# The effect of self-concealment on post-traumatic stress symptoms in breast cancer patients: The mediating role of experiential avoidance

**Authors:** Fan Xu, Shaoju Xie, Qiao Li, Xiaoli Zhong, Jiquan Zhang

PMC · DOI: 10.1371/journal.pone.0342971 · PLOS One · 2026-02-19

## TL;DR

The study finds that avoiding experiences explains how hiding emotions relates to stress symptoms in breast cancer patients.

## Contribution

It identifies experiential avoidance as a mediator between self-concealment and post-traumatic stress symptoms in breast cancer patients.

## Key findings

- Self-concealment was positively linked to experiential avoidance and post-traumatic stress symptoms.
- Experiential avoidance partially mediated the relationship between self-concealment and stress symptoms.
- The mediation effect accounted for 31.35% of the total effect.

## Abstract

Breast cancer is a major global health issue. It brings death threats or serious physical injuries to patients, and is a traumatic event that can seriously affect their mental health and lead to post-traumatic stress, which can lead to serious physical, psychological, cognitive, and social dysfunction, and even increase the risk of suicide, and impose a heavy burden on patients and their families.

To investigate the mediating effect of experiential avoidance between self-concealment and post-traumatic stress symptoms in breast cancer patients.

This study used a cross-sectional survey design. From 15/08/2021 to 31/12/2021, breast cancer patients were recruited as study subjects in the oncology department of a tertiary hospital in Deyang City. Data were collected through the following tools: the general information questionnaire, the Impact of Event Scale-Revised, the Self-Concealment Scale, and the Acceptance and Action Questionnaire-Second Edition.

257 breast cancer patients eventually completed the study, all females. Descriptive results showed that breast cancer patients had self-concealment scores (24.75 ± 7.34), experiential avoidance scores (18.48 ± 5.44), and post-traumatic stress symptoms scores (32.29 ± 14.14). Pearson correlation analyses showed that self-concealment was positively correlated with experiential avoidance and traumatic stress response (r = 0.343, 0.467, both P < 0.01); experiential avoidance was positively correlated with traumatic stress response (r = 0.534, P < 0.01). Mediation effect analyses showed that the total effect of self-concealment on post-traumatic stress symptoms was 0.453, with a direct effect path coefficient of 0.310, and the mediation effect path coefficient of experiential avoidance between self-concealment and post-traumatic stress symptoms was 0.142 (95% CI: 0.074 to 0.223), accounting for 31.35% of the total effect.

Experiential avoidance in breast cancer patients mediates the relationship between self-concealment and posttraumatic stress symptoms. and could guide healthcare professionals in developing tailored interventions to improve the mental health of patients.

## Linked entities

- **Diseases:** breast cancer (MONDO:0004989)

## Full-text entities

- **Diseases:** death (MESH:D003643), mental (MESH:D008607), metastasis (MESH:D009362), psychological disorders (MESH:D000067073), , and social dysfunction (MESH:D000067404), dysfunction (MESH:D006331), social anxiety (MESH:D000072861), Breast Cancer (MESH:D001943), depression (MESH:D003866), cognitive impairment (MESH:D003072), rigidity (MESH:D009127), bodily pains (MESH:D010146), trauma (MESH:D014947), pigmentation (MESH:D010859), anxiety (MESH:D001007), Mental Disorders (MESH:D001523), Cancer (MESH:D009369), fatigue (MESH:D005221), hair loss (MESH:D000505), post-traumatic (MESH:D004834), PTSS (MESH:D013313)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## References

40 references — full list in the complete paper: https://tomesphere.com/paper/PMC12919799/full.md

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Source: https://tomesphere.com/paper/PMC12919799