{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T19:15:31Z","timestamp":1771528531783,"version":"3.50.1"},"reference-count":40,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:00:00Z","timestamp":1771459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"he Sichuan Mental Health Education Research Center","award":["XLJKJY2358C"],"award-info":[{"award-number":["XLJKJY2358C"]}]},{"name":"the Sichuan Applied Psychology Research Center","award":["CSXL-212A14)"],"award-info":[{"award-number":["CSXL-212A14)"]}]},{"name":"Chengdu University of Traditional Chinese Medicine Apricot Grove Scholars","award":["XJ2023001801"],"award-info":[{"award-number":["XJ2023001801"]}]},{"name":"ichuan Nursing Association research project","award":["H23036"],"award-info":[{"award-number":["H23036"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Background<\/jats:title>\n Breast cancer is a major global health issue. It brings death threats or serious physical injuries to patients, and is a traumatic event that can seriously affect their mental health and lead to post-traumatic stress, which can lead to serious physical, psychological, cognitive, and social dysfunction, and even increase the risk of suicide, and impose a heavy burden on patients and their families.<\/jats:p>\n <\/jats:sec>\n \n Aim<\/jats:title>\n To investigate the mediating effect of experiential avoidance between self-concealment and post-traumatic stress symptoms in breast cancer patients.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This study used a cross-sectional survey design. From 15\/08\/2021 to 31\/12\/2021, breast cancer patients were recruited as study subjects in the oncology department of a tertiary hospital in Deyang City. Data were collected through the following tools: the general information questionnaire, the Impact of Event Scale-Revised, the Self-Concealment Scale, and the Acceptance and Action Questionnaire-Second Edition.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n 257 breast cancer patients eventually completed the study, all females. Descriptive results showed that breast cancer patients had self-concealment scores (24.75\u2009\u00b1\u20097.34), experiential avoidance scores (18.48\u2009\u00b1\u20095.44), and post-traumatic stress symptoms scores (32.29\u2009\u00b1\u200914.14). Pearson correlation analyses showed that self-concealment was positively correlated with experiential avoidance and traumatic stress response (r\u2009=\u20090.343, 0.467, both P\u2009<\u20090.01); experiential avoidance was positively correlated with traumatic stress response (r\u2009=\u20090.534, P\u2009<\u20090.01). Mediation effect analyses showed that the total effect of self-concealment on post-traumatic stress symptoms was 0.453, with a direct effect path coefficient of 0.310, and the mediation effect path coefficient of experiential avoidance between self-concealment and post-traumatic stress symptoms was 0.142 (95% CI: 0.074 to 0.223), accounting for 31.35% of the total effect.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Experiential avoidance in breast cancer patients mediates the relationship between self-concealment and posttraumatic stress symptoms. and could guide healthcare professionals in developing tailored interventions to improve the mental health of patients.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0342971","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T18:25:00Z","timestamp":1771525500000},"page":"e0342971","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["The effect of self-concealment on post-traumatic stress symptoms in breast cancer patients: The mediating role of experiential avoidance"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0253-8201","authenticated-orcid":true,"given":"Fan","family":"Xu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaoju","family":"Xie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiao","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoli","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2533-0631","authenticated-orcid":true,"given":"Jiquan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,2,19]]},"reference":[{"issue":"3","key":"pone.0342971.ref001","first-page":"229","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"F Bray","year":"2024","journal-title":"CA Cancer J Clin"},{"issue":"9","key":"pone.0342971.ref002","first-page":"4115","article-title":"Post-traumatic stress symptoms and social constraints in the communication with family caregivers among Chinese-speaking breast cancer survivors","volume":"28","author":"C Acquati","year":"2020","journal-title":"Support Care Cancer"},{"key":"pone.0342971.ref003","doi-asserted-by":"crossref","first-page":"1414","DOI":"10.1007\/978-3-030-22009-9_419","article-title":"Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5).","volume-title":"Encyclopedia of Gerontology and Population Aging","author":"F. 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