Type C Personality and Depression Among Newly Diagnosed Breast Cancer Patients: The Mediating Role of Sense of Coherence

Figures & data

Figure 1 A structural model pathway for mediating the role of SOC in the relationship of type C personality and depression. a: The relationship between type C personality and SOC; b: The relationship between SOC and depression; c: The relationship between type C personality and depression; c’: The relationship between type C personality and depression after adopting SOC as a mediator.

Table 1 Demographic Characteristics of the Participants (N = 575)

Factors	Group	n	%
Age	18–29	84	14.6
	30–39	142	24.7
	40–49	195	33.9
	50–59	106	18.5
	60–69	34	5.9
	70–78	14	2.4
Gender	Male	9	1.6
	Female	566	98.4
Spouse Status	Have	456	79.3
	No	119	20.7
Degree of Education	Elementary school or below	154	26.8
	Junior high school	127	22.1
	High school	122	21.2
	Undergraduate college	167	29.0
	Postgraduate or above	5	0.9
Type of Surgery	Mastectomy	367	63.8
	Lumpectomy	208	36.2
Monthly Income (RMB)	<3000	296	51.5
	3,000–5,000	145	25.2
	5,000–10,000	122	21.2
	10,000–20,000	9	1.6
	>20,000	3	0.5
Occupation	Worker	59	10.3
	Civil servant	57	9.9
	Peasant	185	32.2
	Merchant	33	5.7
	Medical staff	41	7.1
	Teacher	27	4.7
	Other	173	30.1
Inhabitance	Rural	326	56.7
	Urban	249	43.3

Table 2 Correlation Between Main Variables of CB, SOC and HAMD (N = 575)

	1	2	3	4	5	6	7	8	9	10	11	12	13	14	15	16	17	18	19	20	21	22
1 CB	–
2 Anxiety	0.66^a	–
3 Depression	0.73^a	0.29^a	–
4 Anger	0.65^a	0.37^a	0.36^a	–
5 Exin-anger	0.68^a	0.33^a	0.37^a	0.39^a	–
6 Exout-anger	0.69^a	0.38^a	0.41^a	0.40^a	0.47^a	–
7 Rational	0.67^a	0.38^a	0.35^a	0.28^a	0.43^a	0.43^a	–
8 Control	0.67^a	0.36^a	0.47^a	0.39^a	0.43^a	0.41^a	0.35^a	–
9 Optimism	0.65^a	0.35^a	0.43^a	0.39^a	0.43^a	0.42^a	0.34^a	0.46^a	–
10 Social Support	0.69^a	0.33^a	0.43^a	0.39^a	0.56^a	0.44^a	0.40^a	0.52^a	0.52^a	–
11 SOC	−0.41^a	−0.22^a	−0.27^a	−0.27^a	−0.38^a	−0.35^a	−0.21^a	−0.31^a	−0.27^a	−0.33^a	–
12 Comprehensibility	−0.35^a	−0.20^a	−0.24^a	−0.24^a	−0.34^a	−0.32^a	−0.14^a	−0.28^a	−0.21^a	−0.28^a	0.81^a	–
13 Manageability	−0.33^a	−0.16^a	−0.22^a	−0.23^a	−0.28^a	−0.28^a	−0.17^a	−0.26^a	−0.22^a	−0.26^a	0.85^a	0.54^a	–
14 Meaningfulness	−0.34^a	−0.19^a	−0.21^a	−0.20^a	−0.32^a	−0.27^a	−0.20^a	−0.22^a	−0.24^a	−0.28^a	0.82^a	0.49^a	0.55^a	–
15 HAMD	0.51^a	0.28^a	0.33^a	0.37^a	0.38^a	0.42^a	0.25^a	0.40^a	0.42^a	0.41^a	−0.58^a	−0.40^a	-0.51^a	−0.52^a	–
16 Somatization	0.38^a	0.22^a	0.28^a	0.28^a	0.26^a	0.32^a	0.13^a	0.32^a	0.34^a	0.27^a	−0.50^a	−0.37^a	−0.45^a	−0.40^a	0.86^a	–
17 Weight	0.45^a	0.27^a	0.27^a	0.32^a	0.38^a	0.39^a	0.21^a	0.36^a	0.34^a	0.34^a	−0.36^a	-0.28^a	−0.31^a	−0.31^a	0.66^a	0.57^a	–
18 Cognitive Disturbance	0.35^a	0.22^a	0.21^a	0.26^a	0.29^a	0.26^a	0.14^a	0.27^a	0.28^a	0.30^a	−0.48^a	−0.31^a	−0.41^a	−0.47^a	0.78^a	0.58^a	0.49^a	–
19 Diurnal Variation	0.45^a	0.24^a	0.25^a	0.30^a	0.39^a	0.40^a	0.25^a	0.34^a	0.37^a	0.36^a	−0.42^a	−0.34^a	−0.32^a	−0.39^a	0.53^a	0.42^a	0.52^a	0.28^a	–
20 Retardation	0.38^a	0.20^a	0.25^a	0.29^a	0.24^a	0.33^a	0.22^a	0.30^a	0.30^a	0.29^a	−0.37^a	−0.23^a	−0.34^a	−0.36^a	0.74^a	0.53^a	0.36^a	0.41^a	0.35^a	–
21 Sleep Disturbance	0.44^a	0.19^a	0.31^a	0.30^a	0.30^a	0.36^a	0.27^a	0.36^a	0.36^a	0.34^a	−0.43^a	−0.28^a	−0.38^a	−0.40^a	0.74^a	0.60^a	0.35^a	0.45^a	0.36^a	0.51^a	–
22 Hopelessness	0.38^a	0.20^a	0.23^a	0.28^a	0.30^a	0.32^a	0.21^a	0.26^a	0.29^a	0.34^a	−0.45^a	−0.35^a	−0.39^a	−0.37^a	0.78^a	0.60^a	0.51^a	0.53^a	0.43^a	0.55^a	0.48^a	–

Note: ^aP < 0.01.

