Psychological resilience and post-traumatic stress disorder as chain mediators between personality traits and cognitive functioning in patients with breast cancer.

Background: Personality is a unique behavioral trait; cognition is how an individual knows and understands things. It is essential for everyday daily living. In patients with breast cancer, despite the growing body of research on personality and cognitive functioning, exploration of the underlying mechanisms is still relatively scarce. Therefore, this study aimed to investigate the impact of Big Five personality traits on cognitive functioning and the mediating role of psychological resilience and post-traumatic stress disorder(PTSD) between personality traits and cognitive functioning in patients with breast cancer.

Methods: Convenience sampling was used, and a cross-sectional survey of 288 patients clinically diagnosed with breast cancer was conducted in the Department of Breast Surgery of the First Hospital of Jinzhou Medical University. The general information questionnaire, the Ten-Item Personality Inventory in China, the 10-item Connor-Davidson Resilience Scale, the Post-traumatic Stress Disorder Checklist-Civilian Version, and the Montreal Cognitive Assessment were used to measure the patient's general condition, personality traits, psychological resilience, PTSD, and cognitive function, respectively. Descriptive and correlation analyses were performed using SPSS 26.0 software, and mediation effect tests using SPSS PROCESS macro 3.3 software.

Results: (1) Psychological resilience, PTSD, Big Five personality traits, and cognitive functioning were significantly correlated. (2) The effects of the Big Five personality traits (extraversion, conscientiousness, agreeableness, emotional stability, and openness) on cognitive functioning can be mediated through three indirect pathways: the separate mediating effects of psychological resilience and PTSD and the chain mediating effects of psychological resilience and PTSD, with a chain mediation effect of 0.014, 0.018, 0.014, 0.018, and 0.014, respectively. None of the 95% CI contained 0.

Conclusion: Personality traits can indirectly influence cognitive functioning in patients with breast cancer through the separate mediating roles of psychological resilience and PTSD and their chained mediating roles. This result suggests we pay more comprehensive attention to patients' cognitive function. Workers can be guided to assess patients' personality, psychological, and spiritual characteristics promptly in their work and adopt personalized care to safeguard good cognitive functioning.