{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T03:30:09Z","timestamp":1781062209793,"version":"3.54.1"},"reference-count":36,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,6,13]],"date-time":"2024-06-13T00:00:00Z","timestamp":1718236800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"CONAHCYT","award":["CVU 258666"],"award-info":[{"award-number":["CVU 258666"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>(1) Introduction: Cancer diagnosis has been related to depression, anxiety, and distress, as well as to post-traumatic growth (PTG). One of the mediating variables for emotional response is thought style (rumination, cognitive avoidance, and cognitive engagement). (2) Aim: To identify the relationship between thought style and emotional responses to cancer. A secondary aim was to identify the relationship between emotional responses and inflammatory immunological biomarkers. (3) Method: A total of 115 patients with cancer were included in the study. Before initiating cancer treatment, patients were assessed using the Hospital Anxiety and Depression Scale (HADS), distress thermometer, and Post-Traumatic Growth Inventory (PTGI). Patients provided their most recent blood biometry. (4) Results: Rumination correlated with anxiety, depression, and distress. Cognitive avoidance correlated with PTG (\u22120.240) and distress (\u22120.209). Cognitive engagement correlated with PTG (0.393). Regarding thought style and biomarkers, a negative correlation was observed for absolute neutrophils with cognitive avoidance (\u22120.271) and rumination (0.305). Regarding biomarkers and emotional responses, there was a negative correlation between PTG and absolute lymphocytes (\u22120.291). There was also a correlation between PTG and neutrophils (0.357) and neutrophil-to-lymphocyte ratio (NLR) (0.295). (5) Conclusions: Thought style is related to the emotional response to a cancer diagnosis; rumination is related to depression, distress, and anxiety; and cognitive engagement is related to PTG. PTG is related to inflammation and immunological biomarkers.<\/jats:p>","DOI":"10.3390\/ijerph21060763","type":"journal-article","created":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T08:52:10Z","timestamp":1718355130000},"page":"763","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Relationship between Thought Style, Emotional Response, Post-Traumatic Growth (PTG), and Biomarkers in Cancer Patients"],"prefix":"10.3390","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5806-0688","authenticated-orcid":false,"given":"Mariana","family":"Sierra-Murgu\u00eda","sequence":"first","affiliation":[{"name":"Cancer Center Tec100, Ignacio Zaragoza 263 H16, Col. Centro, Quer\u00e9taro 76000, QE, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha L.","family":"Guevara-Sangin\u00e9s","sequence":"additional","affiliation":[{"name":"Economic Administrative Science Division, University of Guanajuato, Fraccionamiento 1, Col. El Establo S\/N, Guanajuato 36250, GJ, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4744-2351","authenticated-orcid":false,"given":"Gabriela","family":"Navarro-Contreras","sequence":"additional","affiliation":[{"name":"Health Science Division, University of Guanajuato, Blvd. Puente Milenio #1001, Fracci\u00f3n del Predio San Carlos, Le\u00f3n 37670, GJ, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo","family":"Peralta-Castillo","sequence":"additional","affiliation":[{"name":"Cancer Center Tec100, Ignacio Zaragoza 263 H16, Col. Centro, Quer\u00e9taro 76000, QE, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amalia","family":"Padilla-Rico","sequence":"additional","affiliation":[{"name":"Cancer Center Tec100, Ignacio Zaragoza 263 H16, Col. Centro, Quer\u00e9taro 76000, QE, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc\u00eda","family":"Gonz\u00e1lez-Alcocer","sequence":"additional","affiliation":[{"name":"Cancer Center Tec100, Ignacio Zaragoza 263 H16, Col. Centro, Quer\u00e9taro 76000, QE, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferr\u00e1n","family":"Padr\u00f3s-Bl\u00e1zquez","sequence":"additional","affiliation":[{"name":"Psychology Faculty, Universidad Michoacana San Nicol\u00e1s de Hidalgo, Francisco Villa 450, Col. Dr. Miguel Silva, Morelia 58120, MC, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,13]]},"reference":[{"key":"ref_1","unstructured":"American Cancer Society (2015). Cancer Facts & Figures, American Cancer Society."},{"key":"ref_2","unstructured":"NCCN (2020). Distress Management. National Comprehensive Cancer Network Guidelines, NCC. Version 2."