Enhanced Self-Appraisal After Cancer: A Bias in Survivors' Self-Report?

许多幸存者将癌症描述为他们个人发展的分水岭事件，这是一项艰巨而困难的挑战，但可能会导致他们自己和他们的关系发生一些积极的变化。1-4对创伤后成长（PTG）3、5和密切相关的受益发现6-8领域的研究开始解决幸存者经历的这一方面。与行为或心理健康结果的研究不同，现有的措施可能会得到充分的发展和验证，这项研究需要概念化广泛的人格结构，并为他们开发新的措施。这一点尤其具有挑战性，因为作为研究重点的人格特质（例如应对、乐观）本身可能会改变幸存者对传统心理措施的反应方式。癌症经历和科普其身体和情感影响的努力现在被理解为改变了幸存者对自己及其随后健康状况的看法。6 -8、11-18由于幸存者在癌症后对自己的评价不同，对其自我报告的健康评级的解释变得复杂。幸存者的成长报告在多大程度上受到自我评价变化的影响？虽然癌症后积极变化的报告被解释为增长的证据，但一些研究得出结论，自我报告的增长是由幸存者自我评价的变化驱动的，而不是行为或内部状态的实际变化。8，20-22建立在人格和社会心理学的研究基础上，本研究采用了自我增强偏见（SEB）的结构，SEB被定义为一种特征倾向，“给予诚实但有积极偏见的自我报告”，23以调查自我评价的变化如何有助于癌症后自我报告的增长。SEB在癌症幸存者中的证据来自研究，显示幸存者比非癌症对照组更有可能具有压抑性应对方式24 -28，26 28-34，并且压抑者报告的痛苦和创伤后应激症状较少。该研究调查了一组长期霍奇金病（HD）幸存者和兄弟姐妹对照组的SEB。 将从现有研究队列中招募200名幸存者和200名对照者进行横断面邮寄调查。创伤后压力的自我报告创伤后诊断量表（PTG）（创伤后成长量表），38将被用于测量幸存者心理调整的这些积极和消极方面，并对与反应偏差相关的报告进行随访。20，35研究目的是：1）检查SEB与自我报告的PTG和创伤后应激的关系; 2）比较长期HD幸存者与同胞对照组的SEB水平; 3）探讨PTG和SEB与治疗因素和健康行为的关系。这项研究对于理解疾病的适应如何影响自我感知，以及这些变化如何影响幸存者的成长经历，以及他们的健康行为和对后续护理的坚持具有重要意义。 公共卫生相关性： 随着美国癌症幸存者人数增长到1200多万，开发有效的情绪健康和长期结果措施至关重要。这项研究调查了疾病改变幸存者对健康和幸福的评价的方式，以及这些健康评价的变化在多大程度上影响癌症后自我报告的增长和幸福的有效性。研究结果对于改善健康结果测量以及理解疾病适应如何影响自我感知和自我表现具有重要意义。

DESCRIPTION (provided by applicant): Project Summary Many survivors describe cancer as a watershed event in their personal development, a demanding and difficult challenge that nonetheless may result in some positive changes in themselves and their relationships. 1-4 Research into posttraumatic growth (PTG) 3, 5 and the closely related area of benefit finding 6-8 is beginning to address this aspect of the survivor experience. Unlike studies of behavioral or mental health outcomes, where existing measures may be adequately developed and validated, this research requires conceptualizing broad personality constructs and developing new measures for them.9, 10. This is particularly challenging since the personality traits that are the focus of research (e.g. coping, optimism) may themselves alter the ways survivors respond to conventional psychological measures. The cancer experience and efforts to cope with its physical and emotional effects are now understood to alter survivors' perceptions of themselves and their subsequent health conditions.6-8, 11-18 To the extent that survivors evaluate themselves differently following their cancer, interpretation of their self-reported health ratings is made complex. To what extent are survivors' reports of growth affected by changes in self-appraisal? While reports of positive changes after cancer have been interpreted as evidence of growth, 3, 4, and 19 some studies conclude that self-reported growth is driven by changes in survivors' self-appraisals rather than actual changes in behavior or internal states. 8, 20-22 Building on research in personality and social psychology this study employs the construct of self-enhancement bias (SEB), defined as a characteristic tendency "to give self-reports that are honest but positively biased,"23 to investigate how changes in self-appraisal may contribute to self-reported growth after cancer. Evidence of SEB in cancer survivors comes from studies showing survivors are more likely to have a repressive coping style24-28 than non-cancer controls, 26 28-34 and that repressors report fewer symptoms of distress and posttraumatic stress.31, 35 Using a recently validated measure, the Balanced Inventory of Desirable Responding,36 the study investigates SEB in a group of long-term Hodgkin's disease (HD) survivors and sibling controls., 200 survivors and 200 controls from an existing research cohort will be recruited for a cross-sectional mailed survey. Self-report of posttraumatic stress (Posttraumatic Diagnostic Scale)37 and PTG (Post Traumatic Growth Inventory),38 will be used to measure these positive and negative aspects of survivors' psychological adjustment, and follow-up on reports that each is linked to response bias.20, 35 Study aims will be to: 1) Examine the relationship of SEB to self-reported PTG and posttraumatic stress; 2) Compare the level of SEB in long-term HD survivors to sibling controls; and 3) Explore the association of PTG and SEB with treatment factors and health behaviors. The study has important implications for understanding how adaptation to illness affects self-perception, and how these changes may affect survivors' experience of growth, as well as their health behaviors and adherence to follow-up care. PUBLIC HEALTH RELEVANCE: Project Narrative With the population of cancer survivors in the US growing to more than 12 million, it is critical that valid measures of their emotional health and long-term outcomes be developed. This study investigates the ways in which illness alters survivors' appraisals of health and well-being, and the extent to which these changes in health appraisal can affect the validity of self-reported growth and well-being after cancer. Study results have important implications for improving health outcome measures, as well as for understanding how adaptation to illness affects self- perception and self-presentation.