The role of social support, family identification, and family constraints in predicting post-traumatic stress after cancer

Objective: We compared social support with other potential psychosocial predictors of post-traumatic stress after cancer. These included family identification, or a sense of belonging to and commonality with family members, and family constraints, or the extent to which family members are closed, judgmental, or unreceptive in conversations about cancer. We also tested the hypothesis that family constraints mediate the relationship between family identification and cancer-related post-traumatic stress. Methods: We used a cross-sectional design. Surveys were collected from two hundred and five colorectal cancer survivors in Tayside, Scotland. Results: Both family identification and family constraints were stronger independent predictors of post-traumatic stress than social support. In multivariate analyses, social support was not a significant independent predictor of post-traumatic stress. In addition, there was a significant indirect effect of family identification on post-traumatic stress through family constraints. Conclusions: Numerous studies demonstrate a link between social support and post-traumatic stress. However, experiences within the family may be more important in predicting post-traumatic stress after cancer. Furthermore, a sense of belonging to and commonality with the family may reduce the extent to which cancer survivors experience constraints on conversations about cancer; this may, in turn, reduce post-traumatic stress.