Social constraints and quality of life among chinese-speaking breast cancer survivors: a mediation model Jin You • Qian Lu Accepted: 14 April 2014 / Published online: 29 April 2014 Ó Springer International Publishing Switzerland 2014 Abstract Purpose Literature has revealed detrimental effects of unsupportive interpersonal interactions on adjustment to cancer. However, no studies have examined this effect and the underlying psychological pathways among Chinese- speaking breast cancer survivors. The study investigated the relationship between social constraints and adjustment to cancer and the underlying psychological pathways among Chinese-speaking breast cancer survivors. Methods Chinese-speaking breast cancer survivors (N = 120) completed a questionnaire package assessing social constraints, intrusive thoughts, affect, and quality of life. Results Results revealed a negative relationship between social constraints and quality of life. Such a relationship between social constraints and quality of life was mediated by negative affect and intrusive thoughts, while the asso- ciation of intrusive thoughts and quality of life were completely mediated by positive and negative affect. Conclusion Findings highlight the negative association between unsupportive interpersonal interactions and adjustment through cognitive and affective pathways among Chinese-speaking breast cancer survivors. Keywords Unsupportive interpersonal interaction Á Social constraints Á Intrusive thoughts Á Adjustment Á Affect Á Minority breast cancer survivors Introduction A diagnosis of breast cancer, as a traumatic event, always poses a variety of physical and psychological challenges. Survivors are physically tormented by disease symptoms and cancer treatment. They are also psychologically bur- dened by a variety of disease-related concerns such as fear of recurrence, challenges of world view, and extreme emotional distress [1]. Social cognitive processing theory argues that unsupportive interactions may hinder adjust- ment to cancer by interrupting the cognitive processing of trauma [2], but the adverse effects of unsupportive inter- actions are relatively understudied. Social constraints refer to the objective existence and subjective construal of social conditions (e.g., unwanted support, negative interactions) that lead individuals to refrain from or modify their disclosure of trauma-related concerns or feelings [3]. Social constraints have displayed strong associations with more intense emotional distress and worse psychological well-being among cancer survi- vors [4–6]. However, the psychological pathways under- lying these associations are unclear. Furthermore, studies are primarily conducted with non-Hispanic whites, and no studies have been conducted with Chinese-speaking breast cancer survivors. Literature has shown that Chinese American breast cancer survivors express more concerns about cancer and possess fewer opportunities for disclosing their concerns to others than do Caucasian counterparts [7–10], suggesting the prevalence of social constraints among Chinese American breast cancer survivors. Quality of life, as an index of self-assessed health status, is one of the most sensitive parameters of adjustment to cancer [11, 12], cancer-related morbidity, and mortality [13–15]. Thus, this study investigated the relationship between social J. You Department of Psychology, Wuhan University, Wuhan, Hubei, China e-mail: jyou@whu.edu.cn Q. Lu (&) Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX 77204, USA e-mail: qlu3@uh.edu 123 Qual Life Res (2014) 23:2577–2584 DOI 10.1007/s11136-014-0698-4