Dissertation/Thesis Abstract

Etiology of positive and negative transitions in core assumptions in the adjustment to cancer in survivors of bone marrow transplants
by Rowland, Susan J., Ph.D., Union Institute and University, 2006, 205; 3256215
Abstract (Summary)

The cancer experience is a traumatic event leading to major adjustments in patients' core assumptions about self, life and one's relationship to others. The Social-Cognitive Transition (SCT) Model of Adjustment (Brennan, 2001) offers a unique approach to account for both positive and negative adjustment. The aim of this study was to validate Brennan's theory-driven SCT model with data that would likewise support Spranger and Schwartz' theoretically parallel Response Shift (RS) Model. Research questions for this study investigated the origins of adjustment from each portion of the Joint SCT/RS Model with instruments that operationalized both Brennan's and Spranger and Schwartz' constructs.

The Posttraumatic Growth Inventory, The Attribution Style Questionnaire, The Medical Outcomes Study Short Form 36, The Mental Adjustment to Cancer and The Life Now/Life Then Questionnaire which was developed specifically for this study, were administered to ten cancer patients, five male and five female, with lymphoma or multiple myeloma who were 24-36 months post-autologous bone marrow transplant. From the results, case histories chart the course of adjustment in these cancer survivors.

Results support the SCT Model and demonstrate that adjustment is the adaptive process that moderates the relationship between the cancer experience and quality of life. The crucial finding is that positive adjustment or positive changes in core assumptions result in the maintenance or enhancement of quality of life and negative adjustment had a negative impact on quality of life. For this sample, two-thirds, or 66.6% of respondents currently perceive a positive quality of life no different from the 1998 US general population. These same respondents also reported the use of Fighting Spirit as a coping strategy, experienced more posttraumatic growth, and made more positive and less negative transitions in core assumptions.

In light of the high comorbidity of affective disorders among cancer patients, a better understanding of who is more likely to make changes, to what, when, why, and how has significant treatment implications. Armed with insights from these relationships, clinicians may have sharper tools with which to increase quality of life by normalizing the struggles involved in making positive adjustment and redirecting the course of adjustment for those at high risk for maladjustment.

Indexing (document details)
Advisor: DeLoach, Joseph
Commitee:
School: Union Institute and University
School Location: United States -- Ohio
Source: DAI-B 68/03, Dissertation Abstracts International
Source Type: DISSERTATION
Subjects: Behaviorial sciences, Psychotherapy, Cognitive therapy
Keywords: Adjustment, Bone marrow transplants, Cancer, Core assumptions, Survivors
Publication Number: 3256215
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