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2083","DOI":"10.12688\/f1000research.11902.1","article-title":"Advancing psychosocial care in cancer patients","volume":"6","author":"Grassi","year":"2017","journal-title":"F1000Res"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.breast.2009.11.007","article-title":"The course of anxiety and depression over 5 years of follow-up and risk factors in women with early breast cancer: Results from the UK Standardisation of Radiotherapy Trials (START)","volume":"19","author":"Hopwood","year":"2010","journal-title":"Breast"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"81","DOI":"10.4067\/S0718-48082013000100008","article-title":"Terapia Psicol\u00f3gica Crecimiento Post-Traum\u00e1tico en Supervivientes de C\u00e1ncer y Sus Otros Significativos. \u00bfCrecimiento Vicario o Posttraumatic Growth in Cancer Survivors and Their Significant Others: Vicarious or Secondary Growth?","volume":"31","author":"Ochoa","year":"2013","journal-title":"Terapia Psicol\u00f3gica"},{"key":"ref_6","unstructured":"Calhoun, L.G., and Tedeschi, R.G. (2006). Handbook of Posttraumatic Growth: Research and Practice, Psychology Press. Lawrence Erlbaum Associates."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1007\/s00520-018-4359-y","article-title":"The role of post-traumatic growth in promoting healthy behavior for couples coping with cancer","volume":"27","author":"Won","year":"2019","journal-title":"Support. Care Cancer"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1080\/07399332.2019.1578360","article-title":"Posttraumatic Growth Experiences and Its Contextual Factors in Women with Breast Cancer: An Integrative Review","volume":"40","author":"Zhai","year":"2019","journal-title":"Health Care Women Int."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1037\/a0016909","article-title":"Cognitive Appraisals and Emotions Predict Cortisol and Immune Responses: A Meta-Analysis of Acute Laboratory Social Stressors and Emotion Inductions","volume":"135","author":"Denson","year":"2009","journal-title":"Psychol Bull."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1177\/1359105317748468","article-title":"The Affect Regulation in Cancer framework: Understanding affective responding across the cancer trajectory","volume":"25","author":"Kangas","year":"2020","journal-title":"J. Health Psychol."},{"key":"ref_11","unstructured":"DuPre, E., and Spreng, N. (2017). Spontaneous thought gets stuck with rumination. The Oxford Handbook of Spontaneous Thought: Mind-Wandering, Creativity, Dreaming, and Clinical Conditions, Oxford University."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1037\/0022-3514.85.5.909","article-title":"A Multidimensional Structure for Repetitive Thought: What\u2019s on Your Mind, and How, and How Much?","volume":"85","author":"Segerstrom","year":"2003","journal-title":"J. Pers. Soc. Psychol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1111\/bjhp.12252","article-title":"Stuck in the spin cycle: Avoidance and intrusions following breast cancer diagnosis","volume":"22","author":"Bauer","year":"2017","journal-title":"Br. J. Health Psychol."},{"key":"ref_14","unstructured":"Tomai, M., Lauriola, M., and Caputo, A. (2019). Are social support and coping styles differently associated with adjustment to cancer in early and advanced stages?. Mediterr. J. Clin. Psychol., 7."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1007\/s10879-006-9008-y","article-title":"Emotional processing theory (EPT) and exposure therapy for PTSD","volume":"36","author":"Rauch","year":"2006","journal-title":"J. Contemp. Psychother."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1023\/A:1023910315561","article-title":"Rumination Reconsidered: A psychometric analysis","volume":"27","author":"Treynor","year":"2003","journal-title":"Cognit. Ther. Res."},{"key":"ref_17","unstructured":"Martin, L.L., and Tesser, A. (1996). Ruminative Thoughts. Ruminative Thoughts: Advances in Social Cognition, Lawrence Erlbaum Associates Publishers."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.sbspro.2014.01.017","article-title":"Meaning Making and Rumination: The Roles of Threat Evaluation and Personality","volume":"113","author":"Kamijo","year":"2014","journal-title":"Procedia Soc. Behav. Sci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2452","DOI":"10.1007\/s10620-006-9477-6","article-title":"Posttraumatic growth, immunity and survival in patients with hepatoma","volume":"52","author":"Dunigan","year":"2007","journal-title":"Dig. Dis. Sci."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1016\/j.critrevonc.2013.03.010","article-title":"The systemic inflammation-based neutrophil-lymphocyte ratio: Experience in patients with cancer","volume":"88","author":"Guthrie","year":"2013","journal-title":"Crit. Rev. Oncol.