Attachment to God and coping with the diagnosis and treatment of breast cancer: a longitudinal study.

backgroundReligious/spiritual factors are important for some individuals in the context of life stress. To the authors' knowledge, the present study is the first to explore the role of women's attachment to God (anxious vs secure) in their adjustment to breast cancer.

objectiveTo explore the (1) pattern of change in women's attachment to God across time and (2) relationship between attachment to God and coping behaviors and depression.

methodsAll English-speaking women who were scheduled to receive a core breast biopsy at a women's breast health center were eligible to participate in the study. Women were assessed on attachment to God, positive and negative coping, and depression at pre-diagnosis and 3, 6, and 12 months post-diagnosis. Women who received a benign diagnosis and those with a diagnosis of breast cancer participated in the study.

resultsAttachment to God remained stable across time for both diagnostic groups (cancer, benign). Women from both groups who had a more anxious attachment to God utilized more avoidance coping and reported more depression at different points across time. Breast cancer patients with a more anxious attachment to God reported engaging in less acceptance coping post-diagnosis. Finally, the association between attachment to God and depression was partially mediated by avoidance coping at pre-diagnosis.

conclusionsFindings indicate that a more anxious attachment to God may contribute to negative patterns of adjustment while a secure attachment may help women remain more directly engaged in their coping with the threat of breast cancer and related diagnostic procedures. IMPLICATIONS FOR PRACTICE: It is suggested that clinicians remain sensitive to and assess the role of spiritual beliefs in women's adjustment to the threat of breast cancer from pre-diagnosis up to 1 year post-diagnosis. In particular, women's belief in and experience of a secure or an anxious attachment with God or higher power may function as a potential resource or as an exacerbating factor, respectively, in their adjustment to breast cancer.