Contextual life stress and coping strategies as predictors of adjustment to breast cancer survivorship.

BACKGROUND/PURPOSE The study presented here examined the influence of contextual life stress and coping strategies on change in adjustment over the year following completion of treatment for breast cancer. We also investigated whether contextual stressful life events moderate the relationship between coping strategies and adjustment, such that cancer-specific emotional approach coping processes would predict better psychosocial outcomes only in the context of lower life stress and would have less impact on adaptation in the context of heightened life stress. METHODS In a sample of women (n = 558) who had recently completed treatment for nonmetastatic breast cancer and were part of a psychoeducational intervention trial to facilitate the transition to survivorship, life stress in the year prior to study entry, cancer-specific coping strategies, and general and cancer-specific adjustment were assessed at baseline, and adjustment outcomes (i.e., vitality, depressive symptoms, cancer-specific distress, personal growth) also were assessed at 6-month (n = 417) and 12-month (n = 397) follow-up. RESULTS/CONCLUSIONS Although cross-sectional relationships between life stress and adjustment were demonstrated, findings suggest that contextual life stress does not appear to have a direct influence on change in adjustment in the first year after breast cancer treatment. Instead, life stress interacted with cancer-specific coping to predict adjustment, such that cancer-specific emotional approach coping was adaptive only under conditions of low contextual life stress.