Enter your email address
Submit
Write your message
Volume 18, Issue 2 (Iranian Journal of Breast Diseases 2025)
ijbd 2025, 18(2): 148-161 |
Back to browse issues page
Research code: IR.PNU.REC.1402.456
Ethics code: IR.PNU.REC.1402.456
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Tabe bordbar F, Shoaei M. The Role of Cognitive Flexibility, Psychological Hardiness, and Self-Compassion in Predicting the Role of Perceived Stress in Women with Breast Cancer. ijbd 2025; 18 (2) :148-161
URL: http://ijbd.ir/article-1-1114-en.html
URL: http://ijbd.ir/article-1-1114-en.html
1- Department of Psychology, Payame Noor University, Tehran, Iran , tabebordbar@pnu.ac.ir
2- Department of Psychology, Payame Noor University, Tehran, Iran
2- Department of Psychology, Payame Noor University, Tehran, Iran
Abstract: (513 Views)
Introduction: Breast cancer is one of the most prevalent diseases among women. The present study aimed to predict perceived stress in women with breast cancer based on cognitive flexibility, psychological hardiness, and self-compassion.
Materials and Methods: This descriptive-analytical study of a correlational type was conducted on 150 women with breast cancer in related treatment centers in Shiraz in 2023. Data were collected using Cohen et al. (1983) perceived stress questionnaire, Dennis and Vanderwal's (2010) cognitive flexibility questionnaire, Neff et al. (2011) self-compassion questionnaire, and Ahvaz Psychological Hardiness Scale (1999). The collected data was analyzed using SPSS software (version 26) with descriptive statistics and multiple regression.
Results: The results indicated a significant relationship between self-compassion, psychological hardiness, and cognitive flexibility in women with breast cancer and their perceived stress (P<0.001). Regression results showed that the variables of self-compassion, psychological hardiness, and cognitive flexibility can predict perceived stress in women with breast cancer, collectively accounting for 45% of the variance in perceived stress. The coefficients of influence for cognitive flexibility (β=-0.41), self-compassion (β=-0.31), and psychological hardiness (β=-0.30) indicate that these three variables play a significant role in the level of perceived stress in women with breast cancer (P<0.001).
Conclusion: Self-compassion, cognitive flexibility, and psychological hardiness can help reduce perceived stress in women with cancer. Therefore, it is recommended that mental health practitioners consider these variables when developing therapeutic models or preventive interventions for this group of patients.
Materials and Methods: This descriptive-analytical study of a correlational type was conducted on 150 women with breast cancer in related treatment centers in Shiraz in 2023. Data were collected using Cohen et al. (1983) perceived stress questionnaire, Dennis and Vanderwal's (2010) cognitive flexibility questionnaire, Neff et al. (2011) self-compassion questionnaire, and Ahvaz Psychological Hardiness Scale (1999). The collected data was analyzed using SPSS software (version 26) with descriptive statistics and multiple regression.
Results: The results indicated a significant relationship between self-compassion, psychological hardiness, and cognitive flexibility in women with breast cancer and their perceived stress (P<0.001). Regression results showed that the variables of self-compassion, psychological hardiness, and cognitive flexibility can predict perceived stress in women with breast cancer, collectively accounting for 45% of the variance in perceived stress. The coefficients of influence for cognitive flexibility (β=-0.41), self-compassion (β=-0.31), and psychological hardiness (β=-0.30) indicate that these three variables play a significant role in the level of perceived stress in women with breast cancer (P<0.001).
Conclusion: Self-compassion, cognitive flexibility, and psychological hardiness can help reduce perceived stress in women with cancer. Therefore, it is recommended that mental health practitioners consider these variables when developing therapeutic models or preventive interventions for this group of patients.
