Academic Journal

The Role of Emotional Entitlement, Gratitude, and Social Support in Psychological Adjustment During Radiotherapy: A Longitudinal Study.

Λεπτομέρειες βιβλιογραφικής εγγραφής
Τίτλος: The Role of Emotional Entitlement, Gratitude, and Social Support in Psychological Adjustment During Radiotherapy: A Longitudinal Study.
Συγγραφείς: Laslo-Roth R; School of Behavioral Sciences, Peres Academic Center, Rehovot, Israel., George-Levi S; Department of Psychology, Achva Academic College, Yinon, Israel., Elimelech L; School of Behavioral Sciences, Peres Academic Center, Rehovot, Israel., Loncich YG; Radiation Oncology Department, Samson Assuta Ashdod University Hospital, Ashdod, Israel., Wiskop-Farkash N; Radiation Oncology Department, Samson Assuta Ashdod University Hospital, Ashdod, Israel., Sultan M; Radiation Oncology Department, Samson Assuta Ashdod University Hospital, Ashdod, Israel., Sapir E; Radiation Oncology Department, Samson Assuta Ashdod University Hospital, Ashdod, Israel.
Πηγή: Stress and health : journal of the International Society for the Investigation of Stress [Stress Health] 2026 Aug; Vol. 42 (4), pp. e70207.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: John Wiley & Sons Country of Publication: England NLM ID: 101089166 Publication Model: Print Cited Medium: Internet ISSN: 1532-2998 (Electronic) Linking ISSN: 15323005 NLM ISO Abbreviation: Stress Health Subsets: MEDLINE
Imprint Name(s): Original Publication: Chichester, West Sussex, UK : John Wiley & Sons, c2001-
Ιατρικοί όροι (MeSH): Depression*/psychology , Anxiety*/psychology , Neoplasms*/radiotherapy , Neoplasms*/psychology , Radiotherapy*/psychology , Social Support* , Personal Satisfaction* , Emotions* , Emotional Adjustment* , Adaptation, Psychological*, Humans ; Female ; Longitudinal Studies ; Middle Aged ; Male ; Aged ; Adult ; Resilience, Psychological
Περίληψη: A cancer diagnosis is frequently accompanied by significant psychological distress, particularly during radiotherapy (RT). Given that many established risk factors for distress are largely immutable, identifying resilience resources that promote adjustment during RT is a central clinical priority. The present longitudinal study examined whether emotional entitlement, gratitude, and perceived social support predict end-of-treatment anxiety, depression, and life satisfaction beyond baseline psychological status. Participants were 146 cancer patients undergoing RT (Mean age = 56.17 years, SD = 11.65; 89.9% female). Data were collected at three time points across the RT regimen: at the pre-treatment RT simulation session, during the first RT session, and at treatment completion, approximately 3-6 weeks later. Measures included anxiety and depression symptoms, life satisfaction, emotional entitlement, gratitude, and perceived social support. Results indicated that anxiety decreased and life satisfaction increased from baseline to treatment completion, whereas depressive symptoms remained stable over time. Hierarchical regression analyses were performed to predict post-treatment outcomes while controlling baseline levels of the respective variables. Across all models, baseline psychological status emerged as a robust predictor of end-of-treatment outcomes. However, resilience resources contributed additional explanatory power for depression and life satisfaction. Higher emotional entitlement to positive emotions predicted greater life satisfaction and lower depressive symptoms, whereas reduced perceived friend support was associated with higher depression. Unexpectedly, higher gratitude was associated with lower life satisfaction at treatment completion. In contrast, anxiety was predicted exclusively by baseline anxiety. These findings suggest distinct predictive patterns across psychological outcomes during RT. Whereas end-of-treatment anxiety was predicted primarily by initial anxiety levels, depression and life satisfaction were also associated with modifiable emotional and interpersonal resources. The results underscore the importance of early psychological screening and targeted psychosocial interventions aimed at strengthening emotional resources and peer support during radiotherapy.
(© 2026 The Author(s). Stress and Health published by John Wiley & Sons Ltd.)
References: Arora, N. K., L. J. Finney Rutten, D. H. Gustafson, R. Moser, and R. P. Hawkins. 2007. “Perceived Helpfulness and Impact of Social Support Provided by Family, Friends, and Health Care Providers to Women Newly Diagnosed With Breast Cancer.” Psycho‐Oncology 16, no. 5: 474–486. https://doi.org/10.1002/pon.1084.
Boakye, E. A., K. M. Polednik, T. L. Deshields, et al. 2022. “Emotional Distress Among Survivors of Adolescent and Young Adult Cancer or Adult Cancer.” Annals of Epidemiology 72: 48–56. https://doi.org/10.1016/j.annepidem.2022.03.014.
