Academic Scientific JournalsChanges of narrative meaning-making markers during the different phases of breast cancer treatment for women below 50 years old
Keywords:
breast cancer, trauma experience, narrative, meaningmaking, medical treatments, turning-point phases, women under fifty, clinical implicationsAbstract
Background
The onset of breast cancer is considered a potential traumatic event associated with physical and psychological effects, in particular when it occurs at the age below 50. The literature lacks a longitudinal narrative exploration of breast cancer experience of young women.
Participants and procedure
Using the narrative device as a diachronic tool aimed at promoting semiotic connection processes during the different phases of the therapeutic path, the authors constructed an ad hoc narrative interview to explore the meaning-making processes of 10 breast cancer patients below 50 years old during three turning-point phases: prehospitalization (T1); postoperative counseling (T2); and adjuvant therapy (T3). The research took place at National Cancer Institute Pascale of Naples. Through an ad hoc qualitative methodology, this study identifies the prevailing modes with which the five narrative meaning-making functions are articulated in the repeated narrative during the three phases.
Results
The findings capture the patterns of change of narrative meaning-making markers during the illness experience, highlighting both integrated modes of connections between aspects of experience over time and moments of block in specific critical phases for women under 50.
Conclusions
From a clinical health psychology point of view the results suggest the promotion of integration between the synchrony of the medical path and the diachrony of the subjective experience of women to support resources for adapting to experience.
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References
Angus, L., & McLeod, J. (2004). The handbook of narrative and psychotherapy: Practice, theory and research. Sage.
Bion, W. R. (1962). Apprendere dall’esperienza [Learning from experience]. Armando.
Bolton, G., & Isaacs, A. (2018). Women’s experiences of cancer-related cognitive impairment, its impact on daily life and care received for it following treatment for breast cancer. Psychology, Health & Medicine, 23, 1261–1274. https://doi.org/10.1080/ 13548506.2018.1500023.
Bonanno, G. A., Wortman, C. B., & Nesse, R. M. (2004). Prospective patterns of resilience and maladjustment during widowhood. Psychology and Aging, 19, 260–271. https://doi.org/10.1037/0882-7974.19.2.260.
Brockmeier, J. (2000). Autobiographical time. Narrative Inquiry, 10, 51–73. https://doi.org/10.1075/ni.10. 1.03bro.
Brockmeier, J. (2009). Reaching for meaning: Human agency and the narrative imagination. Theory & Psychology, 19, 213–233. https://doi.org/10.1177/ 0959354309103540.
Cordova, M. J., Andrykowski, M. A., Kenady, D. E., McGrath, P. C., Sloan, D. A., & Redd, W. H. (1995). Frequency and correlates of posttraumatic-stressdisorder-like symptoms after treatment for breast cancer. Journal of Consulting and Clinical Psychology, 63, 981–986. https://doi.org/10.1037//0022-006x. 63.6.981.
Cordova, M. J., Giese-Davis, J., Golant, M., Kronenwetter, C., Chang, V., & Spiegel, D. (2007). Breast cancer as trauma: Posttraumatic stress and posttraumatic growth. Journal of Clinical Psychology in Medical Settings, 14, 308–319. https://doi.org/10.1007/ s10880-007-9083-6.
De Luca Picione, R. (2020a). The semiotic paradigm in psychology. A mature weltanschauung for the definition of semiotic mind. Integrative Psychological and Behavioral Science, 54, 639–650. https:// doi.org/10.1007/s12124-020-09555-y.
De Luca Picione, R. (2020b). La proposta dell’Idiographic Science. Discussione degli assunti teorici, epistemologici e metodologici di un possibile approccio idiografico in psicologia [The Idiographic Science proposal. Discussion of the theoretical, epistemological and methodological assumptions of a possible idiographic approach in psychology]. Ricerche in Psicologia, 44, 389–432. https://doi. org/10.3280/RIP2020-00200.
De Luca Picione, R., Martino, M. L., & Troisi, G. (2019). The semiotic construction of the sense of agency. The modal articulation in narrative processes. Integrative Psychological and Behavioral Science, 53, 431–449. https://doi.org/10.1007/s12124-019- 9475-9.
Di Giacomo, D., Cannita, K., Ranieri, J., Cocciolone, V., Passafiume, D., & Ficorella, C. (2016). Breast cancer and psychological resilience among young women. Journal of Psychopathology, 22, 191–195.