\/Hematol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e036859","DOI":"10.1136\/bmjopen-2020-036859","article-title":"Neutrophil-lymphocyte ratio across psychiatric diagnoses: A cross-sectional study using electronic health records","volume":"10","author":"Brinn","year":"2020","journal-title":"BMJ Open"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Mantovani, A., Allavena, P., Sica, A., and Balkwill, F. (2008). Cancer-Related Inflammation, Nature.","DOI":"10.1038\/nature07205"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1565","DOI":"10.1126\/science.1203486","article-title":"Cancer Immunoediting: Integrating Immunity\u2019s Roles in Cancer Suppression and Promotion","volume":"331","author":"Schreiber","year":"2011","journal-title":"Science"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2651","DOI":"10.7314\/APJCP.2014.15.6.2651","article-title":"Elevated serum neutrophil to lymphocyte and platelet to lymphocyte ratios could be useful in lung cancer diagnosis","volume":"15","author":"Kemal","year":"2014","journal-title":"Asian Pac. J. Cancer Prev."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1002\/cpp.1985","article-title":"Posttraumatic Growth in Populations with Posttraumatic Stress Disorder\u2014A Systematic Review on Growth-Related Psychological Constructs and Biological Variables","volume":"23","author":"Schubert","year":"2016","journal-title":"Clin. Psychol. Psychother."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1080\/08824096.2017.1409619","article-title":"Co-rumination and Immune Inflammatory Response in Healthy Young Adults: Associations with Interleukin-6 and C-Reactive Protein","volume":"35","author":"Boren","year":"2018","journal-title":"Commun. Res. Rep."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Szabo, Y.Z., Burns, C.M., and Lantrip, C. (2022). Understanding associations between rumination and inflammation: A scoping review. Neurosci. Biobehav. Rev., 135.","DOI":"10.1016\/j.neubiorev.2022.104523"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1177\/2167702617720747","article-title":"Rumination and Psychopathology: Are Anger and Depressive Rumination Differentially Associated with Internalizing and Externalizing Psychopathology?","volume":"6","author":"Corley","year":"2018","journal-title":"Clin. Psychol. Sci."},{"key":"ref_29","first-page":"209","article-title":"Traducci\u00f3n, adaptaci\u00f3n y validaci\u00f3n del term\u00f3metro de distr\u00e9s en una muestra de pacientes mexicanos con c\u00e1ncer","volume":"62","year":"2008","journal-title":"Rev. Sanid. Mil."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1111\/j.1600-0447.1983.tb09716.x","article-title":"The Hospital Anxiety and Depression Scale","volume":"67","author":"Zigmond","year":"1983","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_31","first-page":"108","article-title":"Efectos de la terapia cognitivo conductual en el paciente oncol\u00f3gico: Una revisi\u00f3n","volume":"12","year":"2015","journal-title":"GAMO"},{"key":"ref_32","unstructured":"Guzm\u00e1n Sescosse, M., Padr\u00f3s Bl\u00e1zquez, F., Garc\u00eda Campos, T., Augusto Laca Arocena, F., Gonz\u00e1lez Betanzos, F., and Elena Rivera Heredia, M. (2015). Efecto de la Terapia de Procesamiento Cognitivo con Entrenamiento en Crecimiento Post-Traum\u00e1tico para Pacientes con Trastorno de Estr\u00e9s Post-Traum\u00e1tico, Universidad Michoacana de San Nicol\u00e1s de Hidalgo."},{"key":"ref_33","first-page":"77","article-title":"Design and psychometric properties analysis of the thought style in response to cancer inventory (Ieprac)","volume":"18","year":"2021","journal-title":"Psicooncologia (Pozuelo de Alarcon)"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/j.brat.2010.12.006","article-title":"Rumination as a transdiagnostic factor in depression and anxiety","volume":"49","author":"McLaughlin","year":"2011","journal-title":"Behav. Res. Ther."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1080\/10615806.2010.529901","article-title":"Assessing posttraumatic cognitive processes: The event related rumination inventory","volume":"24","author":"Cann","year":"2011","journal-title":"Anxiety Stress Coping"},{"key":"ref_36","first-page":"84","article-title":"\u00cdndice Linfocito-Monocito y Neutr\u00f3filo-Linfocito como predictores de mortalidad e infecci\u00f3n en pacientes hospitalizados con cirrosis hep\u00e1tica descompensados","volume":"10","year":"2018","journal-title":"Rev. M\u00e9dica MD"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/21\/6\/763\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:57:42Z","timestamp":1760108262000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/21\/6\/763"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,13]]},"references-count":36,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["ijerph21060763"],"URL":"https:\/\/doi.org\/10.3390\/ijerph21060763","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,13]]}}}