Autobiographical Memory
i n L o n g - Te r m B r e a s t
Cancer Survivors
June, 2006
Breast Cancer Survivorship
Over the past 30 years,
breast cancer survivorship has been changing.
While the number of
women diagnosed with
breast cancer has increased, so has the number of women who are
survivors. Both of these
increases have been attributed to advancements in detection and
treatment. A recent research focus has shifted
towards the survivorship
phase. However, survivorship is still viewed
from a disease perspective and counted as
number of years without
a recurrence.
The Health Psychology
Research Group at the University of Houston has been
advocating an integrative
approach to their investigations of breast cancer survivorship. At the core of this
perspective is a developmental approach in which
survivorship is viewed as a
journey in which women
will experience both positive and negative consequences of their diagnosis
and treatment and that their
survivorship may influence
their continuing development.
Much of the previous research has focused on the
negative consequences of
breast cancer diagnosis. In
this new developmental perspective, the positive aspects
of breast cancer are explored.
Although at first this may
seem an oxymoron, human
history has taught us that good
can bloom out of bad. A new
focus in field of psychology
has been put forth by Dr. Martin Seligman, termed positive
psychology. Rather than focusing on unhealthy behaviors there is a shift towards
healthy behaviors. Rather
than focusing on negative
consequences there is a shift
toward the psychological
growth potentials.
This change in perspective
has the potential to influence
Continued on Page 4
A note from Stephen
I would like to take
this opportunity to
once again thank you
for your assistance in
my research endeavors. The information
that you have provided
me has proven to be
interesting. In this
newsletter, I wish to
share with you some of
my preliminary findings.
I have already submitted
my research to a professional conference and am
working on writing a report for a professional
journal. More impor-
tantly, the findings from
my present research
serves as a foundation
from which I may further
explore the survivorship
process in breast cancer
survivors and their family.
Page 2
Autobiographical Memory in Long-Term Breast Cancer
Participants
We're dedicated to
improving the quality of
life for breast cancer
survivors and their
families at home, at
work, and in the
community.
An unique aspect of my
research was the sample of
breast cancer survivors that
participated. Most of the
previous research that has
been conducted examined
early survivorship. My research asked questions about
long-term survivorship.
This research study had
two groups of participants.
The first group were 25
breast cancer survivors. The
average age of the breast
cancer survivor in my study
was 62 years old, with an
average of 18 years of survivorship.
In research studies, the goal
is usually to compare one
group of people to another
group of people who are
similar on most accounts.
This group of people are
oftentimes referred to as the
control group. There were
25 women in the control
group, who were on average
56 years of age. To be included in the control group,
these women had not been
diagnosed with breast cancer
in their life.
The majority of women in
the total sample (breast cancer survivors and control
group) were Caucasian, married with a college education
and working outside the
home.
B r e a s t C a n c e r a s a Tr a u m a t i c E v e n t
DCIS
S t a ge I
S t a ge I I
To answer some of the
questions in the packet, you
had to reflect on a past traumatic event. For the breast
cancer survivors, I asked
that you use your diagnosis
as your traumatic event.
The average age of breast
cancer diagnosis for this
group was 43 years old, with
an average time of survivor-
ship of 18 years. The majority of breast cancer survivors
reported their stage of breast
cancer as either DCIS, Stage
I or Stage II.
You will also remember
that you were asked to rate
the stressfulness of your
breast cancer diagnosis. As
somewhat expected, the ma-
jority of survivors rated their
breast cancer diagnosis as
very stressful. However,
this is interesting in that
many of you did not use the
top category “extremely
stressful” and also interesting in comparison to the
control group.
Tr a u m a t i c E v e n t s
The control participants
were asked to identify an
event from their lives that
they considered to be the
most stressful event in their
lives that had occurred prior
to 1993.
health
interpersonal
death
div orce
employment
other
These specific events could
be categorized into the fol-
lowing areas: another person’s health (24%), interpersonal problems (20%), another’s death (16%), Divorce (16%), employment
concerns (16%).
The average age at which
these events occurred was
40 years old, comparable to
the age of breast cancer diagnosis.
Similar to the breast cancer
survivors, the control participants were asked to rate
the stressfulness of this
event. Control participants
on average rated their events
as being extremely stressful.
