Dyadic effects of illness perception and maladaptive cognitive-emotional regulation strategies on the fear of cancer recurrence in breast cancer patients and spouses: an actor-partner interdependence mediation model

Hui Ren; Tianye Yang; Songli Mei; Zhu Zhu; Jianjun Shi; Lingling Tong; Jia Yang; Yabin Sun

doi:10.1186/s12888-024-06354-2

Dyadic effects of illness perception and maladaptive cognitive-emotional regulation strategies on the fear of cancer recurrence in breast cancer patients and spouses: an actor-partner interdependence mediation model

BMC Psychiatry. 2025 Jan 15;25(1):41. doi: 10.1186/s12888-024-06354-2.

Authors

Hui Ren¹, Tianye Yang², Songli Mei³, Zhu Zhu⁴, Jianjun Shi⁵, Lingling Tong⁶, Jia Yang⁷, Yabin Sun⁸

Affiliations

¹ The First Hospital of Jilin University, Changchun, Jilin Province, China.
² Department of Plastic Surgery, The First Hospital of Jilin University, Changchun, Jilin Province, China.
³ Jilin University School of Public Health, Changchun, Jilin Province, China.
⁴ Department of Breast Surgery, The First Hospital of Jilin University, Changchun, Jilin Province, China.
⁵ Department of Breast Surgery, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi Province, China.
⁶ China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, China.
⁷ Changchun Central Hospital, Changchun, Jilin Province, China.
⁸ The First Hospital of Jilin University, Changchun, Jilin Province, China. yabin@jlu.edu.cn.

Abstract

Purpose: Breast cancer, as a stressful event, profoundly impacts the entire family, especially patients and their spouses. This study used a dyadic analysis approach to explore the dyadic effects of illness perception on the fear of cancer recurrence (FCR) and whether maladaptive cognitive-emotional regulation strategies acted as a mediator in breast cancer patient-spouse dyads.

Methods: This was a cross-sectional study, and 202 dyads of breast cancer patients and their spouses were enrolled. Illness perception, maladaptive cognitive-emotional regulation strategies, and FCR were assessed by the Brief Illness Perception Questionnaire (BIPQ), the Cognitive Emotion Regulation Questionnaire (CERQ), and the Fear of Cancer Recurrence Inventory Short Form (FCRI-SF), respectively. Data were analyzed using the actor-partner interdependence mediation model.

Results: This study found that, for patients and spouses, maladaptive cognitive-emotional regulation strategies mediated the actor effects of illness perception on FCR. That is, illness perception was positively related to their maladaptive cognitive-emotional regulation strategies, which increased the risk of FCR. Another important finding was that patients' illness perception had significant direct and indirect effects on spouses' FCR through spouses' maladaptive cognitive-emotional regulation strategies.

Conclusions: Negative illness perception perceived by patients and spouses can increase their FCR by adapting their maladaptive cognitive-emotional regulation strategies. Furthermore, illness perception perceived by patients can also increase spouses' FCR through spouses' maladaptive cognitive-emotional regulation strategies. Medical staff should identify vulnerable patients and spouses with higher illness perception and maladaptive cognitive-emotional regulation strategies and make focused interventions to decrease the risk of FCR of both breast cancer patients and their spouses.

Keywords: Actor-partner interdependence mediation model; Breast cancer; Fear of cancer recurrence; Illness perception; Maladaptive cognitive-emotional regulation strategies.

MeSH terms

Adaptation, Psychological
Adult
Aged
Breast Neoplasms* / psychology
Cross-Sectional Studies
Emotional Regulation*
Fear* / psychology
Female
Humans
Male
Mediation Analysis
Middle Aged
Neoplasm Recurrence, Local* / psychology
Spouses* / psychology
Surveys and Questionnaires