Moderating Role of Self-compassion in Relation to Psychopathological Symptoms and God Attachment in Women With Breast Cancer
Abstract
Background: In many of past studies, the role of God as an attachment figure in reducing psychopathological symptoms has strongly been confirmed. In an effort to account for the effectiveness of attachment to God in mitigating psychopathological symptoms in healthy people we came upon self-compassion as a potential mediating variable in this process. Hence, in the current research, we studied this relation in Iranian Muslim women diagnosed with breast cancer.
Methods: A total of 360 Muslim women diagnosed with breast cancer were asked to fill the Attachment to God Inventory, Self-Compassion Scale, and Depression, Anxiety, and Stress Scale. Data were analyzed using path analysis method with AMOS 22.
Results: The anxiety dimension of attachment to God was significantly correlated with the severity of anxiety, but the avoidance dimension had no direct effect on any of the symptoms. Also, the anxiety dimension was found to be positively correlated with depression and stress indirectly via self-compassion. However, in the case of the avoidance dimension, no such relationship was observed. As a result, attachment anxiety causes a decrease in self-compassion in this group of women, and this, in turn, results in more severe psychopathological symptoms like anxiety, stress, and depression.
Conclusion: Considering the results of this study, we conclude that improvements in the mental health of Muslim women diagnosed with breast cancer are not exclusively achieved by attachment to material symbols. Rather, attachment to God as a spiritual symbol can have a great impact on the mental health of these women. In fact, secure attachment to God can help improve mental health through positive effects on self-compassion and should be considered as a treatment in psychological interventions.
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References
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin. 2016;66(1):7-30.
Jazayeri SB, Saadat S, Ramezani R, Kaviani A. Incidence of primary breast cancer in Iran: Ten-year national cancer registry data report. Cancer Epidemiol. 2015;39(4):519-27.
Hernandez Blazquez M, Cruzado JA. A longitudinal study on anxiety, depressive and adjustment disorder, suicide ideation and symptoms of emotional distress in patients with cancer undergoing radiotherapy. J Psychosom Res. 2016;87:14-21.
Fafouti M, Paparrigopoulos T, Zervas Y, Rabavilas A, Malamos N, et al. Depression, anxiety and general psychopathology in breast cancer patients: a cross-sectional control study. In Vivo. 2010;24(5):803-10.
Kissane DW, Grabsch B, Love A, Clarke DM, Bloch S, et al. Psychiatric disorder in women with early stage and advanced breast cancer: a comparative analysis. Aust N Z J Psychiatry. 2004;38(5):320-6.
Tojal C, Costa R. Depressive symptoms and mental adjustment in women with breast cancer. Psychooncology. 2015;24(9):1060-5.
Hinnen C. Adaptation to Cancer from the Perspective of Attachment Theory. In: Hunter J, Maunder R, editors. Improving Patient Treatment with Attachment Theory: A Guide for Primary Care Practitioners and Specialists. Cham: Springer International Publishing; 2016. p. 75-91.
Brennan KA, Clark CL, Shaver PR. Self-report measurement of adult attachment: An integrative overview. In: Attachment theory and close relationships. New York: Guilford Press. 1998:46-76.
Hinnen C, Schreuder I, Jong E, van Duijn M, Dahmen R, et al. The contribution of adult attachment and perceived social support to depressive symptoms in patients with HIV. AIDS Care. 2012;24(12):1535-42.
Cicero V, Lo Coco G, Gullo S, Lo Verso G. The role of attachment dimensions and perceived social support in predicting adjustment to cancer. Psychooncology. 2009;18(10):1045-52.
Bowlby J. Attachment, Vol. 1 of Attachment and loss. New York: Basic Books; 1969.
Mikulincer M, Shaver PR. Security-based self-representations in adulthood. Adult attachment: Theory, research, and clinical implications. 2004:159-95.
Mikulincer M, Shaver PR. Attachment in adulthood: Structure, dynamics, and change: Guilford Press; 2007.
Pargament KI, Exline JJ, Jones JW. APA handbook of psychology, religion, and spirituality (Vol 1): Context, theory, and research: American Psychological Association; 2013.
Granqvist P, Kirkpatrick LA. Attachment and religious representations and behavior. 2008.
Tung ES, Ruffing EG, Paine DR, Jankowski PJ, Sandage SJ. Attachment to God as mediator of the relationship between God Representations and mental health. Journal of Spirituality in Mental Health. 2018;20(2):95-113.
Homan KJ. A mediation model linking attachment to God, self-compassion, and mental health. Mental Health, Religion & Culture. 2014;17(10):977-89.
