DOI:10.6129/CJP.202209_64(3).0006
Chinese Journal of Psychology 2022, Vol.64, No.3, 385-412

Post-traumatic Growth and Rumination Following a Cancer Diagnosis: The Moderating Roles of Psychological Distress and Emotional Regulation Strategies

Rou-Jun Chen(Department of Psychology, Chung Yuan Christian University), Pei-Chiung Tu(Department of Psychology, Chung Yuan Christian University)

Abstract

Backgrounds: Many studies have found that the concepts of intrusive rumination (IR) and deliberate rumination (DR) play significant roles in post-traumatic growth, and it is the change from intrusive to deliberate rumination that facilitates post-traumatic growth. However, most studies exploring the relationship between rumination and post- traumatic growth have utilized a cross-sectional methodology or individuals from natural disasters. Additionally, no empirical study has investigated the role of psychological distress and emotion regulation strategies in the revised model of post-traumatic growth. Therefore, this current research employed cancer outpatients as participants and a retrospective two-time-point approach to examine the process of violated core beliefs, two types of ruminative thoughts, and post-traumatic growth among cancer outpatients. Furthermore, the study explored whether psychological distress and emotion-regulation strategies may moderate the above relationship to expand the understanding of the cognitive process of post-traumatic growth. Methods: This study recruited 184 cancer outpatients diagnosed between six months and five years following their initial intensive treatment. Self-reported questionnaires were the major instruments used, and the moderator-mediator analysis was employed to examine the data. Results: The pathways of the sequential relationship between (1) initial IR and recent IR, and (2) initial IR and recent IR, as well as recent DR, can partially mediate the relationship between the destruction of core beliefs by the cancer diagnosis and the post-traumatic growth. Psychological distress positively moderated the relationship between initial IR and recent IR and subsequently impaired post-traumatic growth. The reappraisal strategy negatively moderated the relationship between initial IR and recent IR and then facilitated the subsequent post-traumatic growth. Conclusions: This current study found that IR and DR had a sequential mediating role in the association between the disruption of core beliefs and post-traumatic growth. It is also the first to demonstrate the moderating effect of psychological distress and emotion-regulation strategies on intrusive rumination at different time points, which then affects the post-traumatic growth among cancer patients.

Keywords: cancer, deliberate rumination, emotion-regulation strategies, intrusive rumination, post-traumatic growth, psychological distress