{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T07:23:56Z","timestamp":1787383436093,"version":"build-2736575974"},"reference-count":47,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003975","name":"Israel Cancer Association","doi-asserted-by":"publisher","award":["20240030"],"award-info":[{"award-number":["20240030"]}],"id":[{"id":"10.13039\/501100003975","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["General Hospital Psychiatry"],"published-print":{"date-parts":[[2026,5]]},"DOI":"10.1016\/j.genhosppsych.2026.04.008","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T23:05:36Z","timestamp":1776726336000},"page":"223-231","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["A mixed-methods longitudinal study of demoralization and depression in breast cancer survivors"],"prefix":"10.1016","volume":"100","author":[{"given":"Miri","family":"Cohen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmud","family":"Abu-Amna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Promislovski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Kissane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"3","key":"10.1016\/j.genhosppsych.2026.04.008_bb0005","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1002\/cam4.4406","article-title":"Demoralization and its link with depression, psychological adjustment and suicidality among cancer patients: a network psychometrics approach","volume":"11","author":"Bobevski","year":"2022","journal-title":"Cancer Med"},{"issue":"6","key":"10.1016\/j.genhosppsych.2026.04.008_bb0010","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1046\/j.1440-1614.2002.01086.x","article-title":"Demoralization: its phenomenology and importance","volume":"36","author":"Clarke","year":"2002","journal-title":"Aust N Z J Psychiatry"},{"issue":"14","key":"10.1016\/j.genhosppsych.2026.04.008_bb0015","doi-asserted-by":"crossref","first-page":"2130","DOI":"10.1002\/cncr.30022","article-title":"Demoralization syndrome: new insights in psychosocial cancer care","volume":"122","author":"Grassi","year":"2016","journal-title":"Cancer"},{"issue":"3","key":"10.1016\/j.genhosppsych.2026.04.008_bb0020","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1016\/j.jpainsymman.2014.07.008","article-title":"A systematic review of the demoralization syndrome in individuals with progressive disease and cancer: a decade of research","volume":"49","author":"Robinson","year":"2015","journal-title":"J Pain Symptom Manage"},{"key":"10.1016\/j.genhosppsych.2026.04.008_bb0025","series-title":"International classification of diseases for mortality and morbidity statistics. 11th revision","author":"World Health Organization","year":"2019"},{"issue":"4","key":"10.1016\/j.genhosppsych.2026.04.008_bb0030","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1017\/S0033291714001597","article-title":"Demoralization: a systematic review on its clinical characterization","volume":"45","author":"Tecuta","year":"2015","journal-title":"Psychol Med"},{"issue":"11","key":"10.1016\/j.genhosppsych.2026.04.008_bb0035","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.1177\/10499091231154887","article-title":"Prevalence, associated factors and adverse outcomes of demoralization in cancer patients: a decade of systematic review","volume":"40","author":"Wang","year":"2023","journal-title":"Am J Hosp Palliat Care"},{"issue":"3","key":"10.1016\/j.genhosppsych.2026.04.008_bb0040","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2022-065796","article-title":"Contribution of coping style to the association between illness uncertainty and demoralisation in patients with breast cancer: a cross-sectional mediation analysis","volume":"13","author":"Hao","year":"2023","journal-title":"BMJ Open"},{"issue":"1","key":"10.1016\/j.genhosppsych.2026.04.008_bb0045","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1111\/psyg.13037","article-title":"Demoralization in cancer survivors: an updated systematic review and meta-analysis","volume":"24","author":"Lin","year":"2024","journal-title":"Psychogeriatrics"},{"key":"10.1016\/j.genhosppsych.2026.04.008_bb0050","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1016\/j.jad.2024.12.045","article-title":"Demoralizations