Neff K. Self-compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and identity. 2003;2(2):85-101.
Terry ML, Leary MR. Self-compassion, self-regulation, and health. Self and Identity. 2011;10(3):352-62.
Pinto-Gouveia J, Duarte C, Matos M, Fraguas S. The protective role of self-compassion in relation to psychopathology symptoms and quality of life in chronic and in cancer patients. Clin Psychol Psychother. 2014;21(4):311-23.
Mikail SF, Henderson PR, Tasca GA. An interpersonally based model of chronic pain: An application of attachment theory. Clinical Psychology Review. 1994;14(1):1-16.
Hinnen C, Pool G, Holwerda N, Sprangers M, Sanderman R, et al. Lower levels of trust in one's physician is associated with more distress over time in more anxiously attached individuals with cancer. General hospital psychiatry. 2014;36(4):382-7.
Rodin G, Walsh A, Zimmermann C, Gagliese L, Jones J, et al. The contribution of attachment security and social support to depressive symptoms in patients with metastatic cancer. Psychooncology. 2007;16(12):1080-91.
Raque-Bogdan TL, Ericson SK, Jackson J, Martin HM, Bryan NA. Attachment and mental and physical health: Self-compassion and mattering as mediators. Journal of Counseling Psychology. 2011;58(2):272.
Homan KJ. Secure attachment and eudaimonic well-being in late adulthood: The mediating role of self-compassion. Aging & mental health. 2018;22(3):363-70.
Derakhshan MK, Karbassian MH. Psychiatric and Psychosocial Aspects of Breast Cancer Diagnoses and Treatments. Cancer Genetics and Psychotherapy: Springer; 2017. p. 45-77.
Soper D. Sample Size Calculator for Structural Equation Models. Available; 2017.
Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995;33(3):335-43.
Sahebi A, Asghari MJ, Salari RS. Validation of depression anxiety and stress scale (DASS-21) for an Iranian population. Iranian Psychologists. 2005;4(1):299-313.
Neff KD. The development and validation of a scale to measure self-compassion. Self and identity. 2003;2(3):223-50.
Azizi A, Mohammadkhani P, Lotfi S, Bahramkhani M. The validity and reliability of the Iranian version of the Self-Compassion Scale. Practice in Clinical Psychology. 2013;1(3):149-55.
Beck R, McDonald A. Attachment to God: The Attachment to God Inventory, tests of working model correspondence, and an exploration of faith group differences. Journal of Psychology and Theology. 2004;32(2):92-103.
Oliaee Z, Samani S, Fani H. Psychometric Properties Of The God Attachment Scale Persion Version. 2011.
Corp I. IBM SPSS statistics for windows, version 22.0. Armonk, NY: IBM Corp. 2013.
Arbuckle J. IBM® SPSS® amos™ 22 User’s guide [software]. Chicago, IL: IBM. 2013.
Finney SJ, DiStefano C. Non-normal and categorical data in structural equation modeling. Structural equation modeling: A second course. 2006;10(6):269-314.
Flannelly KJ. Belief in God as an Attachment Figure and Mental Health. Religious Beliefs, Evolutionary Psychiatry, and Mental Health in America: Springer; 2017. p. 211-23.
Neff KD, Rude SS, Kirkpatrick KL. An examination of self-compassion in relation to positive psychological functioning and personality traits. Journal of research in personality. 2007;41(4):908-16.
Przezdziecki A, Sherman KA, Baillie A, Taylor A, Foley E, et al. My changed body: breast cancer, body image, distress and self-compassion. Psychooncology. 2013;22(8):1872-9.
Scheffold K, Philipp R, Koranyi S, Engelmann D, Schulz-Kindermann F, et al. Insecure attachment predicts depression and death anxiety in advanced cancer patients. Palliat Support Care. 2018;16(3):308-16.
Porter LS, Keefe FJ, Davis D, Rumble M, Scipio C, et al. Attachment styles in patients with lung cancer and their spouses: associations with patient and spouse adjustment. Support Care Cancer. 2012;20(10):2459-66.
Meidlinger PC, Hope DA. The new transdiagnostic cognitive behavioral treatments: Commentary for clinicians and clinical researchers. J Anxiety Disord. 2017;46:101-9.
Homan KJ. Secure attachment and eudaimonic well-being in late adulthood: The mediating role of self-compassion. Aging Ment Health. 2018;22(3):363-70.
Flannelly KJ, Galek K. Religion, evolution, and mental health: attachment theory and ETAS theory. J Relig Health. 2010;49(3):337-50.
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