer surgery: stable high (38.4%), middle stable (36.7%), low increasing (11.5%), and sharp decreasing (13.3%). These four groups were different at static and time-varying correlates. Especially, the higher the PTG level, the more adaptive coping strategies, cognitive engagement, and perceived vulnerability. Of noted, these groups had difference on neither medical variables nor cancer severity.We also found four distinct trajectories for either anxiety or depression. They were low anxiety, mild anxiety, moderate anxiety, and high anxiety groups and low depression, mild depression, depression decreasing, and high depression groups. Dual trajectory models showed that the sharp decreasing PTG group had the lowest anxiety level, while the high stable PTG group had the lowest depression level. Curvilinear relationship was found between PTG and anxiety, whereas negative correlation was found between PTG and depression. Differences in the level of adjustment at 24 months and the patterns of the correlations across time were found among these latent subgroups. The high stable PTG group had the least psychological distress and the highest PA. The sharp decreasing PTG group had a rather low level of anxiety but medium level of depression. The middle stable and low increasing groups showed the highest level of distress and a rather low level of PA.Conclusions: This study was the first longitudinal examination of PTG trajectories and their different levels of psychological adjustment. The findings support our argument that identifying distinct PTG trajectories can better understand the nature of the relationship between PTG and psychological adjustment. Further theoretical and practical implications for each PTG trajectories are discussed. en_US dc.description.tableofcontents 第一章、 緒論與文獻回顧 1第一節、 引言 1第二節、 研究動機 7第三節、 創傷後成長（PTG）的定義 10第四節、 創傷後成長的理論 11第五節、 實徵研究 26第六節、 對於PTG與心理適應關係不一致的理論反思 42第七節、 對於PTG與心理適應關係不一致的實徵研究反思 51第八節、 影響PTG反應變化的可能因素？ 65第九節、 研究概述與研究目的 75第十節、 研究問題與預期結果 78第二章、 研究方法 82第一節、 研究參與者 82第二節、 研究設計與研究步驟 85第三節、 收案程序 86第四節、 測量工具 87第五節、 統計分析 94第三章、 結果 101第一節、 PTG之異質性變化軌跡 101第二節、 PTG軌跡之效度 107第三節、 PTG軌跡與心理適應的關係 117第四章、 討論 135第一節、 研究結果摘要 135第二節、 探討PTG異質性變化軌跡的重要性 143第三節、 研究結果在理論上的意涵 159第四節、 研究結果在臨床實務上的意涵 164第五節、 研究限制與未來研究方向 167附錄一：PTGI與HADS跨時間測量恆等性考驗 186附錄二：研究工具 188 zh_TW dc.format.extent 4396276 bytes - dc.format.mimetype application/pdf - dc.language.iso en_US - dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G0098752502 en_US dc.subject (關鍵詞) 創傷後成長 zh_TW dc.subject (關鍵詞) 心理適應 zh_TW dc.subject (關鍵詞) 因應策略 zh_TW dc.subject (關鍵詞) 認知投入 zh_TW dc.subject (關鍵詞) 自覺脆弱性 zh_TW dc.subject (關鍵詞) 變化軌跡 zh_TW dc.subject (關鍵詞) 乳癌 zh_TW dc.subject (關鍵詞) posttraumatic growth en_US dc.subject (關鍵詞) psychological adjustment en_US dc.subject (關鍵詞) coping strategies en_US dc.subject (關鍵詞) cognitive engagement en_US dc.subject (關鍵詞) perceived vulnerability en_US dc.subject (關鍵詞) trajectory en_US dc.subject (關鍵詞) breast cancer en_US dc.title (題名) 初診斷乳癌患者創傷後成長與心理適應的關係之長期追蹤研究－從創傷後成長異質性變化軌跡的觀點探討 zh_TW dc.title (題名) A Longitudinal Study of the Relationship between Posttraumatic Growth and Psychological Adjustment in Women Newly Diagnosed with Breast Cancer－Are There Distinct PTG Trajectories ? en_US dc.type (資料類型) thesis en dc.relation.reference (參考文獻) 周嘉娸（2008）。憂鬱反芻對工作記憶容量的影響之初探。（未出版碩士論文）。國立臺灣大學，臺北市。涂珮瓊（2013）。初診斷乳癌患者的心理沮喪變化軌跡與資源變化, 因應風格之關係探討。（未出版博士論文）。國立政治大學，臺北市。陳佩英、史麗珠、王正旭、賴裕和、張獻崑、陳美玲（1999）。疼痛對癌症病人焦慮與憂鬱之影響。台灣醫學，3，379-382。陳坤虎（2001）。青少年自我認同與父母管教態度及自尊之關係。（未出版碩士論文）。國立臺灣大學，臺北市。蔡美珠（1986）。齊克果存在概念。臺北市：水牛出版社。衛生福利部國民健康署（n.d.）。100年癌症登記年報。未出版之統計數據。2013/4/16取自http://tcr.cph.ntu.edu.tw/main.php?Page=A5Affleck, G., & Tennen, H. (1996). Construing benefits from adversity: Adaptotional significance and disposltional underpinnings. Journal of Personality, 64(4), 899-922. Affleck, G., Tennen, H., Croog, S., & Levine, S. (1987). Causal attribution, perceived benefits, and morbidity after a heart attack: an 8-year study. Journal of consulting and clinical psychology, 55(1), 29-35. Aldwin, C. M. (1994). Stress, coping, and development: An integrative approach. New York, NY: Guilford Press.Algoe, S. B., & Stanton, A. L. (2009). Is benefit finding good for individuals with chronic disease? In C. L. Park, S. C. Lechner, M. H. Antoni & A. L. Stanton (Eds.), Medical Illness and Positive Life Change: Can Crisis Lead to Personal Transformation? (pp. 173-193). Washington, DC: APA.Allison, P. J., Guichard, C., & Gilain, L. (2000). A prospective investigation of dispositional optimism as a predictor of health-related