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A Cross‐Level Diary Study of Psychological Flexibility and Its Effects on Self‐Esteem and Negative Emotional Dynamics in Women Survivors of Breast Cancer.

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Title: A Cross‐Level Diary Study of Psychological Flexibility and Its Effects on Self‐Esteem and Negative Emotional Dynamics in Women Survivors of Breast Cancer.
Authors: Carmona‐Cobo, Isabel (AUTHOR), Ballesteros, M. Modesta (AUTHOR), Camilo, Cristina (AUTHOR), Lima, M. Luisa (AUTHOR)
Source: Psycho-Oncology. May2026, Vol. 35 Issue 5, p1-12. 12p.
Subjects: Self-esteem, Cancer survivors, Ecological momentary assessments (Clinical psychology), Emotion regulation, Anxiety, Females, Control (Psychology), Psychological adaptation
Abstract: Background: Breast cancer primarily affects women from all countries around the world. Psychological flexibility is a personal resource that helps cancer patients accept the disease, reduce emotional distress, and enhance self‐esteem. Scarcely explored within this type of breast cancer, it might help women survivors in their daily lives. Aims: This study investigates whether trait psychological flexibility in women survivors of breast cancer has benefits for their daytime levels of evening self‐esteem, anxiety, and expressive suppression. Methods: A total of 94 women (47 breast cancer survivors and 47 controls) completed full diary surveys twice daily for five consecutive workdays (n = 470 daily data). The diary used a two‐level design: 5‐day repeated measures (Level 1, day‐level) nested within persons (Level 2, person‐level), employing a within‐person approach. Results: Multilevel analyses showed main effects of daily morning negative affect on daily evening self‐esteem, anxiety, and expressive suppression in the breast cancer group, as well as main effects of trait psychological flexibility on all outcomes for both groups. Cross‐level interactions showed that on days when women survivors of breast cancer experienced high levels of daily morning negative affect, those low (vs. high) in trait psychological flexibility decreased their levels of daily evening self‐esteem and increased daily evening anxiety and expressive suppression. Conclusions: A within‐person approach is relevant for understanding psychological flexibility among breast cancer survivors. It has a dual beneficial function for their self‐esteem and for negative emotional dynamics daily. [ABSTRACT FROM AUTHOR]
Copyright of Psycho-Oncology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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PubType: Academic Journal
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Items – Name: Title
  Label: Title
  Group: Ti
  Data: A Cross‐Level Diary Study of Psychological Flexibility and Its Effects on Self‐Esteem and Negative Emotional Dynamics in Women Survivors of Breast Cancer.
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  Data: <searchLink fieldCode="AR" term="%22Carmona‐Cobo%2C+Isabel%22">Carmona‐Cobo, Isabel</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ballesteros%2C+M%2E+Modesta%22">Ballesteros, M. Modesta</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Camilo%2C+Cristina%22">Camilo, Cristina</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lima%2C+M%2E+Luisa%22">Lima, M. Luisa</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Psycho-Oncology%22">Psycho-Oncology</searchLink>. May2026, Vol. 35 Issue 5, p1-12. 12p.
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  Data: <searchLink fieldCode="DE" term="%22Self-esteem%22">Self-esteem</searchLink><br /><searchLink fieldCode="DE" term="%22Cancer+survivors%22">Cancer survivors</searchLink><br /><searchLink fieldCode="DE" term="%22Ecological+momentary+assessments+%28Clinical+psychology%29%22">Ecological momentary assessments (Clinical psychology)</searchLink><br /><searchLink fieldCode="DE" term="%22Emotion+regulation%22">Emotion regulation</searchLink><br /><searchLink fieldCode="DE" term="%22Anxiety%22">Anxiety</searchLink><br /><searchLink fieldCode="DE" term="%22Females%22">Females</searchLink><br /><searchLink fieldCode="DE" term="%22Control+%28Psychology%29%22">Control (Psychology)</searchLink><br /><searchLink fieldCode="DE" term="%22Psychological+adaptation%22">Psychological adaptation</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Breast cancer primarily affects women from all countries around the world. Psychological flexibility is a personal resource that helps cancer patients accept the disease, reduce emotional distress, and enhance self‐esteem. Scarcely explored within this type of breast cancer, it might help women survivors in their daily lives. Aims: This study investigates whether trait psychological flexibility in women survivors of breast cancer has benefits for their daytime levels of evening self‐esteem, anxiety, and expressive suppression. Methods: A total of 94 women (47 breast cancer survivors and 47 controls) completed full diary surveys twice daily for five consecutive workdays (n = 470 daily data). The diary used a two‐level design: 5‐day repeated measures (Level 1, day‐level) nested within persons (Level 2, person‐level), employing a within‐person approach. Results: Multilevel analyses showed main effects of daily morning negative affect on daily evening self‐esteem, anxiety, and expressive suppression in the breast cancer group, as well as main effects of trait psychological flexibility on all outcomes for both groups. Cross‐level interactions showed that on days when women survivors of breast cancer experienced high levels of daily morning negative affect, those low (vs. high) in trait psychological flexibility decreased their levels of daily evening self‐esteem and increased daily evening anxiety and expressive suppression. Conclusions: A within‐person approach is relevant for understanding psychological flexibility among breast cancer survivors. It has a dual beneficial function for their self‐esteem and for negative emotional dynamics daily. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
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  Data: <i>Copyright of Psycho-Oncology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1002/pon.70494
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      – Code: eng
        Text: English
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        PageCount: 12
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      – SubjectFull: Self-esteem
        Type: general
      – SubjectFull: Cancer survivors
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      – SubjectFull: Ecological momentary assessments (Clinical psychology)
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      – SubjectFull: Emotion regulation
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      – SubjectFull: Anxiety
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      – SubjectFull: Females
        Type: general
      – SubjectFull: Control (Psychology)
        Type: general
      – SubjectFull: Psychological adaptation
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      – TitleFull: A Cross‐Level Diary Study of Psychological Flexibility and Its Effects on Self‐Esteem and Negative Emotional Dynamics in Women Survivors of Breast Cancer.
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            NameFull: Carmona‐Cobo, Isabel
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            NameFull: Ballesteros, M. Modesta
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            NameFull: Camilo, Cristina
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              Text: May2026
              Type: published
              Y: 2026
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