Keywords: Breast Cancer, Cognitive Flexibility, Perceived Stress, Psychological Hardiness, Self-Compassion
Type of Study: Research |
Subject:
Diagnosis, treatment, rehabilitation
Received: 2024/06/9 | Accepted: 2025/03/2 | Published: 2025/07/1
Received: 2024/06/9 | Accepted: 2025/03/2 | Published: 2025/07/1
References
1. Nader M, Ghanbari N, Tajabadi pour S, Gholipour S, Esmaeilzadeh N. Effectiveness of Short-term Group Logo-therapy on Life Expectancy and Resilience of Women With Breast Cancer. Arch Breast Cancer. 2019;168-73. [Persian]. [DOI:10.32768/abc.201964168-173]
2. Doi: 10.32768/abc.201964168-173 [DOI:10.32768/abc.201964168-173]
3. Roohparozadeh Nasim, Ghaderi M, Parsa A, and Allahyari A. Prevalence of breast cancer risk factors in women aged 20 to 69 in Isfahan,2014;1(1):62. [Persian]
4. Kazeminia, M., Salari, N., Hosseinian-Far, A. Akbari, H. Bazrafshan, M. Mohammadi, M. The Prevalence of Breast Cancer in Iranian Women: A Systematic Review and Meta-Analysis. Indian J Gynecol Oncolog. 2022;20(14). [Persian] [DOI:10.1007/s40944-022-00613-4]
6. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209-49. [DOI:10.3322/caac.21660] [PMID]
7. Alagizy HA, Soltan MR, Soliman S, Hegazy NN, Gohar SF. Anxiety, depression and perceived stress among breast cancer patients: single institute experience. Middle East Current Psychiatry. 2020;27:1-10. Dio: 10.1186/s43045-020-00036-x. [DOI:10.1186/s43045-020-00036-x]
8. Hansdah RS, Hembram RK, Purty A. A Comparative Study on Perceived Stress among Patients with Chronic Mental Illness, Caregivers of the Patients, and Normal Control. International journal of psychiatry 2024;9:01-3.doi:10.33140. [DOI:10.33140/IJP.09.01.05]
9. Movahedi M, Mohammadkani S, Hasani J, Moghadasin M. The relationship between the perceived stress and the quality of life among the women with breast cancer. Yafte 2018; 20(3) 100-9. [Persian].
10. Alavi N, Monaei M. Anxiety in breast cancer patients and coping with it (letter to the editor). Iranian Breast Diseases. 2009; 2(3-4), 43-5. [Persian]. Doi:10.61186/ijbd.17.1.41. [DOI:10.61186/ijbd.17.1.41]
11. Mahmoud Fakhe H , Shiri H , Rezaei N .Comparing the effects of acceptance and commitment therapy and self-compassion therapy on har of female students with anxiety symptoms. Journal of Positive Psychology,2023; 9(3), 63-82. [Persian]. Doi: 10.22108/ppls.2024.137696.2424.
12. Berrocal Montiel C, Rivas Moya T, Venditti F, Bernini O. On the contribution of psychological flexibility to predict adjustment to breast cancer. Psicothema. 2016;28(3):266-71. [DOI:10.7334/psicothema2015.271] [PMID]
13. doi: 10.7334/psicothema2015.271. [DOI:10.7334/psicothema2015.271] [PMID]
14. Shiranian M, Imani S, Khshkoonesh A. Comparing early maladaptive schemas, psychosocial flexibility in Non-addictive people and opium and stimulant addicts. Rooyesh. 2021;10(7): 163-74. [Persian].
15. doi: 20.1001.1.2383353.1400.10.7.12.4.
16. Sharifpour E, Akbari Amarghan H, Nejat H, Iranmanesh A. Comparing the Efficacy of Compassion-Based Therapy with Cognitive-Behavioral Therapy on Psychological Flexibility and Hope for Life in Cancer Patients. HN [Internet]. 2024;2(1):1-8. doi.org/10.61838/kman.hn.2.1.1. [Persian]. [DOI:10.61838/kman.hn.2.1.1]
17. Jalalpour F, Safarzadeh S. Comparing the Effectiveness of Acceptance and Commitment Therapy and Cognitive-Existential Therapy on the Psychological Flexibility of Women with Breast Cancer. Ijbd. 2025; 17 (4) :151-70. [Persian]. [DOI:10.61186/ijbd.17.4.151]
18. doi:10.61186/ijbd.17.4.151. [DOI:10.61186/ijbd.17.4.151]
19. Sevier-Guy LJ, Ferreira N, Somerville C, Gillanders D. Psychological flexibility and fear of recurrence in prostate cancer. Eur J Cancer Care (Engl). 2021:e13483. [DOI:10.1111/ecc.13483] [PMID]
20. doi. org/10.1111/ecc.13483.
