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Active and Passive Coping Strategies: Comparing Psychological Distress, Cortisol, and Proinflammatory Cytokine Levels in Breast Cancer Survivors

Joana Perez-Tejada
Larraitz Garmendia
Ainitze Labaka
Oscar Vegas
Eneritz Gómez-Lazaro
Amaia Arregi
CJON 2019, A1-A8 DOI:
Background: Breast cancer survivors can experience psychological distress, such as anxiety and depression, long after treatment has ended, and the development of such negative affective states has been related to the coping strategy used by the survivor. In addition, coping strategies can affect the immune and endocrine systems, which are linked to anxiety and depressive symptoms.
Objectives: This pilot study aims to determine whether different coping strategies are associated with differences in psychological distress, cortisol, and tumor necrosis factor (TNF)-alpha levels in breast cancer survivors. 
Methods: 54 breast cancer survivors completed the Stress Coping Questionnaire and the Hospital Anxiety and Depression Scale and provided a blood sample for cortisol and proinflammatory cytokine measures.
Findings: Passive coping strategies were associated with higher psychological distress, cortisol, and TNF-alpha levels. The passive group had more avoidance and negative self-targeting and less positive reappraisal and focusing on a problem’s solution.