quality of life in head and neck cancer patients. Quality of Life Research, 9(8), 951-960. Antoni, M. H., Carver, C. S., & Lechner, S. C. (2009). Enhancing positive adaptation: Example intervention during treatment for breast cancer. In C. L. Park, S. C. Lechner, M. H. Antoni & A. L. Stanton (Eds.), Medical illness and positive life change: Can crisis lead to personal transformation? (pp. 197-214). Washington, DC: APA.Antoni, M. H., Lechner, S., Diaz, A., Vargas, S., Holley, H., Phillips, K., . . . Blomberg, B. (2009). Cognitive behavioral stress management effects on psychosocial and physiological adaptation in women undergoing treatment for breast cancer. Brain, behavior, and immunity, 23(5), 580-591. Antoni, M. H., Lehman, J. M., Klibourn, K. M., Boyers, A. E., Culver, J. L., Alferi, S. M., . . . Harris, S. D. (2001). Cognitive-behavioral stress management intervention decreases the prevalence of depression and enhances benefit finding among women under treatment for early-stage breast cancer. Health Psychology, 20(1), 20-32. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.Baum, A., & Posluszny, D. M. (2000). Traumatic stress as a target for intervention with cancer patients. In A. Baum & B. L. Anderson (Eds.), Psychosocial Interventions for Cancer. Washington, DC: APA.Bellizzi, K. M., & Blank, T. O. (2006). Predicting posttraumatic growth in breast cancer survivors. Health psychology, 25(1), 47-56. Bellizzi, K. M., Miller, M. F., Arora, N. K., & Rowland, J. H. (2007). Positive and negative life changes experienced by survivors of non-Hodgkin’s lymphoma. Annals of Behavioral Medicine, 34(2), 188-199. Bonanno, G. A. (2004). Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? American psychologist, 59(1), 20-28. Bonanno, G. A., Kennedy, P., Galatzer-Levy, I. R., Lude, P., & Elfström, M. L. (2012). Trajectories of resilience, depression, and anxiety following spinal cord injury. Rehabilitation Psychology, 57(3), 236-247. Boot, J. S., Holcombe, C., & Salmon, P. (2010). Positive adjustment to breast cancer: development of a disease‐specific measure and comparison of women diagnosed from 2 weeks to 5 years. Psycho‐Oncology, 19(11), 1187-1194. Bower, J. E., Kemeny, M. E., Taylor, S. E., & Fahey, J. L. (1998). Cognitive processing, discovery of meaning, CD4 decline, and AIDS-related mortality among bereaved HIV-seropositive men. Journal of consulting and clinical psychology, 66(6), 979-986. Bower, J. E., Meyerowitz, B. E., Bernaards, C. A., Rowland, J. H., Ganz, P. A., & Desmond, K. A. (2005). Perceptions of positive meaning and vulnerability following breast cancer: Predictors and outcomes among long-term breast cancer survivors. Annals of Behavioral Medicine, 29(3), 236-245. Bradburn, N. M. (1969). The Structure of Psychological Well-being: Aldine: Chicago.Brame, R., Nagin, D. S., & Wasserman, L. (2006). Exploring some analytical characteristics of finite mixture models. Journal of Quantitative Criminology, 22(1), 31-59. Brannick, M. T. (1995). Critical comments on applying covariance structure modeling. Journal of Organizational Behavior, 16(3), 201-213. Brennan, J. (2001). Adjustment to cancer—coping or personal transition? Psycho‐Oncology, 10(1), 1-18. Browall, M., Ahlberg, K., Karlsson, P., Danielson, E., Persson, L.-O., & Gaston-Johansson, F. (2008). Health-related quality of life during adjuvant treatment for breast cancer among postmenopausal women. European Journal of Oncology Nursing, 12(3), 180-189. Brunet, J., McDonough, M. H., Hadd, V., Crocker, P. R., & Sabiston, C. M. (2010). The Posttraumatic Growth Inventory: An examination of the factor structure and invariance among breast cancer survivors. Psycho‐Oncology, 19(8), 830-838. Butler, L. D., Blasey, C. M., Garlan, R. W., McCaslin, S. E., Azarow, J., Chen, X.-H., . . . Hastings, T. A. (2005). Posttraumatic growth following the terrorist attacks of September 11, 2001: Cognitive, coping, and trauma symptom predictors in an internet convenience sample. Traumatology, 11(4), 247-267. Calhoun, L. G., & Tedeschi, R. G. (1999). Facilitating posttraumatic growth: A clinician`s guide. Mahwah, NJ: Erlbaum.Calhoun, L. G., & Tedeschi, R. G. (2006). The foundations of posttraumatic growth: An expanded framework. In L. G. Calhoun & R. G. Tedeschi (Eds.), Handbook of Posttraumatic Growth: Research and Practice (pp. 3-23). Mahwah, NJ: Lawrence Erlbaum.Carpenter, J. S., Brockopp, D. Y., & Andrykowski, M. A. (1999). Self‐transformation as a factor in the self‐esteem and well‐being of breast cancer