We evaluated whether a self-forgiving attitude and spirituality were related to psychological adjustment among 81 women being treated for breast cancer at a medical oncology clinic in a county general hospital. Both a self-forgiving attitude and spirituality were unique predictors of less mood disturbance and better quality of life (p's < 0.001). These results are consistent with previous research that has demonstrated a positive relationship between spirituality and well-being. The findings also suggest that self-forgiveness should be explored experimentally to determine whether it can protect against the psychological effects of breast cancer-related stress. Interventions targeting these characteristics could improve the quality of life and alleviate stress, especially in women with breast cancer in public sector settings.
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REFERENCES
Aiken, L. S., and West, S. G. (1991). Multiple Regression: Testing and Interpreting Interactions. Sage, Newbury Park, CA.
Al-Mabuk, R. H., Enright, R. D., and Cardis, P. A. (1995). Forgiveness education with parentally love-deprived late adolescents. J. Moral Educ. 24: 427–444.
American Psychiatric Association. (2000). Diagnostic and Statistical Manual for Mental Disorders, 4th ed., text revision. American Psychiatric Association, Washington, DC.
Brown, R. P. (2003). Measuring individual differences in the tendency to forgive: Construct validity and links with depression. Pers. Soc. Psychol. Bull. 29: 759–771.
Cella, D. F. (1997). Manual of the Functional Assessment of Chronic Illness Therapy (quality of life) Scales (Version 4). Center on Outcomes, Research and Education, Evanston Northwestern Healthcare and Northwestern University, Evanston, IL.
Cella, D. F., Tross, S., Orav, J. E., Holland, J. J., Silberfarb, P., and Rafla, S. (1989). Mood states of patients after the diagnosis of cancer. J. Psychosoc. Oncol. 7: 45–54.
Ell, K. O., Mantell, J. E., Hamovitch, M. B., and Nishimoto, R. H. (1989). Social support, sense of control, and coping among patients with breast, lung, or colorectal cancer. J. Psychosoc. Oncol. 7: 63–88.
Ell, K., Sanchez, K., Vourlekis, B., Lee, P. J., Dwight-Johnson, M., Lagomasino, I., Muderspach, L., and Russell, C. (2005). Depression, correlates of depression, and receipt of depression care among low-income women with breast or gynecologic cancer. J. Clin. Oncol. 23: 3052–3060.
Enright, R. D., and The Human Development Study Group. (1996). Counseling within the forgiveness triad: On forgiving, receiving forgiveness, and self-forgiveness. Couns. Values 40: 107–126.
Freedman, S. R., and Enright, R. D. (1996). Forgiveness as an intervention goal with survivors of incest. J. Consult. Clin. Psychol. 64: 983–992.
Girard, M., and Mullet, E. (1997). Forgiveness in adolescents, young, middle-aged, and older adults. J. Adult Development 4: 209–220.
Glinder, J. G., and Compas, B. E. (1999). Self-blame attributions in women with newly diagnosed breast cancer: A prospective study of psychological adjustment. Health Psychol. 18: 475–481.
Gorsuch, R. L., and Hao, J. Y. (1993). Forgiveness: An exploratory factor analysis and its relationships to religious variables. Rev. Relig. Res. 34: 333–347.
Grassi, L., Indelli, M., Marzola, M., Maestri, A., Santini, A., Piva, E., and Boccalon, M. (1996). Depressive symptoms and quality of life in home-care-assisted cancer patients. J. Pain Symptom Manage. 12: 300–307.
Holmbeck, G. N. (1997). Toward terminological, conceptual, and statistical clarity in the study of mediators and moderators: Examples from the child-clinical and pediatric psychology literatures. J. Cons. Clin. Psych. 65: 599–610.
Holt, C. L., Lukwago, S. N., and Kreuter, M. W. (2003). Spirituality, breast cancer beliefs and mammography utilization among urban African American Women. J. Health Psychol. 8: 383–396.
Iconomou, G., Mega, V., Koutras, A., Iconomou, A. V., and Kalofonous, H. P. (2004). Prospective assessment of emotional distress, cognive function, and quality of life in patients with cancer treated with chemotherapy. Cancer 101: 404–411.
Koenig, H. G., Cohen, H. J., Blazer, D. G., Kudler, H. S., Krishnan, K. R., and Sibert, T. E. (1995). Religious coping and cognitive symptoms of depression in elderly medical patients. Psychosomatics 36: 369–375.
Koenig, H. G., George, L. K., and Siegler, I. C. (1988). The use of religion and other emotion-regulating coping strategies among older adults. Gerontologist 28: 303–310.
Koenig, H. G., George, L. K., and Titus, P. (2004). Religion, spirituality, and health in medically ill hospitalized older patients. J. Am. Geriatr. Soc. 52: 554–562.
Koenig, H. G., Pargament, K. I., and Nielsen, J. (1998). Religious coping and health status in medically ill hospitalized adults. J. Nerv. Ment. Dis. 186: 513–521.
Konstam, V., Chernoff, M., and Deveney, S. (2001). Toward forgiveness: The role of shame, guilt, anger, and empathy. Couns. Values 46: 26–39.
Krause, N., and Ellison, C. G. (2003). Forgiveness by God, forgiveness of others, and psychological well-being in late life. J. Sci. Study Relig. 42: 77–93.
