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

描述(由申请人提供)：项目摘要许多幸存者将癌症描述为他们个人发展的分水岭事件，这是一个艰巨而困难的挑战，但可能会给他们自己和他们的关系带来一些积极的变化。1-4创伤后成长研究(PTG)3、5和密切相关的惠益发现领域6-8开始处理幸存者经历的这一方面。与对行为或心理健康结果的研究不同，现有的测量可以得到充分的开发和验证，这项研究需要概念化广泛的人格结构并为其开发新的测量。9、10.这特别具有挑战性，因为作为研究重点的人格特征(例如应对、乐观)本身可能会改变幸存者对传统心理测量的反应方式。癌症的经历以及应对其身体和情感影响的努力现在被认为改变了幸存者对自己及其随后的健康状况的看法。6-8、11-18如果幸存者在癌症后对自己的评估不同，那么对他们自我报告的健康评级的解释就变得复杂起来。幸存者关于成长的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道被解释为成长的证据，但3、4和19一些研究得出结论，自我报告的成长是由幸存者自我评估的变化推动的，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研究的基础上，这项研究采用了自我提升偏见(SEB)的结构，SEB被定义为一种特征倾向，“给出诚实但有积极偏见的自我报告”23来调查自我评估的变化如何有助于癌症后自我报告的增长。癌症幸存者中SEB的证据来自研究，研究表明幸存者比非癌症对照组更有可能有压抑的应对方式24-28，26 28-34，抑制者报告的痛苦症状和创伤后压力较少。31，35使用最近得到验证的衡量标准--理想反应平衡清单，36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的SEB。现有研究队列中的200名幸存者和200名对照组将被招募进行横断面邮寄调查。创伤后应激自评量表(创伤后诊断量表)37和创伤后成长问卷(PTG)，38将被用来测量幸存者心理适应的这些积极和消极方面，并跟踪报道，每个方面都与反应偏差有关。20，35研究的目的是：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幸存者与同胞对照的SEB水平；以及3)探索PTG和SEB与治疗因素和健康行为的关联。这项研究对于理解对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，具有重要的意义。 公共卫生相关性：项目叙述随着美国癌症幸存者的人口增长到1200万以上，开发有效的测量他们的情绪健康和长期结果是至关重要的。这项研究调查了疾病如何改变幸存者对健康和幸福的评估，以及这些健康评估的变化会在多大程度上影响癌症后自我报告的生长和幸福的有效性。研究结果对于改进健康结果衡量标准以及理解疾病适应如何影响自我认知和自我呈现具有重要意义。

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.