The Role of Early Maladaptive Schemas on Coping Styles and Fear of Recurrence in Women With Breast Cancer: A Cross-Sectional Study

Maladaptive schemas influence the mental and physical health of patients. This study aimed to examine the role of early maladaptive schemas on coping styles and fear of recurrence in women with breast cancer (BC).

This study was conducted; using a descriptive-correlational design. The research population included all female patients with BC who were referred to the radiotherapy ward of Five Hospitals in the center of Tehran from June to December 2020. The participants were 118 BC patients who were selected; using a simple random sampling technique. The inclusion criteria were undergoing radiotherapy, having BC surgery at least one month ago, and having at least a middle school education to answer questions independently. The exclusion criteria were being a widow and/or suffering from other specific physical and mental health problems in addition to cancer. The participants completed the Schema Questionnaire - Short Form (SQ-SF) (Young, 1998), the Coping Inventory for Stressful Situations (CISS; Endler & Parker, 1990), and Fear of Cancer Recurrence Inventory (FCRI). The collected data were analyzed; using the Pearson correlation coefficient and multiple linear regression analysis.

Data analysis demonstrated that emotional inhibition, entitlement/grandiosity, enmeshment/undeveloped self, unrelenting standards/hyper criticalness, and insufficient self-control/self-discipline were positively correlated with fear of cancer recurrence (FCR). The strongest correlations with fear of recurrence were related to the emotional inhibition (r=0.35), unrelenting standards/hyper criticalness, and entitlement/grandiosity (r=0.28) (P<0.001). Emotional and avoidance coping styles were also associated with the fear of recurrence (r=0.50 and r=0.20). Furthermore, the independent variables could explain 41% of the variances in FCR (P<0,001).

Understanding the role of dysfunctional cognitive schemas on coping mechanisms and FCR can help clinicians and mental health professionals to form treatment interventions for BC patients.