link to depression and anxiety symptoms: a network analysis","volume":"372","author":"Ramm","year":"2025","journal-title":"J Affect Disord"},{"issue":"14","key":"10.1016\/j.genhosppsych.2026.04.008_bb0055","doi-asserted-by":"crossref","first-page":"2251","DOI":"10.1002\/cncr.30015","article-title":"Refinement and revalidation of the demoralization scale: the DS-II\u2014external validity","volume":"122","author":"Robinson","year":"2016","journal-title":"Cancer"},{"key":"10.1016\/j.genhosppsych.2026.04.008_bb0060","doi-asserted-by":"crossref","DOI":"10.3389\/fpsyt.2025.1554128","article-title":"Modeling of demoralization in breast cancer","volume":"16","author":"de Figueiredo","year":"2025","journal-title":"Front Psychiatry"},{"issue":"19","key":"10.1016\/j.genhosppsych.2026.04.008_bb0065","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph191912815","article-title":"Demoralization and its association with quality of life, sleep quality, spiritual interests, and suicide risk in breast cancer inpatients","volume":"19","author":"Chang","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"10.1016\/j.genhosppsych.2026.04.008_bb0070","doi-asserted-by":"crossref","DOI":"10.3389\/fpsyg.2025.1523164","article-title":"Demoralization in breast cancer survivors","volume":"16","author":"Sender","year":"2025","journal-title":"Front Psychol"},{"key":"10.1016\/j.genhosppsych.2026.04.008_bb0075","doi-asserted-by":"crossref","DOI":"10.1017\/S1478951524001597","article-title":"Factors correlated with demoralization among cancer patients: a systematic review and meta-analysis","volume":"23","author":"Tang","year":"2025","journal-title":"Palliat Support Care"},{"issue":"11","key":"10.1016\/j.genhosppsych.2026.04.008_bb0080","first-page":"828","article-title":"Management of cancer-related fatigue","volume":"4","author":"Bower","year":"2006","journal-title":"Clin Adv Hematol Oncol"},{"key":"10.1016\/j.genhosppsych.2026.04.008_bb0085","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1146\/annurev-psych-032420-031047","article-title":"Self-compassion: theory, method, research, and intervention","volume":"74","author":"Neff","year":"2023","journal-title":"Annu Rev Psychol"},{"issue":"8","key":"10.1016\/j.genhosppsych.2026.04.008_bb0090","first-page":"3265","article-title":"From normal response to clinical problem: definition and clinical features of fear of cancer recurrence","volume":"24","author":"Lebel","year":"2016","journal-title":"Support Care Cancer"},{"key":"10.1016\/j.genhosppsych.2026.04.008_bb0095","article-title":"The associations of emotion regulation, self-compassion, and perceived lifestyle discrepancy with breast cancer survivors' healthy lifestyle maintenance","author":"Ben-Artzi TJ","year":"2024","journal-title":"J Cancer Surviv"},{"key":"10.1016\/j.genhosppsych.2026.04.008_bb0100","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.ijpsycho.2020.09.011","article-title":"Low physical activity, fatigue and depression in breast cancer survivors: moderation by levels of IL-6 and IL-8","volume":"158","author":"Cohen","year":"2020","journal-title":"Int J Psychophysiol"},{"key":"10.1016\/j.genhosppsych.2026.04.008_bb0105","first-page":"241","article-title":"Fear of cancer recurrence inventory: development and initial validation","volume":"17","author":"Simard","year":"2009","journal-title":"Support Care Cancer"},{"issue":"5","key":"10.1016\/j.genhosppsych.2026.04.008_bb0110","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1007\/s12529-020-09952-y","article-title":"Post-treatment psychological distress among colorectal cancer survivors: relation to emotion regulation patterns and personal resources","volume":"28","author":"Baziliansky","year":"2021","journal-title":"Int J Behav Med"},{"key":"10.1016\/j.genhosppsych.2026.04.008_bb0115","doi-asserted-by":"crossref","DOI":"10.1016\/j.brat.2022.104103","article-title":"Intervention and mediation effects of target processes in a randomized controlled trial of acceptance and commitment therapy for anxious