survivors. Journal of Advanced Nursing, 29(6), 1402-1411. Carver, C. S. (1997). You want to measure coping but your protocol’too long: Consider the brief cope. International Journal of Behavioral Medicine, 4(1), 92-100. Carver, C. S., & Antoni, M. H. (2004). Finding benefit in breast cancer during the year after diagnosis predicts better adjustment 5 to 8 years after diagnosis. Health Psychology, 23, 595-598. Carver, C. S., Lechner, S. C., & Antoni, M. H. (2009). Callenges in studying positive change after adversity : Illusions form research on breast cancer. In C. L. Park, S. C. Lechner, M. H. Antoni & A. L. Stanton (Eds.), Medical illness and positive life change: Can crisis lead to personal transformation? (pp. 51-62). Washington, DC: APA.Carver, C. S., Pozo, C., Harris, S. D., Noriega, V., Scheier, M. F., Robinson, D. S., . . . Clark, K. C. (1993). How coping mediates the effect of optimism on distress: a study of women with early stage breast cancer. Journal of Personality and social psychology, 65(2), 375-390. Carver, C. S., Scheier, M. F., & Weintraub, J. K. (1989). Assessing coping strategies: A theoretically based approach. Journal of Personality and Social Psychology, 56(2), 267-283. Cella, D. F., & Tross, S. (1986). Psychological adjustment to survival from Hodgkin`s disease. Journal of Consulting and Clinical Psychology, 54(5), 616-622. Cheng, C., Wong, W.-m., & Tsang, K. W. (2006). Perception of benefits and costs during SARS outbreak: An 18-month prospective study. Journal of consulting and clinical psychology, 74(5), 870-879. Cheung, G. W., & Rensvold, R. B. (2002). Evaluating goodness-of-fit indexes for testing measurement invariance. Structural Equation Modeling, 9(2), 233-255. Christopher, M. (2004). A broader view of trauma: A biopsychosocial-evolutionary view of the role of the traumatic stress response in the emergence of pathology and/or growth. Clinical Psychology Review, 24(1), 75-98. Cohen, J. (1983). The Cost of dichotomization. Applied Psychological Measurement, 7(3), 249-253. Cohen, L. H., Hettler, T. R., & Pane, N. (1998). Assessment of posttraumatic growth. In R. G. Tedeschi, C. L. Park & L. G. Calhoun (Eds.), Posttraumatic growth: Positive changes in the aftermath of crisis (pp. 23-42). Mahwah, NJ, USA: Lawrence Erlbaum Associates.Conway, M., Csank, P. A., Holm, S. L., & Blake, C. K. (2000). On assessing individual differences in rumination on sadness. Journal of personality assessment, 75(3), 404-425. Cordova, M. J., Cunningham, L. L., Carlson, C. R., & Andrykowski, M. A. (2001). Posttraumatic growth following breast cancer: a controlled comparison study. Health Psychology, 20(3), 176-185. Cordova, M. J., Giese-Davis, J., Golant, M., Kronenwetter, C., Chang, V., & Spiegel, D. (2007). Breast cancer as trauma: Posttraumatic stress and posttraumatic growth. Journal of Clinical Psychology in Medical Settings, 14(4), 308-319. Coward, D. (1991). Self-transcendence and emotional well-being in women with advanced breast cancer. Paper presented at the Oncology Nursing Forum.Crowne, D. P., & Marlowe, D. (1960). A new scale of social desirability independent of psychopathology. Journal of consulting psychology, 24(4), 349-354. Cruess, D. G., Antoni, M. H., McGregor, B. A., Kilbourn, K. M., Boyers, A. E., Alferi, S. M., . . . Kumar, M. (2000). Cognitive-behavioral stress management reduces serum cortisol by enhancing benefit finding among women being treated for early stage breast cancer. Psychosomatic Medicine, 62(3), 304-308. Curbow, B., Somerfield, M. R., Baker, F., Wingard, J. R., & Legro, M. W. (1993). Personal changes, dispositional optimism, and psychological adjustment to bone marrow transplantation. Journal of Behavioral Medicine, 16(5), 423-443. Danoff-Burg, S., & Revenson, T. A. (2005). Benefit-finding among patients with rheumatoid arthritis: Positive effects on interpersonal relationships. Journal of Behavioral Medicine, 28(1), 91-103. Davis, C. G., & Nolen-Hoeksema, S. (2001). Loss and Meaning How Do People Make Sense of Loss? American Behavioral Scientist, 44(5), 726-741. Davis, C. G., Nolen-Hoeksema, S., & Larson, J. (1998). Making sense of loss and benefiting from the experience: two construals of meaning. Journal of Personality and Social Psychology, 75(2), 561-574. Dolbeault, S., Szporn, A., & Holland, J. (1999). Psycho-oncology: Where have we been? Where are we going? European Journal of Cancer, 35(11), 1554-1558. Dunn, L. B., Cooper, B. A., Neuhaus, J., West, C., Paul, S., Aouizerat, B., . . . Miaskowski, C. (2011). Identification