{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:03:55Z","timestamp":1786122235875,"version":"build-2736575974"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":218,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Depression and Anxiety"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Social anxiety and avoidance behaviors are prevalent among breast cancer patients, yet their interrelationships with protective factors such as spiritual well\u2010being remain poorly understood. Network analysis offers a novel approach to identify central and bridge nodes that may serve as key targets for psychosocial intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross\u2010sectional study of 302 female breast cancer patients from a tertiary hospital in China. Participants completed the Social Anxiety Scale (SAS_1), Social Avoidance Scale (SAS_2), and the Functional Assessment of Chronic Illness Therapy\u2013Spiritual Well\u2010Being (FACIT\u2010Sp). A network model was constructed to examine the interrelationships among these constructs, with centrality and bridge centrality indices used to identify influential nodes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Spiritual well\u2010being\u2014particularly items such as \u201cstrength from faith\u201d and \u201cconfidence in recovery\u201d\u2014showed the highest strength centrality, indicating its central role in the psychological adaptation network. Social avoidance emerged as the strongest bridge node, connecting spiritual well\u2010being with social anxiety. Surgical approach did not significantly alter the global network structure, but subgroup analyses revealed distinct node\u2010level bridge strengths, suggesting differential psychological adaptation pathways.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Spiritual well\u2010being occupies a central position in the psychological network of breast cancer patients, and social avoidance shows the strongest bridging function between spiritual resources and emotional symptoms. These findings support the integration of spiritual assessment and targeted avoidance\u2010reduction strategies into supportive care. Future research should validate these networks in larger samples and develop node\u2010specific interventions to improve psychological adjustment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/da\/9076098","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T08:48:56Z","timestamp":1786092536000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Network Analysis of Social Anxiety, Avoidant Behavior, and Spiritual Well\u2010Being in Breast Cancer Patients: A Pathway to Targeted Psychosocial Interventions"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9761-9261","authenticated-orcid":false,"given":"Cheng","family":"Yang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0722-4751","authenticated-orcid":false,"given":"Jiawei","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9688-3863","authenticated-orcid":false,"given":"Yang","family":"Wen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2596-4612","authenticated-orcid":false,"given":"Peijin","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4113-311X","authenticated-orcid":false,"given":"Qin","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"e_1_2_11_1_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD008729.pub3"},{"key":"e_1_2_11_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13167-024-00386-0"},{"key":"e_1_2_11_3_2","first-page":"993","article-title":"Assessment of Overall Functioning in Patients With Chronic Diseases Based on the WHO Disability Assessment Schedule 2.0","volume":"25","author":"Yueying X.","year":"2019","journal-title":"Chinese Journal of Rehabilitation Theory and Practice"},{"key":"e_1_2_11_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41523-025-00804-0"},{"key":"e_1_2_11_5_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003504"},{"key":"e_1_2_11_6_2","doi-asserted-by":"publisher","DOI":"10.20892\/j.issn.2095-3941.2020.0523"},{"key":"e_1_2_11_7_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41416-021-01542-3"},{"key":"e_1_2_11_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.compbiomed.2021.104266"},{"key":"e_1_2_11_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jncc.2022.06.002"},{"key":"e_1_2_11_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-025-06821-4"},{"key":"e_1_2_11_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.34934"},{"key":"e_1_2_11_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.35508"},{"key":"e_1_2_11_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djab100"},{"key":"e_1_2_11_14_2","doi-asserted-by":"publisher","DOI":"10.62347\/NLDK3210"},{"key":"e_1_2_11_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5663"},{"key":"e_1_2_11_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/bjhp.12719"},{"key":"e_1_2_11_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bodyim.2020.11.010"},{"key":"e_1_2_11_18_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41523-024-00698-4"},{"key":"e_1_2_11_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2022.103781"},{"key":"e_1_2_11_20_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21663"},{"key":"e_1_2_11_21_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12966-022-01350-9"},{"key":"e_1_2_11_22_2","doi-asserted-by":"crossref","DOI":"10.1037\/met0000555","article-title":"A General Monte Carlo Method for Sample Size Analysis in the Context of Network Models","volume":"31","author":"Constantin M. 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