Brajković, L., K. Milat‐Panža, and V. Kopilaš. 2023. “Subjective Well‐Being in Cancer Patients: The Roles of Social Support, Purpose in Life, Resilience, and Informativeness.” Healthcare 11, no. 24: 3181. https://doi.org/10.3390/healthcare11243181.
Chandra, R. A., F. K. Keane, F. E. M. Voncken, and C. R. Thomas Jr. 2021. “Contemporary Radiotherapy: Present and Future.” Lancet 398, no. 10295: 171–184. https://doi.org/10.1016/S0140‐6736(21)00233‐6.
Chuang, E. Y., P. Y. Hou, P. W. Shueng, et al. 2024. “Improved Quality of Life in Head and Neck Cancer Patients Treated With Modern Arc Radiotherapy Techniques—A Prospective Longitudinal Analysis.” Frontiers in Oncology 14: 1424034. https://doi.org/10.3389/fonc.2024.1424034.
Cook, S. A., P. Salmon, G. Hayes, A. Byrne, and P. L. Fisher. 2018. “Predictors of Emotional Distress a Year or More After Diagnosis of Cancer: A Systematic Review of the Literature.” Psycho‐Oncology, 27, no. 3: 791–801. https://doi.org/10.1002/pon.4601.
Cousin, L., D. Braithwaite, S. Anton, et al. 2024. “A Pilot Study of a Gratitude Journaling Intervention to Enhance Spiritual Well‐Being and Exercise Self‐Efficacy in Black Breast Cancer Survivors.” BMC Psychiatry 24, no. 1: 931. https://doi.org/10.1186/s12888‐024‐06362‐2.
Curran, L., L. Sharpe, and P. Butow. 2017. “Anxiety in the Context of Cancer: A Systematic Review and Development of an Integrated Model.” Clinical Psychology Review 56: 40–54. https://doi.org/10.1016/j.cpr.2017.06.003.
Diener, E., R. A. Emmons, R. J. Larsen, and S. Griffin. 1985. “The Satisfaction With Life Scale.” Journal of Personality Assessment 49, no. 1: 71–75. https://doi.org/10.1207/s15327752jpa4901_13.
Fredrickson, B. L. 2001. “The Role of Positive Emotions in Positive Psychology: The Broaden‐and‐Build Theory of Positive Emotions.” American Psychologist 56, no. 3: 218–226. https://doi.org/10.1037/0003‐066X.56.3.218.
Fredrickson, B. L. 2025. Positive Emotions: Key Scientific Contributions and the Stories Behind Them. Oxford University Press. https://doi.org/10.1093/9780197754825.001.0001.
Fredrickson, B. L., and T. Joiner. 2018. “Reflections on Positive Emotions and Upward Spirals.” Perspectives on Psychological Science 13, no. 2: 194–199. https://doi.org/10.1177/1745691617692106.
Garnefski, N., and V. Kraaij. 2018. “Specificity of Relations Between Adolescents' Cognitive Emotion Regulation Strategies and Symptoms of Depression and Anxiety.” Cognition & Emotion 32, no. 7: 1401–1408. https://doi.org/10.1080/02699931.2016.1232698.
Hinz, A., P. Y. Herzberg, F. Lordick, et al. 2019. “Age and Gender Differences in Anxiety and Depression in Cancer Patients Compared With the General Population.” European Journal of Cancer Care 28, no. 5: e13129. https://doi.org/10.1111/ecc.13129.
Huang, Y., M. Xie, L. Wen, L. Yang, and S. Zhang. 2025. “Exploring Emotional Entitlement: Validity Evidence for the Chinese EEQ and Its Influence on University Students’ Mental Health.” Measurement and Evaluation in Counseling and Development 59: 1–15. https://doi.org/10.1080/07481756.2025.2509511.
Kawachi, I., and L. F. Berkman. 2001. “Social Ties and Mental Health.” Journal of Urban Health Bulletin of the New York Academy of Medicine 78, no. 3: 458–467. https://doi.org/10.1093/jurban/78.3.458.
Kim, K., and H. Park. 2021. “Factors Affecting Anxiety and Depression in Young Breast Cancer Survivors Undergoing Radiotherapy.” European Journal of Oncology Nursing 50: 101898. https://doi.org/10.1016/j.ejon.2021.101898.
Laslo‐Roth, R., and S. George‐Levi. 2024. “The Development and Validation of the Emotional Entitlement Questionnaire (EEQ).” Emotion 24, no. 8: 1853–1867. https://doi.org/10.1037/emo0001394.