of distinct depressive symptom trajectories in women following surgery for breast cancer. Health psychology, 30(6), 683-692.Ehlers, A., & Steil, R. (1995). Maintenance of intrusive memories in posttraumatic stress disorder: A cognitive approach. Behavioural and Cognitive Psychotherapy, 23, 217-217. Epping-Jordan, J. E., Compas, B. E., Osowiecki, D. M., Oppedisano, G., Gerhardt, C., Primo, K., & Krag, D. N. (1999). Psychological adjustment in breast cancer: processes of emotional distress. Health Psychology, 18(4), 315-326. Folkman, S., & Moskowitz, J. T. (2000). Positive affect and the other side of coping. American psychologist, 55(6), 647-654. Frazier, P., Conlon, A., & Glaser, T. (2001). Positive and negative life changes following sexual assault. Journal of Consulting and Clinical Psychology, 69(6), 1048-1055. Frazier, P., Tashiro, T., Berman, M., Steger, M., & Long, J. (2004). Correlates of levels and patterns of positive life changes following sexual assault. Journal of Consulting and Clinical Psychology, 72(1), 19-30. Fromm, K., Andrykowski, M. A., & Hunt, J. (1996). Positive and negative psychosocial sequelae of bone marrow transplantation: implications for quality of life assessment. Journal of behavioral medicine, 19(3), 221-240. Grubaugh, A. L., & Resick, P. A. (2007). Posttraumatic growth in treatment-seeking female assault victims. Psychiatric Quarterly, 78(2), 145-155. Gueorguieva, R., & Krystal, J. H. (2004). Move over anova: Progress in analyzing repeated-measures data andits reflection in papers published in the archives of general psychiatry. Archives of general psychiatry, 61(3), 310-317. Harper, K., Felicity, W., Schmidt, J. E., Beacham, A. O., Salsman, J. M., Averill, A. J., . . . Andrykowski, M. A. (2007). The role of social cognitive processing theory and optimism in positive psychosocial and physical behavior change after cancer diagnosis and treatment. Psycho‐Oncology, 16(1), 79-91. Heim, E., Valach, L., & Schaffner, L. (1997). Coping and psychosocial adaptation: longitudinal effects over time and stages in breast cancer. Psychosomatic Medicine, 59(4), 408-418. Helgeson, V. S., Reynolds, K. A., & Tomich, P. L. (2006). A meta-analytic review of benefit finding and growth. Journal of Consulting and Clinical Psychology, 74(5), 797-816. Helgeson, V. S., Snyder, P., & Seltman, H. (2004). Psychological and physical adjustment to breast cancer over 4 years: identifying distinct trajectories of change. Health Psychology, 23(1), 3-15. Henselmans, I., Helgeson, V. S., Seltman, H., de Vries, J., Sanderman, R., & Ranchor, A. V. (2010). Identification and prediction of distress trajectories in the first year after a breast cancer diagnosis. Health Psychology, 29(2), 160-168. Ho, S. M., Chan, C. L., & Ho, R. T. (2004). Posttraumatic growth in Chinese cancer survivors. Psycho‐Oncology, 13(6), 377-389. Hobfoll, S. E., Hall, B. J., Canetti‐Nisim, D., Galea, S., Johnson, R. J., & Palmieri, P. A. (2007). Refining our understanding of traumatic growth in the face of terrorism: Moving from meaning cognitions to doing what is meaningful. Applied Psychology, 56(3), 345-366. Hou, W. K., Law, C. C., Yin, J., & Fu, Y. T. (2010). Resource loss, resource gain, and psychological resilience and dysfunction following cancer diagnosis: a growth mixture modeling approach. Health Psychology, 29(5), 484-495. Hu, L., & Bentler, P. M. (1998). Fit indices in covariance structure modeling: Sensitivity to underparameterized model misspecification. Psychological Methods, 3(4), 424-453. Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1-55. Jöreskog, K., & Sörbom, D. (2004). LISREL 8.7 Computer Software Lincolnwood. IL: Scientific Software International, Inc.Janoff-Bulman, R. (1992). Shattered assumptions: Towards a new psychology of trauma. New York: Free Press.Jim, H. S., Richardson, S. A., Golden-Kreutz, D. M., & Andersen, B. L. (2006). Strategies used in coping with a cancer diagnosis predict meaning in life for survivors. Health Psychology, 25(6), 753-761. Jones, B. L., Nagin, D. S., & Roeder, K. (2001). A SAS procedure based on mixture models for estimating developmental trajectories. Sociological Methods & Research, 29(3), 374-393. Joseph, S., & Linley, P. A. (2005). Positive adjustment to threatening events: An organismic valuing theory of growth through adversity. Review of general psychology, 9(3), 262-280. Joseph, S., & Linley, P. A. (2006). Growth following adversity: Theoretical perspectives and implications for clinical practice. Clinical