Nicole Bungaro, Livia Sani, Daniela Belella, Stefano Magno, Agata Benfante, Rossella Mattea Quinto, Andrea Schiralli, Francesca Veccia, Ernesto Greco, Gianluca Franceschini, Daniela Pia Rosaria Chieffo, Francesco De Vincenzo
The findings suggest that PTG and its prospective factors, both positive and negative, should be monitored over time in BC patients across all disease stages, from treatment to survivorship, to inform personalized psychological support programs. Future research should also investigate PTD alongside PTG and adopt standardized timeframes to objectively assess changes in posttraumatic outcomes.
PURPOSE: Breast cancer remains a global health concern, with post-traumatic psychological changes, both positive and negative, during treatment and survivorship. This systematic review aimed to examine the prospective predictors of Posttraumatic Growth (PTG) and Posttraumatic Depreciation (PTD), as well as their temporal dynamics in women diagnosed with breast cancer.
METHODS: PubMed, Scopus, CINAHL, and PsycINFO were systematically searched on 31st January 2025, using a combination of terms and Boolean operators, following PRISMA guidelines. A narrative synthesis was conducted, classifying included studies into investigations of prospective predictors of PTG/PTD and of longitudinal changes in PTG/PTD levels; findings were summarised in tabular form, and the Quality in Prognosis Studies tool was used for the assessment of study risk of bias.
RESULTS: Eighteen studies met the inclusion criteria and were included in this review. No longitudinal studies were found investigating PTD. For PTG, several biopsychosocial predictors emerged, highlighting substantial heterogeneity across studies. Many variables showed only limited evidence, preventing conclusive inferences. Only illness-specific stress demonstrated strong evidence as a positive predictor of PTG, while clinical factors were inconclusive. Regarding PTG trajectories, studies reported significant increases over time, with mixed evidence concerning the timing and pattern of these changes.
CONCLUSION: The findings suggest that PTG and its prospective factors, both positive and negative, should be monitored over time in BC patients across all disease stages, from treatment to survivorship, to inform personalized psychological support programs. Future research should also investigate PTD alongside PTG and adopt standardized timeframes to objectively assess changes in posttraumatic outcomes.