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Variations in symptom development among breast cancer (BC) survivors are understudied. We examined: (Q1) Symptom trajectories of pain, fatigue, insomnia, breast, and arm symptoms in BC survivors, (Q2) possible patterns or cluster-like associations between trajectory classification of different symptoms, and (Q3) characteristics of survivors assigned to high-burden symptom trajectories. Participants were 968 women (mean age = 59.6 years) treated for early-stage BC and followed across a three-year postoperative period. As part of routine follow-up procedures, patients reported symptom burden and functioning levels at each hospital visit using the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30) and the BC-specific module (QLQ-BR-23). Growth mixture modeling (GMM) analysis was used to differentiate potential subgroups of individuals with similar longitudinal symptom patterns, i.e., symptom trajectories (Q1). With this approach, groups experiencing persistent, highly distressing cancer- and treatment-related late effects (LEs) may be identified. Latent class analysis (LCA) was used for Q2 and logistic regression analysis for Q3. GMM identified two relatively parallel trajectories across the tested symptoms: The majority of the sample exhibited a low-burden symptom trajectory (74.4–89.2%) and a minority by a high-burden symptom trajectory (10.8–25.6%). LCA revealed that approximately one in five women (18.8%) were likely to be members of the high-burden symptom trajectory across all tested symptoms. In addition to a high probability of being burdened over time across multiple symptoms, these women were also characterized by poorer self-reported physical and social functioning. A substantial minority followed a high-burden symptom trajectory for several years following BC treatment. Associations were found in trajectory classification across symptoms, indicating that cancer-related LEs appear in clusters of multiple concurrent symptoms. [ABSTRACT FROM AUTHOR]

Background and Objectives: According to the Dual Process Model (DPM), shifting between loss-oriented (LO) and restoration-oriented (RO) coping is essential for adjustment following bereavement. Knowledge about how LO and RO coping change over time and how such changes are related to adjustment is missing. With a prospective design this study investigated (1) relations between levels of LO/RO coping and selected outcomes and (2) changes in LO/RO coping across time and their relations to adjustment.Methods: A sample of 145 spousal bereaved individuals completed questionnaires measuring LO and RO coping, grief symptoms, positive affect, and attachment orientation approximately 2-3 months (baseline) and 7 months (follow-up) post-loss.Results: High usage of LO coping was associated with poorer outcomes and high usage of RO coping was associated with better outcomes at both baseline and follow-up. Individuals generally shifted towards more RO coping across time and those who exhibited this shift showed lower levels of grief at follow-up compared to individuals who changed towards more LO coping across time.Conclusions: Individuals showing more RO coping reported better adjustment both early and later in the bereavement process. Changes in coping orientation over time might be useful for understanding complicated grief reactions following loss. [ABSTRACT FROM AUTHOR]

The purpose of the study was to explore relations between narrative identity and reactions to bereavement. Approximately 2–3 months after losing their partner, 161 older participants completed questionnaires measuring grief symptoms, positive affect, and neuroticism. They also described past and future chapters in their life stories and rated chapters on positive and negative emotional tone. Past chapters were coded for whether they were related to the loss of the partner and these loss chapters were coded for positive and negative emotional tone. Future chapters were content coded for positive and negative emotional tone as well as whether the content reflected new roles/activities and continuation of roles/activities. At follow-up (5–6 months later), participants completed questionnaires measuring grief symptoms and positive affect. Individuals with more positive future chapters and future chapters emphasizing continuation of roles and activities experienced less severe grief reactions and more positive affect. Thus, narrative identity may be useful for understanding reactions to bereavement. [ABSTRACT FROM AUTHOR]