psychology review, 26(8), 1041-1053. Kangas, M., Henry, J. L., & Bryant, R. A. (2002). Posttraumatic stress disorder following cancer: A conceptual and empirical review. Clinical psychology review, 22(4), 499-524. Karanci, A. N., & Erkam, A. (2007). Variables related to stress‐related growth among Turkish breast cancer patients. Stress and Health, 23(5), 315-322. Katz, R. C., Flasher, L., Cacciapaglia, H., & Nelson, S. (2001). The psychosocial impact of cancer and lupus: A cross validation study that extends the generality of “benefit-finding” in patients with chronic disease. Journal of Behavioral Medicine, 24(6), 561-571. Keltner, D., & Gross, J. J. (1999). Functional accounts of emotions. Cognition & Emotion, 13(5), 467-480. Kinsinger, D. P., Penedo, F. J., Antoni, M. H., Dahn, J. R., Lechner, S., & Schneiderman, N. (2006). Psychosocial and sociodemographic correlates of benefit‐finding in men treated for localized prostate cancer. Psycho‐Oncology, 15(11), 954-961. Kleim, B., & Ehlers, A. (2009). Evidence for a curvilinear relationship between posttraumatic growth and posttrauma depression and PTSD in assault survivors. Journal of traumatic stress, 22(1), 45-52. Kuner, S., Orsborn, C., Quigley, L., & Stroup, K. （李巧雲譯；1999/2002）。別為癌症哭泣—四個女子抗癌的療傷心聲（Speak the Language of healing）。台北：商訊文化。Lam, W. W., Bonanno, G. A., Mancini, A. D., Ho, S., Chan, M., Hung, W. K., . . . Fielding, R. (2010). Trajectories of psychological distress among Chinese women diagnosed with breast cancer. Psycho‐Oncology, 19(10), 1044-1051. Lechner, S. C., & Antoni, M. H. (2004). Posttraumatic growth and group-based interventions for persons dealing with cancer: What have we learned so far? Psychological Inquiry, 15(1), 35-41. Lechner, S. C., Carver, C. S., Antoni, M. H., Weaver, K. E., & Phillips, K. M. (2006). Curvilinear associations between benefit finding and psychosocial adjustment to breast cancer. Journal of Consulting and Clinical Psychology, 74(5), 828-840. Lechner, S. C., Zakowski, S. G., Antoni, M. H., Greenhawt, M., Block, K., & Block, P. (2003). Do sociodemographic and disease‐related variables influence benefit‐finding in cancer patients? Psycho‐Oncology, 12(5), 491-499. Lehman, D. R., Davis, C. G., DeLongis, A., Wortman, C. B., Bluck, S., Mandel, D. R., & Ellard, J. H. (1993). Positive and negative life changes following bereavement and their relations to adjustment. Journal of Social and Clinical Psychology, 12(1), 90-112. Lelorain, S., Bonnaud-Antignac, A., & Florin, A. (2010). Long term posttraumatic growth after breast cancer: prevalence, predictors and relationships with psychological health. Journal of Clinical Psychology in Medical Settings, 17(1), 14-22. Linley, P. A., & Joseph, S. (2004). Positive change following trauma and adversity: A review. Journal of Traumatic Stress, 17(1), 11-21. Low, C. A., Stanton, A. L., Bower, J. E., & Gyllenhammer, L. (2010). A randomized controlled trial of emotionally expressive writing for women with metastatic breast cancer. Health Psychology, 29(4), 460-466. Maercker, A., & Zoellner, T. (2004). The Janus face of self-perceived growth: Toward a two-component model of posttraumatic growth. Psychological Inquiry, 15(1), 41-48. Manne, S., Ostroff, J., Winkel, G., Goldstein, L., Fox, K., & Grana, G. (2004). Posttraumatic growth after breast cancer: Patient, partner, and couple perspectives. Psychosomatic Medicine, 66(3), 442-454. Matthews, E. E., & Cook, P. F. (2009). Relationships among optimism, well‐being, self‐transcendence, coping, and social support in women during treatment for breast cancer. Psycho‐Oncology, 18(7), 716-726. Maxwell, S. E., & Delaney, H. D. (1993). Bivariate median splits and spurious statistical significance. Psychological bulletin, 113(1), 181-190. McDonald, R. P., & Ho, M. H. R. (2002). Principles and practice in reporting structural equation analyses. Psychological Methods, 7(1), 64-82. McGregor, B. A., Antoni, M. H., Boyers, A., Alferi, S. M., Blomberg, B. B., & Carver, C. S. (2004). Cognitive–behavioral stress management increases benefit finding and immune function among women with early-stage breast cancer. Journal of psychosomatic research, 56(1), 1-8. McMillen, C., Zuravin, S., & Rideout, G. (1995). Perceived benefit from child sexual abuse. Journal of Consulting and Clinical Psychology, 63(6), 1037-1043. Milam, J. (2004). Posttraumatic Growth Among HIV/AIDS Patients. Journal of Applied Social Psychology, 34(11), 2353-2376. Milam, J. (2006). Posttraumatic growth and HIV disease progression. Journal