Growth through Trauma: Posttraumatic Growth in African American Breast Cancer Survivors

Background and Purpose: Cancer diagnosis and treatment is a stressful process, which have been compared to those seen in individuals with prolonged combat exposure.  While much of the focus is placed upon the negative consequences of this severe stress, the Posttraumatic Growth (PTG) model suggests that positive change can occur in response to a traumatic event that disrupts an individual’s belief about the world and through the process of rebuilding those beliefs, growth known as PTG can occur. (Calhoun & Tedeschi, 2006; Tedeschi, Park, & Calhoun, 1998).  Understanding this potential growth is important, as PTG may not be regularly monitored in many cancer centers. This can result in incomplete behavioral healthcare and incorrectly fitted treatment procedures which fail to consider individual strengths and barriers which can aid, or limit, treatment effectiveness. The purpose of the current study was to assess the positive growth experienced by African American women diagnosed and treated for breast cancer and to answer the following question: “What are the factors that affect the amount of reported PTG in African American breast cancer survivors?.”

Methods:  Data were collected using a cross-sectional survey design. A purposive sample of African American women with breast cancer (N=48) were recruited from a community organization that provided services to underserved breast cancer patients in various locations across a rural southern state.  The information collected included scores from the Posttraumatic Growth Inventory (PTGI), a 21 item scale which measures five factors of post-crisis personal growth.  In addition to PTGI scores, several factors were examined, including age at diagnosis, number of children, and household income.  The age of respondents ranged from 33 to 84, with a mean of 54.55 (SD=10.63). 

Results:  Posttraumatic Growth Inventory (PTGI) scores indicated that the majority of respondents (80%) experienced at least a “moderate” level of personal growth as a result of their diagnosis and treatment, with 95.8% of participants reporting moderate growth in at least one of the five factors of PTG.  Notably, individuals in the lowest category of household income reported the lowest level of PTG, with 57% indicating sub-moderate levels.  Additionally, participants with four or more children were less likely to experience increased “Appreciation of Life” (χ²(7)=17.265, p=0.02).  No relationship was found in reported levels of PTG and the age of diagnosis.

Implications:  Understanding the role of posttraumatic growth and its relation to the stress resulting from the cancer experience can be important to improving patient care and outcomes.  Social workers have the values, training, and skills to assume a leading role in improving the integration of positive growth knowledge and assessment into the treatment of cancer patients. Within an integrative health care structure, social workers can provide a unique perspective which accounts for factors beyond the scope of today’s standard of care.