cancer survivors in community oncology clinics","volume":"153","author":"Fishbein","year":"2022","journal-title":"Behav Res Ther"},{"issue":"2","key":"10.1016\/j.genhosppsych.2026.04.008_bb0120","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1007\/s10567-024-00471-w","article-title":"Strong relations between reversed self-compassion and symptoms of anxiety and depression in young people","volume":"27","author":"Muris","year":"2024","journal-title":"Clin Child Fam Psychol Rev"},{"issue":"9","key":"10.1016\/j.genhosppsych.2026.04.008_bb0125","doi-asserted-by":"crossref","first-page":"1918","DOI":"10.1002\/pon.5174","article-title":"The predictive role of self-compassion in cancer patients\u2019 symptoms of depression, anxiety, and fatigue: a longitudinal study","volume":"28","author":"Zhu","year":"2019","journal-title":"Psychooncology"},{"issue":"12","key":"10.1016\/j.genhosppsych.2026.04.008_bb0130","doi-asserted-by":"crossref","first-page":"2141","DOI":"10.1002\/pon.6055","article-title":"Psychosocial predictors of fear of cancer recurrence","volume":"31","author":"Mell","year":"2022","journal-title":"Psychooncology"},{"issue":"13","key":"10.1016\/j.genhosppsych.2026.04.008_bb0135","doi-asserted-by":"crossref","first-page":"4696","DOI":"10.3390\/jcm14134696","article-title":"Be kind to yourself: testing self-compassion, fear of recurrence, and generalized anxiety in women with cancer within a multiple-mediation model","volume":"14","author":"Krok","year":"2025","journal-title":"J Clin Med"},{"issue":"6","key":"10.1016\/j.genhosppsych.2026.04.008_bb0140","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1177\/10499091241274315","article-title":"Demoralization syndrome in end-of-life cancer patients: a qualitative study","volume":"42","author":"Bovero","year":"2025","journal-title":"Am J Hosp Palliat Care"},{"issue":"12","key":"10.1016\/j.genhosppsych.2026.04.008_bb0145","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0337182","article-title":"The experience of demoralization syndrome in patients with decompensated cirrhosis: a qualitative research","volume":"20","author":"Shu","year":"2025","journal-title":"PloS One"},{"issue":"6 Pt 2","key":"10.1016\/j.genhosppsych.2026.04.008_bb0150","doi-asserted-by":"crossref","first-page":"2134","DOI":"10.1111\/1475-6773.12117","article-title":"Achieving integration in mixed methods designs-principles and practices","volume":"48","author":"Fetters","year":"2013","journal-title":"Health Serv Res"},{"issue":"4","key":"10.1016\/j.genhosppsych.2026.04.008_bb0155","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1177\/082585970402000402","article-title":"The demoralization scale: a report of its development and preliminary validation","volume":"20","author":"Kissane","year":"2004","journal-title":"J Palliat Care"},{"key":"10.1016\/j.genhosppsych.2026.04.008_bb0160","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: validity of a brief depression severity measure","volume":"16","author":"Kroenke","year":"2001","journal-title":"J Gen Intern Med"},{"issue":"5","key":"10.1016\/j.genhosppsych.2026.04.008_bb0165","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1093\/jnci\/85.5.365","article-title":"The european organisation for research and treatment of cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology","volume":"85","author":"Aaronson","year":"1993","journal-title":"J Natl Cancer Inst"},{"issue":"3","key":"10.1016\/j.genhosppsych.2026.04.008_bb0170","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1002\/cpp.702","article-title":"Construction and factorial validation of a short form of the self-compassion scale","volume":"18","author":"Raes","year":"2011","journal-title":"Clin Psychol Psychother"},{"key":"10.1016\/j.genhosppsych.2026.04.008_bb0175","series-title":"Thematic analysis: A practical guide","author":"Braun","year":"2021"},{"key":"10.1016\/j.genhosppsych.2026.04.008_bb0180","series-title":"Diagnostic and statistical manual of mental disorders","author":"American Psychiatric