of consulting and clinical psychology, 74(5), 817-827. Millar, K., Purushotham, A. D., McLatchie, E., George, W. D., & Murray, G. D. (2005). A 1-year prospective study of individual variation in distress, and illness perceptions, after treatment for breast cancer. Journal of Psychosomatic Research, 58(4), 335-342. Mineka, S., & Sutton, S. K. (1992). Cognitive biases and the emotional disorders. Psychological Science, 3(1), 65-69. Morris, B. A., Shakespeare-Finch, J. E., & Scott, J. L. (2007). Coping processes and dimensions of posttraumatic growth. The Australasian Journal of Disaster and Trauma Studies, 2007(1), 1-12. Moskowitz, J. T., & Epel, E. S. (2006). Benefit finding and diurnal cortisol slope in maternal caregivers: A moderating role for positive emotion. The Journal of Positive Psychology, 1(2), 83-91. Nagin, D. S. (2005). Group-Based Modeling of Development. Cambridge, MA: Harvard University Press.Nagin, D. S., & Tremblay, R. E. (2001). Parental and early childhood predictors of persistent physical aggression in boys from kindergarten to high school. Archives of General psychiatry, 58(4), 389-394. Nolen-Hoeksema, S., & Davis, C. G. (2004). Theoretical and methodological issues in the assessment and interpretation of posttraumatic growth. Psychological Inquiry, 15(1), 60-64. Nolen-Hoeksema, S., & Morrow, J. (1991). A prospective study of depression and posttraumatic stress symptoms after a natural disaster: the 1989 Loma Prieta Earthquake. Journal of personality and social psychology, 61(1), 115-121. O`Leary, V. E., Alday, C. S., & Ickovics, J. R. (1998). Models of life change and posttraumatic growth. In R. G. Tedeschi, C. L. Park & L. G. Calhoun (Eds.), Posttraumatic growth: Positive changes in the aftermath of crisis (pp. 127-151). Mahwah, NJ, USA: Lawrence Erlbaum Associates.Pakenham, K. I. (2005). Benefit finding in multiple sclerosis and associations with positive and negative outcomes. Health Psychology, 24(2), 123-132. Park, C. L. (2009). Overview of theoretical perspectives. In C. L. Park, S. C. Lechner, M. H. Antoni & A. L. Stanton (Eds.), Medical Illness and Positive Life Change: Can Crisis Lead to Personal Transformation? (pp. 11-30). Washington, DC: APA.Park, C. L., Cohen, L. H., & Murch, R. L. (1996). Assessment and Prediction of Stress‐Related Growth. Journal of personality, 64(1), 71-105. Park, C. L., & Fenster, J. R. (2004). Stress-related growth: Predictors of occurrence and correlates with psychological adjustment. Journal of Social and Clinical Psychology, 23(2), 195-215. Park, C. L., & Folkman, S. (1997). Meaning in the context of stress and coping. Review of General Psychology, 1(2), 115-144. Park, C. L., & Helgeson, V. S. (2006). Introduction to the special section: Growth following highly stressful life events- Current status and future directions. Journal of Consulting and Clinical Psychology, 74(5), 791-796. Parkes, C. M. (1988). Bereavement as a psychosocial transition: Processes of adaptation to change. Journal of Social Issues, 44(3), 53-65. Pat‐Horenczyk, R., & Brom, D. (2007). The Multiple Faces of Post‐Traumatic Growth. Applied Psychology, 56(3), 379-385. Paul, T. (1952). The Courage to be: Yale University Press.Prati, G., & Pietrantoni, L. (2009). Optimism, social support, and coping strategies as factors contributing to posttraumatic growth: A meta-analysis. Journal of Loss and Trauma, 14(5), 364-388. Ransom, S., Sheldon, K. M., & Jacobsen, P. B. (2008). Actual change and inaccurate recall contribute to posttraumatic growth following radiotherapy. Journal of consulting and clinical psychology, 76(5), 811-819. Reynolds, W. M. (1982). Development of reliable and valid short forms of the Marlowe‐Crowne Social Desirability Scale. Journal of clinical psychology, 38(1), 119-125. Rieker, P. P., Fitzgerald, E. M., Kalish, L. A., Richie, J. P., Lederman, G. S., Edbril, S. D., & Garnick, M. B. (1989). Psychosocial factors, curative therapies, and behavioral outcomes. A comparison of testis cancer survivors and a control group of healthy men. Cancer, 64(11), 2399-2407. Rini, C., Manne, S., DuHamel, K. N., Austin, J., Ostroff, J., Boulad, F., . . . Mee, L. (2004). Mothers’ perceptions of benefit following pediatric stem cell transplantation: A longitudinal investigation of the roles of optimism, medical risk, and sociodemographic resources. Annals of behavioral medicine, 28(2), 132-141. Riskind, J. H., Williams, N. L., & Joiner, T. E. (2006). The looming cognitive style: A cognitive vulnerability for anxiety disorders. Journal of Social and Clinical Psychology, 25(7), 779-801. Robinette, R. L. (1991). The relationship between the Marlowe‐Crowne form C and the validity scales of the MMPI. Journal of Clinical Psychology, 47(3), 396-399.Robinson, J. P., Shaver, P. R., & Wrightsman, L. S. （楊宜音、張志學譯；1990/1998）。