Difficulty in emotion regulation, psychological resilience, and depression are associated with Prolonged Grief Disorder in patients with breast cancer

Objective: Grief is a natural reaction to potential losses faced by women with breast cancer. To our knowledge, no study has been conducted on prolonged grief disorder (PGD) in women with breast cancer. This study investigated the sociodemographic, cancer-specific, and psychological factors affecting PGD and the relationship between psychological resilience (PR), difficulty in emotion regulation (DER), and PGD in patients with breast cancer. Method: Breast cancer patients who met the inclusion criteria were included in the study (N=177). The Prolonged Grief Disorder Scale-Patient Form, Resilience Scale for Adults, Difficulties in Emotion Regulation Scale-Brief Form, and Hospital Anxiety and Depression Scale were administered to the patients. The DSM-5-oriented clinical interview was also conducted. Results: No significant relationships were found between PGD and clinical variables such as tumor stage, recurrence, or treatment types. Significant relationships were found between PGD and a history of mental illness and active psychotropic use. PGD was negatively correlated with age, total duration of cancer, and resilience. PGD was also positively associated with DER. DER was found to be a partial mediator variable (PR-DER-PGD), and depression score acted as a moderator variable in the relationship between PR and PGD, after adjusting for confounders. Discussion: The findings of our study indicate that DER, depression, and PR influence PGD in breast cancer patients. We believe that all patients with breast cancer for more than six months should be evaluated for prolonged grief and, if necessary, referred to grief psychotherapies that help them to accept their losses easily.