April 12, 2006
Page 3
Autobiographical Memory
Control
BCS
25%
The primary research question of this
study was whether breast
cancer survivorship would
effect autobiographical
memory retrieval. As you
may remember, I asked
you to recall 20 events
that had occurred across
your life. These events
were autobiographical
memories, which can be
defined as important
events in our lives that
serve to define our identity.
percentage of total memories
20%
15%
10%
5%
0%
0-10
11-20
21-30
31-40
41-50
51-60
+61
chronological decades
rupted an individual’s
sense of safety, which perhaps caused them to reflect on the priorities of
their life that event would
become a new anchor
point in their memory
timeline, perhaps replacing the typical landmark
According to previous research, if a life
event occurred that dis-
of adolescence. My hypothesis was that breast
cancer diagnosis is one
of those events that
would disrupt an individual’s timeline.
The graph to the
right, represents the distribution of memories
Psychological Growth
low
high
25%
20%
Percentage of memories
Psychological
growth is the concept
that following a traumatic or stressful event,
that some people are
able to find benefit and
growth potential from
that event. All of the
participants, following
the recall of their
memories, completed a
paper questionnaire that
asked question about
the stressful event that
you identified. On this
questionnaire, you were
asked to circle on a 6-
15%
10%
5%
0%
0-10
11-20
21-30
31-40
41-50
51-60
+60
Decades
point scale your answers.
Through simple addition of
those numbers, a psychological growth index could
be computed. I then simply
split the group of breast can-
across the decades for
the breast cancer survivors and for the control participants. What
you will notice is that
there is a large number of memories from
the time period of adolescence for the control participants, but
that reminiscence
bump is missing for
the breast cancer survivor group. The
question now becomes, what happens
to the reminiscence
bump?
cer survivors in half based
on the middle score, creating a group of low growth
survivors and a group of
high growth survivors.
The graph to
the left shows the pattern of memories recalled for the 2 groups.
What you should notice is that the group
who reported finding
benefit in their diagnosis, recalled a greater
number of memories
from around the time
of their diagnosis. The
survivors in the low
growth group, recalled
memories from their
adolescence, or the
time of the expected
reminiscence bump.
Breast Cancer
Survivorship (continued)
greatly breast cancer survivors in the future. As we
gain a better understanding
of how breast cancer survivors journey from diagnosis
to treatment to long-term
survivorship, how they navigate both the negative obstacles and the positive passages, we can tailor programs to assist newly diagnosed breast cancer survivors to begin their journey,
until that day when a cure
has been found. Our further
understanding of this journey,
will aid in developing programs for the family and
friends of breast cancer survivors who are also on a journey of survivorship, with its
own unique obstacles and passages.
Summary
The primary question
of this research was supported. Breast Cancer diagnosis can effect a woman’s sense
of identity as manifested in
their recall of memories from
across their lifespan. While
we all experience traumatic
and stressful events in our
lives, these events do not have
equal impact on our sense of
identity and the prioritization
of our goals.
In addition to the
stressful event, the individual
in their struggle to make sense
of that event attempts to integrate it into their life. For
some individuals , this integration involves a reprioritization of their goals, which suggests a modification of their
sense of identity. For other
people, the integration of the
event is to reconnect to the
identity that they established in
adolescence and young adulthood.
The benefit of this research is that it opens our understanding of the survivorship process. It continues the shift towards
the positive benefits of traumatic
events rather than a focus on the
negative. The research does not
end here, research serves to elicit
questions as much as to answer
questions. What are some other
events that occur in our life that
have the potential to shift our life
trajectory? What is the role that
the age at which an event occurs
influences our ability to integrate
it into our life?
These are just a few questions that might be asked. However, in taking a developmental
perspective, survivorship can be
seen as a life-long journey.
Vo l u n t e e r s N e e d e d
The Health Psychology Research
Group at the University of Houston are always interested in recruiting participants for various
research ongoing and new research studies. Through your
generous participation, researchers and clinicians can develop a
better understanding of the complexity of the survivorship process for both the individual and
their family and friends. Please
consider contacting the Health
Psychology Research Group at
713-743-8449 or passing this information on to other survivors.
Stephen H. Baker, Ph.D.
Health Psychology Research
Group
University of Houston
Department of Psychology
Heyne Building
Houston, TX 77204
Phone: 713-743-8449
E-mail: HPRG@mail.uh.edu
Web: www.psychology.uh.edu/hprg