性格與社會心理測量總覽。台北：遠流出版社。Rollo, M. (1953). The Meaning of Anxiety. The Journal of Nervous and Mental Disease, 118(3), 280-281. Rosenberg, M. (1965). Society and the adolescent self-image. Princeton, N J: Princeton Univ. Press.Ross, M., & Wilson, A. E. (2002). It feels like yesterday: self-esteem, valence of personal past experiences, and judgments of subjective distance. Journal of personality and social psychology, 82(5), 792-803. Salsman, J. M., Segerstrom, S. C., Brechting, E. H., Carlson, C. R., & Andrykowski, M. A. (2009). Posttraumatic growth and PTSD symptomatology among colorectal cancer survivors: a 3‐month longitudinal examination of cognitive processing. Psycho‐Oncology, 18(1), 30-41. Sawyer, A., Ayers, S., & Field, A. P. (2010). Posttraumatic growth and adjustment among individuals with cancer or HIV/AIDS: A meta-analysis. Clinical Psychology Review, 30(4), 436-447. Schaefer, J. A., & Moos, R. H. (1992). Life crises and personal growth. In B. N. Carpenter (Ed.), Personal Coping: Theory, Research, and Application (pp. 149-170). Westport, CT: Praeger.Schroevers, M. J., Kraaij, V., & Garnefski, N. (2011). Cancer patients` experience of positive and negative changes due to the illness: relationships with psychological well‐being, coping, and goal reengagement. Psycho‐Oncology, 20(2), 165-172. Schroevers, M. J., & Teo, I. (2008). The report of posttraumatic growth in Malaysian cancer patients: Relationships with psychological distress and coping strategies. Psycho‐Oncology, 17(12), 1239-1246. Schulz, U., & Mohamed, N. E. (2004). Turning the tide: benefit finding after cancer surgery. Social science & medicine, 59(3), 653-662. Schwarzer, R., Luszczynska, A., Boehmer, S., Taubert, S., & Knoll, N. (2006). Changes in finding benefit after cancer surgery and the prediction of well-being one year later. Social Science & Medicine, 63(6), 1614-1624. Scrignaro, M., Barni, S., & Magrin, M. E. (2011). The combined contribution of social support and coping strategies in predicting post‐traumatic growth: a longitudinal study on cancer patients. Psycho‐Oncology, 20(8), 823-831. Sears, S. R., Stanton, A. L., & Danoff-Burg, S. (2003). The yellow brick road and the emerald city: benefit finding, positive reappraisal coping and posttraumatic growth in women with early-stage breast cancer. Health Psychology, 22(5), 487-497. Shakespeare-Finch, J., & Lurie-Beck, J. (2014). A meta-analytic clarification of the relationship between posttraumatic growth and symptoms of posttraumatic distress disorder. Journal of anxiety disorders, 28(2), 223-229. Shapiro, J. P., McCue, K., Heyman, E. N., Dey, T., & Haller, H. S. (2010). Coping-related variables associated with individual differences in adjustment to cancer. Journal of psychosocial oncology, 28(1), 1-22. Spiegel, D., Butler, L. D., Giese‐Davis, J., Koopman, C., Miller, E., DiMiceli, S., . . . Kraemer, H. C. (2007). Effects of supportive‐expressive group therapy on survival of patients with metastatic breast cancer. Cancer, 110(5), 1130-1138. Stanton, A. L., Bower, J. E., & Low, C. A. (2006). Posttraumatic Growth After Cancer. In L. G. Calhoun & R. G. Tedeschi (Eds.), Handbook of Posttraumatic Growth: Research and Practice (pp. 138–175). Mahwah, NJ: Lawrence Erlbaum.Stanton, A. L., & Snider, P. R. (1993). Coping with a breast cancer diagnosis: A prospective study. Health Psychology, 12(1), 16-23. Steenkamp, J. B. E. M., & Baumgartner, H. (1998). Assessing measurement invariance in cross-national consumer research. Journal of Consumer Research, 25(1), 78-107. Sumalla, E. C., Ochoa, C., & Blanco, I. (2009). Posttraumatic growth in cancer: reality or illusion? Clinical Psychology Review, 29(1), 24-33. Taku, K., Cann, A., Calhoun, L. G., & Tedeschi, R. G. (2008). The factor structure of the Posttraumatic Growth Inventory: A comparison of five models using confirmatory factor analysis. Journal of Traumatic Stress, 21(2), 158-164. Tallman, B. A., Altmaier, E., & Garcia, C. (2007). Finding benefit from cancer. Journal of Counseling Psychology, 54(4), 481-487. Taylor, S. E. (1983). Adjustment to threatening events. A theory of cognitive adaptation. American Psychologist, 38(11), 1161-1173. Taylor, S. E., & Armor, D. A. (1996). Positive illusions