The effects of posttraumatic stress symptoms on anxiety and depression in patients with breast cancer: mediating role of negative interpretation bias

Abstract

Background: This study examined the associations between posttraumatic stress symptoms (PTSS), anxiety, depression, and negative interpretation bias in breast cancer patients, with a specific focus on the potential mediating role of negative interpretation bias. Methods: Eighty breast cancer patients completed a cross-sectional assessment including the Impact of Event Scale (IES), the Hospital Anxiety and Depression Scale (HADS), and an ambiguous emotional face recognition task. Participants were categorized into PTSS and non-PTSS groups based on IES scores. Data were analyzed using descriptive statistics, independent-samples t-tests, ANOVA, and mediation analyses (PROCESS Model 4, 5,000 bootstraps, 95% CI). Results: Patients with PTSS reported significantly higher levels of anxiety and depression, and demonstrated a stronger tendency to interpret ambiguous emotional expressions in a negative manner. Negative interpretation bias partially mediated the association between PTSS and emotional distress. Conclusions: Breast cancer patients with PTSS tend to experience heightened emotional distress, which may be partly accounted for by negative interpretation bias. Additional psychological and physiological mechanisms may also contribute.