Greater Post-Surgical Pain Predicts Long-Term Depressed Affect in Breast Cancer Patients: The Role of Coping

Hannah M. Fisher, Chloe J. Taub, Suzanne C Lechner, Michael H. Antoni

Research output: Contribution to journalArticlepeer-review


Background: Depressed affect is observed during primary treatment for early-stage breast cancer and often persists into survivorship. Pain can influence the long-term emotions of women with breast cancer. Behavioral mechanisms explaining this relationship are less clear. Coping during primary treatment may play a role in the association between pain and depressed affect. Aims: Our observational study examined a longitudinal mediation model testing whether post-surgical pain intensity predicted depressed affect 5 years later via disengagement and/or engagement coping at the end of treatment. Method: Women (N = 240) with stage 0-III breast cancer completed measures of pain, coping, and depressed affect 4-10 weeks post-surgery, and 12 months and 5 years later. Results: Structural modeling yielded measurement models of 12-month disengagement and engagement coping. Direct effects emerged between post-surgical pain intensity and 12-month disengagement (β =.37, p <.001) and engagement coping (β =.16, p <.05). Post-surgical pain intensity was also related to 5-year depressed affect (β =.25, p <.05). Disengagement and engagement coping were not associated with depressed affect at 5-year follow-up, and there was no evidence of mediation. Limitations: This is a secondary analysis of data from a trial conducted several years ago, and may not generalize due to a homogenous sample with attrition at long-term follow-up. Conclusions: Greater post-surgical pain intensity predicts more disengagement and engagement coping at the end of primary treatment, as well as depressed affect during survivorship. Managing post-surgical pain may influence the emotions of survivors of breast cancer up to 5 years later, possibly through coping or non-coping processes.

Original languageEnglish (US)
JournalEuropean Journal of Health Psychology
StateAccepted/In press - 2021


  • breast cancer
  • depressed affect
  • disengagement coping
  • engagement coping
  • pain

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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