and coping with adversity. Journal of personality, 64(4), 873-898. Taylor, S. E., & Brown, J. D. (1988). Illusion and well-being: a social psychological perspective on mental health. Psychological bulletin, 103(2), 193-210. Taylor, S. E., Lichtman, R. R., & Wood, J. V. (1984). Attributions, beliefs about control, and adjustment to breast cancer. Journal of personality and social psychology, 46(3), 489-502. Tedeschi, R. G., & Calhoun, L. G. (1996). The Posttraumatic Growth Inventory: Measuring the positive legacy of trauma. Journal of Traumatic Stress, 9(3), 455-471. Tedeschi, R. G., & Calhoun, L. G. (2004). Posttraumatic Growth: Conceptual Foundations and Empirical Evidence. Psychological Inquiry, 15(1), 1-18. Tedeschi, R. G., Park, C. L., & Calhoun, L. G. (1998). Posttraumatic growth: Positive changes in the aftermath of crisis: Psychology Press.Tennen, H., & Affleck, G. (2002). Benefit-finding and benefit-reminding. In C. R. Snyder & S. Lopez (Eds.), The handbook of positive psychology (pp. 584-597). New York: Oxford University Pres.Tennen, H., & Affleck, G. (2009). Assessing positive life change: In search of meticulous methods. In C. L. Park, S. C. Lechner, M. H. Antoni & A. L. Stanton (Eds.), Medical illness and positive life change: Can crisis lead to personal transformation? (pp. 31-50). Washington, DC: APA.Tennen, H., Affleck, G., Urrows, S., Higgins, P., & Mendola, R. (1992). Perceiving control, construing benefits, and daily processes in rheumatoid arthritis. Canadian Journal of Behavioural Science, 24(2), 186-203. Thornton, A. A., Owen, J. E., Kernstine, K., Koczywas, M., Grannis, F., Cristea, M., . . . Stanton, A. L. (2012). Predictors of finding benefit after lung cancer diagnosis. Psycho‐Oncology, 21(4), 365-373. Thornton, A. A., & Perez, M. A. (2006). Posttraumatic growth in prostate cancer survivors and their partners. Psycho‐Oncology, 15(4), 285-296. Thuné-Boyle, I. C., Myers, L. B., & Newman, S. P. (2006). The role of illness beliefs, treatment beliefs, and perceived severity of symptoms in explaining distress in cancer patients during chemotherapy treatment. Behavioral Medicine, 32(1), 19-29. Tomich, P. L., & Helgeson, V. S. (2002). Five years later: a cross‐sectional comparison of breast cancer survivors with healthy women. Psycho‐oncology, 11(2), 154-169. Tomich, P. L., & Helgeson, V. S. (2004). Is finding something good in the bad always good? Benefit finding among women with breast cancer. Health Psychology, 23(1), 16-23. Tomich, P. L., Helgeson, V. S., & Nowak Vache, E. J. (2005). Perceived growth and decline following breast cancer: a comparison to age‐matched controls 5‐years later. Psycho‐Oncology, 14(12), 1018-1029. Treynor, W., Gonzalez, R., & Nolen-Hoeksema, S. (2003). Rumination reconsidered: A psychometric analysis. Cognitive Therapy and Research, 27(3), 247-259. Urcuyo, K. R., Boyers, A. E., Carver, C. S., & Antoni, M. H. (2005). Finding benefit in breast cancer: Relations with personality, coping, and concurrent well-being. Psychology & Health, 20(2), 175-192. Vandenberg, R. J., & Lance, C. E. (2000). A review and synthesis of the measurement invariance literature: Suggestions, practices, and recommendations for organizational research. Organizational Research Methods, 3(1), 4-70. Watkins, E. R. (2008). Constructive and unconstructive repetitive thought. Psychological bulletin, 134(2), 163-206. Watson, M., Law, M. G., Santos, M. d., Greer, S., Baruch, J., & Bliss, J. (1994). The Mini-MAC: further development of the mental adjustment to cancer scale. Journal of Psychosocial Oncology, 12(3), 33-46. Westphal, M., & Bonanno, G. A. (2007). Posttraumatic growth and resilience to trauma: Different sides of the same coin or different coins? Applied Psychology, 56(3), 417-427. Widows, M. R., Jacobsen, P. B., Booth-Jones, M., & Fields, K. K. (2005). Predictors of posttraumatic growth following bone marrow transplantation for cancer. Health Psychology, 24(3), 266-273. Wilkinson, S., & Kitzinger, C. (2006). Surprise as an interactional achievement: Reaction tokens in conversation. Social psychology quarterly, 69(2), 150-182. Yalom, I. D., & Lieberman, M. A. (1991). Bereavement and heightened existential awareness. Psychiatry: Interpersonal and Biological Processes, 54, 334-345. Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361-370. Zoellner, T., & Maercker, A. (2006). Posttraumatic growth in clinical psychology—A critical review and introduction of a two component model. Clinical Psychology Review, 26(5), 626-653. zh_TW