Esposito, G, Ribeiro, A. P., Alves, D., Goncalves, M. M., & Freda, M. F. (2017). Meaning co-construction in group counselling: the development of innovative moments. Journal of Constructivist Psychology, 30, 404–426. https://doi.org/10.1080/10720537.2016.12 38789.
Gillies, J., & Neimeyer, R. A. (2006). Loss, grief, and the search for significance: Toward a model of meaning reconstruction in bereavement. Journal of Constructivist Psychology, 19, 31–65. https://doi.org/ 10.1080/10720530500311182.
Goula, I., Alikari, V., Charalampous, G., Tzavella, F., Zyga, S., Tsironi, M., & Theofilou, P. (2020). Social support and quality of life in Greek women with breast cancer during chemotherapy and two years later. Health Psychology Report, 2, 98–106, https://doi.org/10.5114/hpr.2020.93757.
Greenberg, L., Elliott, R., & Rice, L. (1993). Facilitating emotional change. Guilford. Gurevich, M., Devins, G. M., & Rodin, G. M. (2002). Stress response syndromes and cancer: Conceptual and assessment issues. Psychosomatics, 43, 259–281. https://doi.org/10.1176/appi.psy.43.4.259.
Hall, J. M. (2011). Narrative methods in a study of trauma recovery. Qualitative Health Research, 21, 3–13. https://doi.org/10.1177/1049732310377181.
Helms, R. L., O’Hea, E. L., & Corso, M. (2008). Body image issues in women with breast cancer. Psychology, Health & Medicine, 13, 313–325. https:// doi.org/10.1080/13548500701405509.
IHME (2018). Global Burden of Disease Study 2017. Institute for Health Metrics and Evaluation.
Janoff-Bulman, R. (2004). Posttraumatic growth: Three explanatory models. Psychological Inquiry, 15, 30–34.
Jones, S. L., Hadjistavropoulos, H. D., & Gullickson, K. (2014). Understanding health anxiety following breast cancer diagnosis. Psychology, Health & Medicine, 19, 525–535. https://doi.org/10.1080/ 13548506.2013.845300.
Joseph, S., & Linley, P. A. (2005). Positive adjustment to threatening events: an organismic valuing theory of growth through adversity. Review of General Psychology, 9, 262–280. https://doi.org/ 10.1037/1089-2680.9.3.262.
Lemmo, D., Martino, M. L., Nunziante Cesàro, A., & Solbakk, J. H. (2020). Idiosyncratic ambivalence: a three-dimensional interpretative model to understand the non-adhesion of women to breast and cervical cancer screening. Mediterranean Journal of Clinical Psychology, 8, 3, 1–19. https://doi. org/10.6092/2282-1619/mjcp-2563.
Martino, M. L., De Luca Picione, R., Lemmo, D., Bolursier, V., & Freda, M. F. (2019a). Meaning-making trajectories of resilience in narratives of adolescents with multiple sclerosis. Mediterranean Journal of Clinical Psychology, 7, 1–25. https://doi. org/10.6092/2282-1619/2019.7.2049.
Martino, M. L., Gargiulo, A., Lemmo, D., Dolce, P., Barberio, D., Abate, V., Avino, F., & Tortriello, R. (2019b). Longitudinal effect of emotional processing on psychological symptoms in women under 50 with breast cancer. Health Psychology Open, 6, 1–9. https://doi.org/10.1177/20551029198445.
Martino, M. L., Lemmo, D., Gargiulo, A., Barberio, D., Abate, V., Avino, F., & Tortoriello, R. (2019c). Underfifty women and breast cancer: Narrative markers of meaning-making in traumatic experience. Frontiers in Psychology, 10, 618. https://doi.org/10.3389/ fpsyg.2019.00618.
McAdams, D. P. (2008). Personal narratives and the life story. In O. P. John, R. W. Robins, & L. A. Pervin (Eds.), Handbook of personality: Theory and research (pp. 242–262). The Guilford Press.
Neimeyer, R. A. (2004). Fostering posttraumatic growth: a narrative elaboration. Psychological Inquiry, 15, 53–59. Neimeyer, R. A. (2006). Complicated grief and the quest for meaning: a constructivist contribution. Journal of Death and Dying, 52, 37–52. https://doi. org/10.2190/EQL1-LN3V-KNYR-18TF.
