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，这是一项艰巨而艰难的挑战，尽管如此，它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对创伤后成长（PTG） 3,5和密切相关的利益发现领域6-8的研究开始解决幸存者经历的这方面问题。与行为或心理健康结果的研究不同，在这些研究中，现有的测量方法可能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它们开发新的测量方法。9、10。这尤其具有挑战性，因为作为研究重点的人格特征（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。癌症经历和应对其身体和情感影响的努力现在被理解为改变幸存者对自己和他们随后的健康状况的看法。在某种程度上，幸存者在癌症后对自己的评价不同，对他们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？虽然癌症后的积极变化报告被解释为成长的证据，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在人格和社会心理学研究的基础上，本研究采用自我增强偏差（SEB）的结构，定义为一种“给出诚实但积极偏见的自我报告”的特征倾向，23来调查自我评价的变化如何有助于癌症后自我报告的成长。研究表明，癌症幸存者中SEB的证据表明，与非癌症控制者相比，幸存者更有可能具有压抑的应对方式（24-28），压抑者报告的痛苦和创伤后应激症状更少。31,35使用最近验证的测量方法，理想反应平衡量表，36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。从现有的研究队列中招募200名幸存者和200名对照者进行横断面邮寄调查。创伤后压力自我报告（创伤后诊断量表）37和创伤后成长量表38将被用来衡量幸存者心理调整的这些积极和消极方面，并对每一个与反应偏差相关的报告进行随访。20,35研究的目的是：1)检验SEB与自我报告的创伤后应激障碍和创伤后应激的关系；2)比较长期HD幸存者与兄弟姐妹对照组的SEB水平；3)探讨PTG和SEB与治疗因素和健康行为的关系。这项研究对于理解对疾病的适应如何影响自我认知，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依从性具有重要意义。

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.