Lamb, S., and Murphy, J. (2002). Before Forgiving: Cautionary Views of Forgiveness in Psychotherapy. Oxford University Press, Oxford, England.
Levine, E. G., and Targ, E. (2002). Spiritual correlates of functional well-being in women with breast cancer. Integr. Cancer Ther. 1: 166–174.
Maltby, J., Macaskill, A., and Day, L. (2001). Failure to forgive self and others: A replication and extension of the relationship between forgiveness, personality, social desirability and general health. Pers. Ind. Diff. 30: 881–885.
Mauger, P. A., Perry, J. E., Freeman, T., Grove, D. C., McBride, A. G., and McKinney, K. (1992). The measurement of forgiveness: Preliminary research. J. Psychol. Christianity 11: 170–180.
McCullough, M. E., Bellah, C. G., Kilpatrick, S. D., and Johnson, J. L. (2001). Vengefulness: Relationships with forgiveness, rumination, well-being, and the Big Five. Pers. Soc. Psychol. Bull. 27: 601–610.
McCullough, M. E., Pargament, K. I., and Thoresen, C. E. (2000). Forgiveness: Theory, Research, and Practice. Guilford, New York.
McCullough, M. E., Rachal, K. C., Sandage, S. J., Worthington, E. L., Jr., Brown, S. W., and Hight, T. L. (1998). Interpersonal forgiving in close relationships: II. Theoretical elaboration and measurement. J. Pers. Soc. Psychol. 75: 1586–1603.
McCullough, M. E., Worthington, E. L., Jr., and Rachal, K. C. (1997). Interpersonal forgiving in close relationships. J. Pers. Soc. Psychol. 73: 321–336.
McCullough, M. E., and Worthington, E. L., Jr. (1994). Encouraging clients to forgive people who have hurt them: Review, critique, and research prospectus. J. Psychol. Theol. 22: 3–20.
McCullough, M. E., and Worthington, E. L., Jr. (1999). Religion and the forgiving personality. J. Pers. 67: 1141–1164.
Meraviglia, M. G. (2004). The effects of spirituality on well-being of people with lung cancer. Oncol. Nurs. Forum 31: 89–94.
Mullet, E., Barris, J., Frongia, L., Usaie, V., and Shafighi, S. R. (2003). Religious involvement and the forgiving personality. J. Pers. 71: 1–19.
Mullet, E., Houdbine, A., Laumonier, S., and Girard, M. (1998). “Forgiveness”: Factor structure in a sample of young, middle-aged, and elderly adults. European Psychol. 3: 289–297.
Pargament, K. I. (1997). The Psychology of Religion and Coping: Theory, Research, Practice. Guilford, New York.
Parker, M., Lee, R. L., Klemmack, D. L., Koenig, H. G., Baker, P., and Allman, R. M. (2003). Religiosity and mental health in southern, community-dwelling older adults. Aging Ment. Health 7: 390–397.
Powell, L. H., Shahabi, L., and Thoreson, C. E. (2003). Religion and spirituality: Linkages to physical health. Am. Psychol. 58: 36–52.
Ross, S. R., Kendall, A. C., Matters, K. G., Wrobel, T. A., and Rye, M. S. (2004). A personological examination of self- and other-forgiveness in the five factor model. J. Pers. Assess. 82: 207–214.
Seeman, T. E., Dubin, L. F., and Seeman, M. (2003). Religiosity/spirituality and health: A critical review of the evidence for biological pathways. Am. Psychol. 58: 53–63.
Shacham, S. (1983). A shortened version of the profile of mood states. J. Pers. Assess. 47: 305–306.
Subkoviak, M. J., Enright, R. D., Wu, C., Gassin, E. A., Freedman, S., Olson, L., and Sarinopoulos, I. (1995). Measuring interpersonal forgiveness in late adolescence and middle adulthood. J. Adolesc. 18: 641–655.
Tix, A. P., and Frazier, P. A. (1998). The use of religious coping during stressful life events: Main effects, moderation, and mediation. J. Consult. Clin. Psychol. 66: 411–422.
Walker, D. F., and Gorsuch, R. L. (2002). Forgiveness within the Big Five personality model. Pers. Individ. Differ. 32: 1127–1137.
Witvliet, C. V., Ludwig, T. E., and VanderLaan, K. L. (2001). Granting forgiveness or harboring grudges: Implications for emotion, physiology, and health. Psychol. Sci. 12: 117–123.
Worthington, E. L., Jr. (1998). Dimensions of Forgiveness: Psychological Research and Theological Speculations. The Templeton Foundation Press, Philadelphia, PA.
Worthington, E. L., Jr., Berry, J. W., and Parrott, L. III (2001). Unforgiveness, forgiveness, religion, and health. In Plante, T. G., and Sherman, A. C. (Eds.), Faith and Health: Psychological Perspectives. Guilford, New York, pp. 107–138.
Yates, J. W., Chalmer, B. J., St. James, P., Follansbee, M., and McKegney, F. D. (1981). Religion in patients with advanced cancer. Med. Pediat. Oncol. 9: 121–128.
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Romero, C., Friedman, L., Kalidas, M. et al. Self-Forgiveness, Spirituality, and Psychological Adjustment in Women with Breast Cancer. J Behav Med 29, 29–36 (2006). https://doi.org/10.1007/s10865-005-9038-z
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DOI: https://doi.org/10.1007/s10865-005-9038-z