21. Carbonella, J. Y., & Timpano, K. R. Examining the link between hoarding symptoms and cognitive flexibility deficits. Behavior Therapy. .2016;47(2): 262-73. [DOI:10.1016/j.beth.2015.11.003] [PMID]
22. doi.org/10.1016/j.beth.2015.11.003.
23. Shamushaki B,Taqi M, Landrani M, Sadeghi E. Relationship between cognitive flexibility and fear of cancer recurrence in breast cancer patients.2021 [Persian].
24. Joladari S, Sodagar Sh, Bahrami Hidji M. The effectiveness of treatment based on acceptance and commitment on psychological flexibility and cognitive regulation of emotion in women with breast cancer. Applied Psychology.2018;4(52): 527-48. [Persian].
25. Danaei-Kousha M, Tabatabaei S S, Shahabizadeh F, Ahi G. Comparison of the effectiveness of group positive behavior therapy with group cognitive behavioral therapy on the cognitive regulation of emotion in women with breast cancer. Phys Med Sci J. 2023;27(1):50-60 [DOI:10.18502/htaa.v6i3.12433]
26. dio: 10.48307/FMSJ.2023.27.1.50.
27. Kobasa, S. C., Maddi, S. R., & Kahn, S. Hardiness and health: A prospective study. Journal of Personality and Social Psychology.1982; 42(1): 168-77. [DOI:10.1037/0022-3514.42.1.168] [PMID]
28. doi.org/10.1037/0022-3514.42.1.168.
29. Jalali M, Rahimi M. The Relationship between Psychological Hardiness and Social Support in Women with Breast Cancer. Avicenna J Neuro Psycho Physiology. 2019; 6 (4) :159-64. [DOI:10.32598/ajnpp.6.4.1]
30. doi:10.32598/ajnpp.6.4.1. [DOI:10.32598/ajnpp.6.4.1]
31. Abdollahi A, Alsaikhan F, Nikolenko DA, Al-Gazally ME, Mahmudiono T, Allen KA, Abdullaev B. Self-care behaviors mediates the relationship between resilience and quality of life in breast cancer patients. BMC Psychiatry. 2022;22(1):825. [DOI:10.1186/s12888-022-04470-5] [PMID] []
33. Bahrami M, Mohamadirizi S, Mohamadirizi S. Hardiness and Optimism in Women with Breast Cancer. Iran J Nurs Midwifery Res. 2018;23(2):105-10. [Persian]. [DOI:10.4103/ijnmr.IJNMR_200_16] [PMID] []
34. Afshari N, Moradnejad A. Studying the relationship between psychological toughness and life expectancy in cancer patients, Seventh Regional Congress of Students of Ilam University of Medical Sciences, Ilam, 2018.[Persian].
35. Soroush M, Hejazi E, Shoakazemi M, Gheranpayeh L. Body Image Psychological Characteristics and Hope in Women with Breast Cancer. Iranian Journal of Breast Disease . 2015;7:52-63. [Persian].
36. Ghadampour, E., Mansouri, L. The Effectiveness of Compassion Focused Therapy on Increasing Optimism and Self-compassion in Female Students with Generalized Anxiety Disorder. Journal of Psychological Studies, 2018;14(1):59-74. doi: 10.22051/psy.2017.13705.1329. [Persian].
37. De Souza, L.K., Policarpo, D., & Hutz, C.S. Self-compassion and Symptoms of Stress, Anxiety, and Depression. Trends in Psychology.2020;28:85-98. [DOI:10.1007/s43076-020-00018-2]
38. dio: 10.1007/s43076-020-00018-2.
39. Pourhosseini Dehkordi, Razieh,. Sajjadian, Ilnaz, & Shaerbafchi, Mohammad Reza. The effectiveness of compassion-based therapy on perceived stress and psychological distress in women with breast cancer. Health Psychology.2018;8(31):37-52. [Persian].