Lazarus, R. S., and S. Folkman. 1984. Stress, Appraisal, and Coping. Springer Publishing Company.
Lee, A. R. Y. B., C. E. Yau, C. E. Low, J. Li, R. C. M. Ho, and C. S. H. Ho. 2023. “Severity and Longitudinal Course of Depression, Anxiety and Post‐Traumatic Stress in Paediatric and Young Adult Cancer Patients: A Systematic Review and Meta‐Analysis.” Journal of Clinical Medicine 12, no. 5: 1784. https://doi.org/10.3390/jcm12051784.
Li, J., X. Li, J. Chen, Y. Zhang, Y. Yao, and H. Yang. 2025. “Psychological Distress and Its Influencing Factors in Esophageal Cancer Patients Undergoing Radiotherapy: A Longitudinal Study.” Frontiers in Oncology 5: 1582870. https://doi.org/10.3389/fonc.2025.1582870.
Liang, J., L. Li,, F. Yang, et al. 2025. “Longitudinal Effects of Psychological Intervention During Radiotherapy on Anxiety, Depression and Quality of Life in Patients With Breast Cancer.” International Journal of Psychiatry in Medicine: 00912174251408971. https://doi.org/10.1177/0091274251408971.
McCullough, M. E., S. D. Kilpatrick, R. A. Emmons, and D. B. Larson. 2001. “Is Gratitude a Moral Affect?” Psychological Bulletin 127, no. 2: 249–266. https://doi.org/10.1037/0033‐2909.127.2.249.
McCullough, M. E., R. A. Emmons, and J.‐A. Tsang. 2002. “The Grateful Disposition: A Conceptual and Empirical Topography.” Journal of Personality and Social Psychology 82, no. 1: 112–127. https://doi.org/10.1037/0022‐3514.82.1.112.
Mungase, M., S. Chaudhury, A. A. Patil, B. Jagtap, and V. Jain. 2021. “Stress, Anxiety, Depression, and Resilience in Cancer Patients on Radiotherapy.” Industrial Psychiatry Journal 30, no. 2: 346–352. https://doi.org/10.4103/ipj.ipj_78_20.
Naser, A. Y., A. N. Hameed, N. Mustafa, et al. 2021. “Depression and Anxiety in Patients With Cancer: A Cross‐Sectional Study.” Frontiers in Psychology 12: 585534. https://doi.org/10.3389/fpsyg.2021.585534.
Niedzwiedz, C. L., L. Knifton, K. A. Robb, S. V. Katikireddi, and D. J. Smith. 2019. “Depression and Anxiety Among People Living With and Beyond Cancer: A Growing Clinical and Research Priority.” BMC Cancer 19, no. 1: 943. https://doi.org/10.1186/s12885‐019‐6181‐4.
Phoosuwan, N., and P. C. Lundberg. 2023. “Life Satisfaction, Body Image and Associated Factors Among Women With Breast Cancer After Mastectomy.” Psycho‐Oncology 32, no. 4: 610–618. https://doi.org/10.1002/pon.6106.
Pitman, A., S. Suleman, N. Hyde, and A. Hodgkiss. 2018. “Depression and Suicide in Patients With Cancer.” Lancet Psychiatry 5, no. 3: 243–257. https://doi.org/10.1136/bmj.k1488.
Prinzing, M., K. Le Nguyen, and B. L. Fredrickson. 2023. “Does Shared Positivity Make Life More Meaningful? Perceived Positivity Resonance Is Uniquely Associated With Perceived Meaning in Life.” Journal of Personality and Social Psychology 125, no. 2: 345–366. https://doi.org/10.1037/pspi0000418.
Riley, K. E., C. L. Park, C. C. Wong, and B. S. Russell. 2022. “Mindfulness, Self‐Distancing, and Self‐Compassion as Buffers of the Effects of Rumination on Health Behaviors: A Daily Diary Study.” International Journal of Cognitive Therapy 15, no. 3: 277–303. https://doi.org/10.1007/s41811‐022‐00142‐0.
Rook, K. S. 2018. “Stressful Aspects of Older Adults’ Social Relationships: Current Theory and Research.” In Stress and Coping in later‐life Families, 173–192. Taylor & Francis.
Ruiz‐Rodríguez, I., I. Hombrados‐Mendieta, A. Melguizo‐Garín, and M. J. Martos‐Méndez. 2022. “The Importance of Social Support, Optimism and Resilience on the Quality of Life of Cancer Patients.” Frontiers in Psychology 13: 833176. https://doi.org/10.3389/fpsyg.2022.833176.
