{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T19:50:38Z","timestamp":1792698638925,"version":"4.5.0"},"reference-count":39,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,3,31]],"date-time":"2021-03-31T00:00:00Z","timestamp":1617148800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psycho-Oncology"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Many breast cancer survivors (BCSs) recover from the negative sequelae of cancer treatment. However, some report persistent and disruptive distress well into disease\u2010free survivorship. More information is needed on the predictors of distress in this growing population of BCS, including the role of avoidant coping, or attempts to avoid thoughts, feelings, and reminders of cancer, in mediating the relationship between distress and psychological, physical, and social domains of well\u2010being.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In a large cross\u2010sectional study, BCS (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a01,127), who were 3 to 8 years post\u2010diagnosis, completed a survey assessing demographic characteristics, medical history, distress (anxiety and depressive symptoms), avoidant coping, and physical (fatigue), psychological (fear of recurrence, attention, body image), and social (social support from a partner, social constraints from a partner) well\u2010being. Multiple mediation analyses were conducted to determine if avoidant coping mediated the relationship between each distress variable (anxiety and depressive symptoms) and each well\u2010being (fear of recurrence, attention, body image, fatigue, social support, and social constraints) variable.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In all six mediation models, avoidant coping significantly (\n                      <jats:italic>p\u00a0&lt;\u00a00<\/jats:italic>\n                      .\n                      <jats:italic>001)<\/jats:italic>\n                      mediated the relationship between each well\u2010being variable (fear of recurrence, attention, body image, fatigue, social support, and social constraints) and each distress indicator (depression and anxiety). Avoidant coping mediated 19%\u201354% of the effects of the contributing factors on the distress variables.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Avoidant coping may indicate risk for, or presence of, distress among BCS. Interventions to reduce distress may benefit from addressing avoidant coping styles.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pon.5663","type":"journal-article","created":{"date-parts":[[2021,3,22]],"date-time":"2021-03-22T02:01:20Z","timestamp":1616378480000},"page":"1129-1136","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["The mediating role of avoidant coping in the relationships between physical, psychological, and social wellbeing and distress in breast cancer survivors"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7928-6491","authenticated-orcid":false,"given":"Andrea","family":"Cohee","sequence":"first","affiliation":[{"name":"School of Nursing Indiana University School of Nursing  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelley A.","family":"Johns","sequence":"additional","affiliation":[{"name":"School of Medicine Indiana University School of Medicine  Indianapolis Indiana USA"},{"name":"Regenstrief Institute, Inc.  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer S.","family":"Alwine","sequence":"additional","affiliation":[{"name":"School of Nursing Indiana University School of Nursing  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tasneem","family":"Talib","sequence":"additional","affiliation":[{"name":"School of Nursing Indiana University School of Nursing  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick O.","family":"Monahan","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Indiana University School of Medicine  Indianapolis Indiana USA"},{"name":"Fairbanks School of Public Health Indiana University Fairbanks School of Public Health  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy E.","family":"Stump","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Cella","sequence":"additional","affiliation":[{"name":"Feinberg School of Medicine Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria L.","family":"Champion","sequence":"additional","affiliation":[{"name":"School of Nursing Indiana University School of Nursing  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,31]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21565"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549-020-05522-8"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.3432"},{"key":"e_1_2_10_5_1","volume-title":"NCCN Clinical Practice Guidelines in Oncology (NCCN 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