Neimeyer, R. A., Burke, L. A., Mackay, M. M., & van Dyke Stringer, J. G. (2010). Grief therapy and the reconstruction of meaning: From principles to practice. Journal of Contemporary Psychotherapy, 40, 73–83. https://doi.org/10.1007/s10879-009-9135-3.
Pennebaker, J. W., Mayne, T. J., & Francis, M. E. (1997). Linguistic predictors of adaptive bereavement. Journal of Personality and Social Psychology, 72, 863– 871. https://doi.org/10.1037//0022-3514.72.4.863.
Piaget, J. (1964). Cognitive development in children: Piaget development and learning. Journal of Research in Science Teaching, 2, 176–186. https://doi. org/10.1002/tea.3660020306.
Quattropani, M. C., Lenzo, V., Baio, M., Bordino, V., Germanà, A., Grasso, D., Grisolia, E., Indelicato, F., Manzone, R., & Pennica, S. (2017). Credenze metacognitive e strategie di coping in operatori di cure domiciliari a rischio di burnout [Metacognitive beliefs and coping strategies in home care providers at risk of burnout]. Psicologia della Salute, 2, 121–142. https://doi.org/10.3280/pds2017-002006.
Rainone, N., Chiodi, A., Lanzillo, R., Magri, V., Napolitano, A., Morra, V. B., Valerio, P., & Freda, M. F. (2017). Affective disorders and health-related quality of life (HRQoL) in adolescents and young adults with multiple sclerosis (MS): The moderating role of resilience. Quality of Life Research, 26, 727–736. https://doi.org/10.1007/s11136-016-1466-4.
Rasmussen, D. M., & Elverdam, B. (2007). Cancer survivors’ experience of time: Time disruption and time appropriation. Journal of Advanced Nursing, 57, 614–622. https://doi.org/10.1111/j.1365-2648. 2006.04133.x.
Rimè, B. (2009). Emotion elicits the social sharing of emotion: Theory and empirical review. Emotion Review, 1, 60–85. https://doi.org/10.1177/17540739 08097189.
Salvatore, S. (2016). Psychology in black and white. The project of a theory-driven science. Information Age.
Salvatore, S., & Valsiner, J. (2011). Idiographic science as a non-existing object: The importance of the reality of the dynamic system. In S. Salvatore, J. Valsiner, J. Travers Simon, & A. Gennaro (Eds.), YIS: Yearbook of idiographic science (Vol. 3, pp. 7–26). Firera.
Santaniello, A., Dicé, F., Carratù, R. C., Amato, A., Fioretti, A., & Menna, L. F. (2020). Methodological and terminological issues in animal-assisted interventions: an umbrella review of systematic reviews. Animals, 10, 759. https://doi.org/10.3390/ ani10050759.
Sherman, D. K., & Cohen, G. L. (2006). Psychology of self-defense: Self-affirmation theory. Advances in Experimental Social Psychology, 38, 183–242. https://doi.org/10.1016/S0065-2601(06)38004-5.
Smorti, A., & Fioretti, C. (2016). Why narrating changes memory: a contribution to an integrative model of memory and narrative processes. Integrative Psychological and Behavioral Science, 50, 296–319. https://doi.org/10.1007/s12124-015-9330-6.
Tronick, E. (2010). Multilevel meaning making and dyadic expansion of consciousness theory: The emotional and the polymorphic polysemic flow of meaning. In D. Fosha, D. J. Siegel, & M. Solomon (Eds.), The healing power of emotion (pp. 86–111). W. W. Norton & Co.
Valsiner, J. (2014). An invitation to cultural psychology. Sage. Villani, D., Cognetta, C., Toniolo, D., Scanzi, F., & Riva, G. (2016). Engaging elderly breast cancer patients: The potential of e-health interventions. Frontiers in Psychology, 7, 1825. https://doi. org/10.3389/fpsyg.2016.01825.
Waters, T. E. A., Shallcross, J. F., & Fivush, R. (2013). The many facets of meaning-making: Comparing multiple measures of meaning-making and their relations to psychological distress. Memory, 21, 111– 124. https://doi.org/10.1080/09658211.2012.705300.
Winnicott, D. W. (1945). Lo sviluppo emozionale primario [The development of primary emotional state]. Martinelli.
