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However, empirical investigations of their purported bidirectional relationship are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This study presents a longitudinal investigation of the reciprocal relationship between intrusions and avoidance coping over a 6\u2010month period in the year following breast cancer diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Breast cancer patients (\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a0460) completed measures of cancer\u2010related intrusions and avoidance at study entry, 3\u00a0months, and 6\u00a0months later (i.e., an average of 2, 5, and 8\u00a0months after diagnosis, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Cross\u2010lagged panel analyses revealed that intrusive thoughts, feelings, and images at study entry predicted greater avoidance 3\u00a0months later, and avoidance coping at study entry predicted intrusions 3\u00a0months later, controlling for the stability of intrusions and avoidance as well as time since diagnosis. Findings were not statistically significant for avoidance predicting intrusions, or vice versa, between the 3\u2010month and the 6\u2010month assessment period, during which they declined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings provide empirical support for the theoretical contention that avoidance and intrusive thoughts and emotions reciprocally influence one another following stressful events. Additionally, in the months shortly after breast cancer diagnosis, intrusions and avoidance are positively related. However, the relationships attenuate over time, which could indicate resolved cognitive and emotional processing of the cancer experience.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:sec>\n                      <jats:label\/>\n                      <jats:p>\n                        <jats:boxed-text content-type=\"box\" position=\"anchor\">\n                          <jats:caption>\n                            <jats:title>Statement of contribution<\/jats:title>\n                          <\/jats:caption>\n                          <jats:p>\n                            <jats:italic>\n                              <jats:bold>What is already known on this subject?<\/jats:bold>\n                            <\/jats:italic>\n                          <\/jats:p>\n                          <jats:p>Following stressful life events, individuals often experience intrusive thoughts and feelings related to the event and they report avoidance of such reminders. Many studies demonstrate that greater intrusions predict more subsequent use of avoidance coping, and other studies show that greater use of avoidance predicts more intrusions. Their reciprocal relation has not been examined, however.<\/jats:p>\n                          <jats:p>\n                            <jats:italic>\n                              <jats:bold>What does this study add?<\/jats:bold>\n                            <\/jats:italic>\n                          <\/jats:p>\n                          <jats:p>\n                            <jats:list list-type=\"bullet\">\n                              <jats:list-item>\n                                <jats:p>This is the first examination of the concurrent, reciprocal influence of intrusions and avoidance.<\/jats:p>\n                              <\/jats:list-item>\n                              <jats:list-item>\n                                <jats:p>Findings suggest that accounting for the bidirectional influence of avoidance and intrusions best estimates hypothesized models.<\/jats:p>\n                              <\/jats:list-item>\n                              <jats:list-item>\n                                <jats:p>Higher intrusions and avoidance predicted each other for the first 3\u00a0months after study entry, but the relationship diminished 6 months after study entry, perhaps due to productive mental processing of the stress of breast cancer diagnosis and treatment.<\/jats:p>\n                              <\/jats:list-item>\n                            <\/jats:list>\n                          <\/jats:p>\n                        <\/jats:boxed-text>\n                      <\/jats:p>\n                    <\/jats:sec>\n                  <\/jats:sec>","DOI":"10.1111\/bjhp.12252","type":"journal-article","created":{"date-parts":[[2017,6,19]],"date-time":"2017-06-19T14:06:40Z","timestamp":1497881200000},"page":"609-626","source":"Crossref","is-referenced-by-count":14,"title":["Stuck in the spin cycle: Avoidance and intrusions following breast cancer diagnosis"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5104-8210","authenticated-orcid":false,"given":"Margaret R.","family":"Bauer","sequence":"first","affiliation":[{"name":"Department of Psychology University of California, Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua F.","family":"Wiley","sequence":"additional","affiliation":[{"name":"School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences Monash University Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen L.","family":"Weihs","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Arizona Tucson Arizona USA"},{"name":"University of Arizona Cancer Center Tucson Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annette L.","family":"Stanton","sequence":"additional","affiliation":[{"name":"Department of Psychology University of California, Los Angeles California USA"},{"name":"Department of Psychiatry and Biobehavioral Sciences University of California, Los\u00a0Angeles California USA"},{"name":"Center for Cancer Prevention and Control Research Jonsson Comprehensive Cancer Center University of California, Los Angeles California 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