Association","year":"2022"},{"issue":"24","key":"10.1016\/j.genhosppsych.2026.04.008_bb0185","doi-asserted-by":"crossref","first-page":"5740","DOI":"10.1002\/cncr.25294","article-title":"Prevalence, predictors, and characteristics of off-treatment fatigue in breast cancer survivors","volume":"116","author":"Andrykowski","year":"2010","journal-title":"Cancer"},{"issue":"3","key":"10.1016\/j.genhosppsych.2026.04.008_bb0190","doi-asserted-by":"crossref","DOI":"10.1002\/pon.6319","article-title":"The longitudinal relationship between self-compassion and cancer patients\u2019 unmet supportive care needs","volume":"33","author":"Yu","year":"2024","journal-title":"Psychooncology"},{"issue":"1","key":"10.1016\/j.genhosppsych.2026.04.008_bb0195","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1002\/smi.3180","article-title":"Fear of cancer recurrence as a pathway from fatigue to psychological distress in mothers who are breast cancer survivors","volume":"39","author":"Kuswanto","year":"2023","journal-title":"Stress Health"},{"issue":"5","key":"10.1016\/j.genhosppsych.2026.04.008_bb0200","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1017\/S147895151400087X","article-title":"Cancer-related fatigue and depression in breast cancer patients post chemotherapy: different associations with optimism and stress appraisals","volume":"13","author":"Levkovich","year":"2015","journal-title":"Palliat Support Care"},{"key":"10.1016\/j.genhosppsych.2026.04.008_bb0205","series-title":"Existential psychotherapy","author":"Yalom","year":"1980"},{"key":"10.1016\/j.genhosppsych.2026.04.008_bb0210","series-title":"Handbook of psychooncology: Psychological care of the patient with cancer","article-title":"Breast cancer","author":"Rowland","year":"1989"},{"issue":"4","key":"10.1016\/j.genhosppsych.2026.04.008_bb0215","doi-asserted-by":"crossref","first-page":"273","DOI":"10.2190\/OM.61.4.b","article-title":"The dual process model of coping with bereavement: a decade on","volume":"61","author":"Stroebe","year":"2010","journal-title":"Omega"},{"issue":"2","key":"10.1016\/j.genhosppsych.2026.04.008_bb0220","first-page":"96","article-title":"Demoralization, anhedonia and grief in patients with severe physical illness","volume":"4","author":"Clarke","year":"2005","journal-title":"World Psychiatry"},{"issue":"4","key":"10.1016\/j.genhosppsych.2026.04.008_bb0225","doi-asserted-by":"crossref","DOI":"10.1016\/j.ejtd.2020.100195","article-title":"What promotes post traumatic growth? A systematic review","volume":"5","author":"Henson","year":"2021","journal-title":"Eur J Trauma Dissociation"},{"issue":"4","key":"10.1016\/j.genhosppsych.2026.04.008_bb0230","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1037\/1089-2680.5.4.323","article-title":"Bad is stronger than good","volume":"5","author":"Baumeister","year":"2001","journal-title":"Rev Gen Psychol"},{"issue":"14","key":"10.1016\/j.genhosppsych.2026.04.008_bb0235","doi-asserted-by":"crossref","first-page":"2383","DOI":"10.1002\/cncr.32078","article-title":"Effects of psychosocial interventions on meaning and purpose in adults with cancer: a systematic review and meta-analysis","volume":"125","author":"Park","year":"2019","journal-title":"Cancer"}],"container-title":["General Hospital Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0163834326000794?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0163834326000794?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T06:40:00Z","timestamp":1787380800000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0163834326000794"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":47,"alternative-id":["S0163834326000794"],"URL":"https:\/\/doi.org\/10.1016\/j.genhosppsych.2026.04.008","relation":{},"ISSN":["0163-8343"],"issn-type":[{"value":"0163-8343","type":"print"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"A mixed-methods longitudinal study of demoralization and depression in breast cancer survivors","name":"articletitle","label":"Article Title"},{"value":"General Hospital Psychiatry","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.genhosppsych.2026.04.008","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier Inc.","name":"copyright","label":"Copyright"}]}}