Abbreviations: CB, cancer behaviors scale; SOC, sense of coherence scale; HAMD, Hamilton depression scale.

Table 3 Results of Multiple Linear Regression Analysis (Enter Method) (N = 575)

Models	Variables	B(SE)	Beta	t	P	F value	Adjusted R^2
Model I	Age	0.042(0.021)	0.067	1.989	0.047	5.191^a	0.029
	Spouse Status	−1.695(0.581)	−0.098	−2.918	0.004
	Type of Surgery	1.201(0.493)	0.082	2.437	0.015
	Degree of Education	−0.187(0.209)	−0.030	−0.897	0.370
	Monthly Income	−0.711(0.270)	−0.088	−2.638	0.008
Model II	Age	0.026(0.018)	0.042	1.471	0.142	31.050^b	0.337
	Spouse Status	−1.083(0.487)	−0.063	−2.226	0.026
	Type of Surgery	0.953(0.414)	0.065	2.303	0.022
	Degree of Education	−0.217(0.174)	−0.035	−1.245	0.213
	Monthly Income	−0.264(0.227)	−0.033	−1.161	0.246
	Anxiety	0.428(0.102)	0.133	4.211	0.000
	Depression	0.252(0.116)	0.082	2.170	0.030
	Anger	0.179(0.053)	0.110	3.349	0.001
	Exin-anger	0.172(0.086)	0.076	2.002	0.046
	Exout-anger	0.305(0.079)	0.137	3.839	0.000
	Rational	0.104(0.053)	0.071	1.951	0.051
	Control	0.339(0.110)	0.111	3.090	0.002
	Optimism	0.020(0.036)	0.036	0.554	0.580
	Social Support	0.253(0.115)	0.084	2.204	0.028
Model III	Age	0.012(0.016)	0.019	0.768	0.443	47.437^b	0.486
	Spouse Status	−0.483(0.431)	−0.028	−1.121	0.263
	Type of Surgery	0.667(0.366)	0.046	1.822	0.069
	Degree of Education Monthly	−0.268(0.154)	−0.044	−1.743	0.082
	Income	0.073(0.202)	0.009	0.359	0.720
	Anxiety	0.354(0.090)	0.110	3.921	0.000
	Depression	0.247(0.103)	0.081	2.410	0.016
	Anger	0.148(0.047)	0.091	3.130	0.002
	Exin-anger	0.070(0.076)	0.031	0.915	0.361
	Exout-anger	0.225(0.071)	0.101	3.188	0.001
	Rational	0.045(0.047)	0.031	0.956	0.339
	Control	0.299(0.097)	0.098	3.079	0.002
	Optimism	0.009(0.032)	0.009	0.293	0.770
	Social Support	0.142(0.102)	0.047	1.396	0.163
	Comprehensibility	−0.197(0.072)	−0.075	−2.727	0.007
	Manageability	−0.495(0.084)	−0.192	−5.897	0.000
	Meaningfulness	−0.694(0.083)	−0.254	−8.368	0.000

Notes: The variable of age was entered as a continuous variable. The other sociodemographic variables were entered as categorical variables. Spouse Status (0: no, 1: have); Type of Surgery (1: Lumpectomy, 2: mastectomy); Degree of Education (1: elementary school or below, 2: junior high school, 3: high school, 4: undergraduate college, 5: postgraduate or above); Monthly Income (1: <3,000, 2: 3,000–5,000, 3: 5,000–10,000, 4: 10,000–20,000, 5: >20,000). ^aP < 0.01; ^bP < 0.001.

Table 4 The Goodness-of-Fit Indices of the SEM (N = 575)

Index	χ^2/Df	GFI	AGFI	RMSEA	NFI	CFI	IFI
Statistical value	2.970	0.951	0.938	0.047	0.911	0.939	0.939

Notes: An SEM was considered to have a good fit if all path coefficients were significant at the level of 0.05; χ²/df, was <3; the root-mean-square error of approximation (RMSEA) was <0.08; as well as the goodness-of-fit index (GFI), the adjusted goodness-of-fit index (AGFI); the normed fit index (NFI), the comparative fit index (CFI) and the incremental fit index (IFI) were ≥0.90.

Table 5 The Standardized Total, Indirect, and Direct Effects Among Type C Personality, SOC and Depression (N = 575)

Model Pathway		Point Estimate	Product of Coefficients		Bootstrap^a
					Bias-Corrected 95% CI		Percentile 95% CI
			SE	Z	Lower	Upper	Lower	Upper
Total effect	CB→HAMD	0.594	0.037	16.054	0.516	0.662	0.516	0.662
Indirect effect	CB→HAMD	0.269	0.036	7.472	0.203	0.344	0.201	0.341
Direct effect	CB→HAMD	0.323	0.044	7.341	0.236	0.410	0.235	0.409
	CB→SOC	−0.524	0.039	−13.435	−0.593	−0.443	−0.594	−0.443
	SOC→HAMD	−0.514	0.054	−9.518	−0617	−0.405	−0.617	−0.405

Note: ^aNumber of bootstrap samples: 2000.

Abbreviations: CB, cancer behaviors scale; SOC, sense of coherence scale; HAMD, Hamilton depression scale.

Figure 2 Pathway coefficients of the SEM (N = 575).

Abbreviations: CB, cancer behaviors scale; SOC, sense of coherence scale; HAMD, Hamilton depression scale; e1–e19, measurement errors of observed variables; e20–e21, residuals that may affect the latent variables.