40. doi: 10.30473/hpj.201935444.4050.
41. Salari Rad Z, Lil Abadi L, Kraskian Mojambari A, Salehi M, Ma. Stable reduction of depression and increase of self-compassion in women with breast cancer with emotion-focused therapy: a quasi-experimental study. Iranian Breast Diseases.2021; 14(4 (55)):4-20. [Persian]. [DOI:10.30699/ijbd.14.4.4]
42. Neff K D, Bluth K, Tóth-Király I, Davidson O, Knox M C, Williamson Z, Costigan, A. Development and Validation of the Self_Compassion Scale for Youth. Journal of Personality Assessment. 2020; 103:92-105. doi.org/10.1080/00223891.2020.1729774. [DOI:10.1080/00223891.2020.1729774] [PMID]
43. Tabachnick, B., & Fidell, L. Using multivariate statistics (5thedn) New York. NY: Allyn and Bacon.2007
44. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. Journal of Health and Social Behavior.1983;24(4): 385-96.
https://doi.org/10.2307/2136404 [DOI:10.2307/2136404.] [PMID]
45. Behrouzi N, Shahni Yilaq M, Porsaid S M. The relationship between perfectionism, perceived stress and social support with academic burnout. Culture Strategy2011; 5(20): 83-102. [Persian].
46. Cranford JA. Stress‐buffering or stress‐ exacerbation? Social support and social undermining as moderators of the relationship between perceived stress and depressive symptoms among married people. Personal Relationships. 2004; 11(1):23-40. [DOI:10.1111/j.1475-6811.2004.00069.x] [PMID] []
47. Dennis, John P. ؛ Vander Wall, Jillon S. The Cognitive Flexibility Inventory. Instrument Development and Estimates of Reliability and Validity. Cogn Ther Res. 2010;34(3): 241-53. DOI: 10.1007/s10608-009-9276-4. [DOI:10.1007/s10608-009-9276-4]
48. Shareh H, Farmani A, Soltani E. Investigating the Reliability and Validity of the Cognitive Flexibility Inventory (CFI-I) among Iranian University Students. Practice in Clinical Psychology. 2014; 2(1):43-50. http://jpcp.uswr.ac.ir/article-1- 163-en.html. [Persian].
49. Neff K D, Kirkpatrick K L, Rude S S. Self-compassion and adaptive psychological functioning. Journal of Research in Personality. 2007;41(1),139-54. [DOI:10.1016/j.jrp.2006.03.004]
50. doi.org/10.1016/j.jrp.2006.03.004.
51. Khosravi S, Sadeghi M, Yabandeh, M R. Psychometric adequacy of the Self-Compassion Scale (SCS). Psychological Methods and Models. 2013;3(13):47-58. [Persian].
52. Momeni F, Shahidi Sh, Motabi F, Heydari M. Psychometric properties of the Persian version of the Self-Compassion Scale. Contemporary Psychology. 2013; 8(2 (16th issue), 27-40. [Persian].
53. Najarian B, Kiamarthi A, Mehrabizadeh Artman M. Construction and validation of a scale to measure psychological toughness. Journal of Educational Sciences and Psychology. 2018;5(4-3):271-285 [Persian].
54. kazlou H, akbari M, jasisi H, senaei B. Compilation of the Relationship between Psychosocial Factors and Self-Efficacy of Pain by Mediating Optimism and Psychological Hardiness in Cancer Patients. IJPN.2019;7(2):74-82 [Persian].
55. Turner, P. Critical values for the Durbin-Watson test in large samples. Applied Economics Letters. 2020;27(18):1495-9. doi.org/10.1080/13504851.2019.1691711. [DOI:10.1080/13504851.2019.1691711]
56. Marcoulides K M, Raykov T. Evaluation of Variance Inflation Factors in Regression Models Using Latent Variable Modeling Methods. Educational and psychological measurement.2019;79(5):874-82. doi.org/10.1177/0013164418817803. [DOI:10.1177/0013164418817803] [PMID] []
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