Sampson, R., F. E. McDonald, V. O. Mancini, P. M. McEvoy, and A. L. Finlay‐Jones. 2025. “The Role of Friends in Supporting Young People With Cancer: A Scoping Review.” Psycho‐Oncology 34, no. 2: e70107. https://doi.org/10.1002/pon.70107.
Shariatmadari, H., Z. Taheri‐Kharameh, N. Kamaliuon, B. A. Ghanbari Hashem Abadi, and M. Shokouhi‐Tabar. 2025. “Comparing the Effectiveness of Gratitude Intervention and Behavioral Activation Technique in Breast Cancer Patients: A Randomized Trial.” BMC Cancer 25, no. 1: 1226. https://doi.org/10.1186/s12885‐025‐14492‐3.
Siegel, R. L., T. B. Kratzer, A. N. Giaquinto, H. Sung, and A. Jemal. 2025. “Cancer Statistics, 2025.” CA: A Cancer Journal for Clinicians 75, no. 1: 10–45. https://doi.org/10.3322/caac.21871.
Silva, S., A. Bartolo, I. M. Santos, A. Pereira, and S. Monteiro. 2022. “Towards a Better Understanding of the Factors Associated With Distress in Elderly Cancer Patients: A Systematic Review.” International Journal of Environmental Research and Public Health 19, no. 6: 3424. https://doi.org/10.3390/ijerph19063424.
Taylor, S. E. 2011. “Social Support: A Review.” In The Oxford Handbook of Health Psychology, edited by H. S. Friedman, 189–214. Oxford University Press.
Tian, X., X. Zhou, M. Sun, et al. 2024. “The Effectiveness of Positive Psychological Interventions for Patients With Cancer: A Systematic Review and Meta‐Analysis.” Journal of Clinical Nursing 33, no. 9: 3752–3774. https://doi.org/10.1111/jocn.17358.
Uchino, B. N. 2009. “Understanding the Links Between Social Support and Physical Health: A Life‐Span Perspective With Emphasis on the Separability of Perceived and Received Support.” Perspectives on Psychological Science4, no. 3: 236–255. https://doi.org/10.1111/j.1745‐6924.2009.01122.x.
Van Cappellen, P., E. L. Rice, L. I. Catalino, and B. L. Fredrickson. 2018. “Positive Affective Processes Underlie Positive Health Behaviour Change.” Psychology and Health 33, no. 1: 77–97. https://doi.org/10.1080/08870446.2017.1320798.
Wang, S. J., X. Feng, W. Zhang, et al. 2025. “Depression and Anxiety in Patients With Breast Cancer Receiving Radiotherapy: A Longitudinal Study.” Therapeutic Advances in Medical Oncology 17: 17588359251345930. https://doi.org/10.1177/17588359251345930.
Wong, Y. J. 2023. “The Catalyst Model of Change: Gratitude Interventions With Positive Long‐Term Effects.” Affective Science 4, no. 1: 152–162. https://doi.org/10.1007/s42761‐022‐00136‐3.
Zhang, L., N. Zhu, W. Li, C. Li, and F. Kong. 2022. “Cognitive‐Affective Structure of Gratitude and Its Relationships With Subjective Well‐Being.” Personality and Individual Differences 196: 111758. https://doi.org/10.1016/j.paid.2022.111758.
Zigmond, A. S., and R. P. Snaith. 1983. “The Hospital Anxiety and Depression Scale.” Acta Psychiatrica Scandinavica 67, no. 6: 361–370. https://doi.org/10.1111/j.1600‐0447.1983.tb09716.x.
Zimet, G. D., N. W. Dahlem, S. G. Zimet, and G. K. Farley. 1988. “The Multidimensional Scale of Perceived Social Support.” Journal of Personality Assessment 52, no. 1: 30–41. https://doi.org/10.1207/s15327752jpa5201_2.
Zingler, H., D. Steinmann, J. Ernst, et al. 2025. “Psychosocial Distress, Perceived Need and Utilization of Psycho‐ Social Support Services in Patients in the Early Phase After the First Cancer Diagnosis.” Journal of Cancer Research and Clinical Oncology 151, no. 2: 65. https://doi.org/10.1007/s00432‐025‐06107‐y.
Contributed Indexing: Keywords: anxiety; depression; emotional entitlement; gratitude; life satisfaction; radiation therapy; social support
Entry Date(s): Date Created: 20260714 Date Completed: 20260714 Latest Revision: 20260726
Update Code: 20260726
PubMed Central ID: PMC13366011
DOI: 10.1002/smi.70207
PMID: 42444262
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:1532-2998
DOI:10.1002/smi.70207