When body image and fear collide: a fuzzy-set qualitative comparative (fsQCA) and mediation analysis of sufficient pathways to post-traumatic stress in breast cancer survivors.

Yifan Gong, Bingnan Du, Minyi Wang, Xinchen Wang, Zhihui Gu, Li Liu, Hui Wu, Mengyao Li

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Article in Frontiers in psychology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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8 authors.

Yifan Gong *Department of Social Medicine, School of Health Management, China Medical University, Shenyang, Liaoning, China.

Bingnan Du *Department of Social Medicine, School of Health Management, China Medical University, Shenyang, Liaoning, China.

Minyi WangDepartment of Social Medicine, School of Health Management, China Medical University, Shenyang, Liaoning, China.

Xinchen WangDepartment of Social Medicine, School of Health Management, China Medical University, Shenyang, Liaoning, China.

Zhihui GuDepartment of Social Medicine, School of Health Management, China Medical University, Shenyang, Liaoning, China.

Li LiuDepartment of Social Medicine, School of Health Management, China Medical University, Shenyang, Liaoning, China.

Hui WuDepartment of Social Medicine, School of Health Management, China Medical University, Shenyang, Liaoning, China.

Mengyao LiDepartment of Social Medicine, School of Health Management, China Medical University, Shenyang, Liaoning, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Breast cancer survivors frequently experience significant posttraumatic stress symptoms (PTSS). Using the Conservation of Resources (COR) theory as a framework, this study aimed to investigate the configurational patterns and underlying psychological associations linked to high PTSS in post-operative patients. Methods: A cross-sectional study was conducted with 172 post-operative breast cancer patients. Participants completed measures for PTSS, resilience, perceived social support (PSS), self-efficacy, fear of progression (FoP), body image disturbance (BID), and shared decision-making (SDM). The analysis employed fuzzy-set Qualitative Comparative Analysis (fsQCA) to identify sufficient combinations of factors associated with high PTSS. This was followed by mediation analysis to test interrelationships among the identified core conditions. Results: The prevalence of PTSS was 89.5%. fsQCA identified five sufficient configurations for high PTSS. The combination of high BID and high FoP emerged as a core condition across these patterns. Mediation analysis demonstrated that FoP was associated with the link between BID and PTSS, and linked PSS to PTSS. Conclusion: High FoP and high BID are central factors correlated with PTSS in breast cancer survivors, operating within a COR-based "loss spiral." Low SDM functions as a conditional factor related to resource obstruction. Findings suggest a need for stratified interventions targeting these specific resource depletions.

Indexed as

body image disturbancebreast cancer survivorsConservation of Resources Theoryfear of progressionfsQCAposttraumatic stress symptoms

Identifiers

PMID42052080

DOI10.3389/fpsyg.2026.1769571

PMCPMC13111568

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.