Women Coping with Breast Cancer: The Impact of Personality and Close Relationships On Coping Strategies

Background and Purpose: Women's coping styles and psychosocial adjustment to cancer depend on multiple individual and interpersonal factors. Despite the extensive research on women's adjustment to cancer, we still do not have a full understanding of how individual personality factors affect the coping strategies that women use in dealing with stress. Yet our approach to social work interventions with cancer patients assumes that “one size fits all.” This study examines whether certain personality traits affect the ways in which women cope with breast cancer. We also investigate the relationship between the closeness with a primary support person and coping styles.

Methods: Seventy-two northern Italian women who were starting adjuvant treatment for early stage breast cancer were recruited for the study. Survey data were collected by completing questionnaires consisting of standardized instruments measuring personality traits (Interpersonal Adaptation Questionnaire; DiNuovo, 1998), interpersonal closeness (Inclusion of Other Scale; Aron, Aron, & Smollan, 1992), and adjustment to cancer (Mini-Mental Adjustment to Cancer Scale; Grassi, et al, 2004). Multiple regression analyses were conducted to test the influence of personality traits, interpersonal closeness, and moderating variables (demographic and clinical characteristics) on coping styles.

Results: Controlling for demographic and clinical characteristics, participants who rated high on assertiveness tended to report a positive, active style of coping (beta=.27, p< .02). There was a positive relationship between worry about social image and an anxious pre-occupation of their cancer which approached a level of statistical significance (beta=.21, p <.07). Participants who rated high on impulsiveness tended to use avoidance as a coping strategy, again approaching statistical significance (beta=.22, p<.06). A high degree of closeness to a support person was positively associated with an active coping style (r=0.24, p<.05) and an anxious preoccupation coping style (r=0.25, p<.05). A high level of closeness was negatively related to the coping styles of helpless/uncontrollability (r=-0.26, p<.05) and impulsiveness (r=-0.33, p<.01). The overall number of support persons did not correlate highly with any of the coping styles.

Conclusions and Implications: Results from the study highlight how personality traits play a key role in the coping process. In particular, a woman's ability to be self-affirming and asserting her own needs is critical to her ability to use positive coping strategies. However, women who tend to worry about social image are more likely to have a coping style of anxious preoccupation.

The findings on the influence of close relationships on coping reveal that a high degree of closeness is not always associated with positive coping in that women rating their relationships as very high in closeness were also more likely to report an anxious preoccupation coping style. Our findings also indicate that the size of the social network does not exert a significant influence on coping style.

These results have implications for developing psychosocial interventions for cancer patients and in particular, for social work practitioners who are selecting the best practices for their patients. Future research needs to determine which type of psychosocial interventions are effective and for whom.