Personality characteristics, alexithymia and anxiety/depression in breast cancer patients undergoing radiotherapy: a cross-sectional mediation analysis

Vollständiger Abstract

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Objective This study aims to explore the relationship between personality characteristics and both anxiety and depression in breast cancer patients undergoing radiotherapy after surgery, and to assess the indirect effects of alexithymia. Methods This cross-sectional study was conducted in the Department of Radiation Oncology from January 2024 to May 2024. A convenient sampling method was used to recruit breast cancer patients receiving radiotherapy after surgery. Participants completed the survey during the last two weeks of their treatment. Personality characteristics were assessed using the Eysenck Personality Questionnaire (EPQ), alexithymia using the Toronto Alexithymia Scale (TAS-26), and anxiety/depression using the Hospital Anxiety and Depression Scale (HADS). Correlation and mediation analyses of anxiety, depression, personality characteristics, and alexithymia were conducted using SPSS version 27.0 with the PROCESS macro. Results A total of 231 patients were included in the analysis. The rates of probable anxiety and depression among breast cancer patients undergoing radiotherapy after surgery were 34.6% and 51.5%, respectively. Neuroticism and psychoticism were positively correlated with both anxiety and depression (r ranging from 0.246 to 0.571, all P <.05), while extraversion was negatively correlated with depression (r = -0.208, P <.01). Alexithymia was positively associated with both anxiety and depression (r = 0.294 and 0.407, respectively, both P <.001). Mediation analysis revealed that alexithymia showed significant indirect effects in the relationships among personality characteristics, anxiety, and depression (indirect effects: -0.027 to 0.020, all 95% confidence intervals excluded 0). Conclusions This study suggests that personality characteristics are associated with anxiety and depression in breast cancer patients undergoing radiotherapy, with alexithymia showing significant indirect effects in these relationships. Given the cross-sectional design, these findings represent indirect associations rather than causal pathways.