Degree of self-certainty is related to the association between cognitive flexibility and anxiety following breast cancer treatments.

Authors

Joy Perrier, Mylène Duivon, Bénédicte Clarisse, François Christy, François Gernier, Djelila Allouache, Sabine Noal, Christelle Levy, Jacques Dayan, Fausto Viader, Florence Joly, Francis Eustache, Bénédicte Giffard

Published in

Neuropsychology. Oct 05, 2026. Epub Oct 05, 2026.

Abstract

Executive functioning difficulties-notably cognitive flexibility-are frequent following breast cancer (BC) treatment. Conflicting findings suggest that factors beyond anticancer treatments contribute to these changes. Anxiety and self-representation modifications are potential contributors. We explored the relationships among self-representations, anxiety, and cognitive flexibility in women with nonmetastatic BC compared with healthy controls (HCs).
We compared 54 BC patients to 47 HCs. We collected questionnaire data on self-representations (Questionnaire of Self-Representation: certainty and valence), state-trait anxiety (State-Trait Anxiety Inventory), and cognitive flexibility (Trail Making Test). Group comparisons were made using t tests or Wilcoxon tests, as appropriate. Spearman's correlations were calculated within each group. Linear regression was used to evaluate how self-representations were associated with the anxiety-cognitive flexibility relationship.
BC patients had higher self-certainty and Trail Making Test scores, indicating slightly reduced cognitive flexibility compared with HCs. In both groups, lower Questionnaire of Self-Representation scores (i.e., less certainty and positivity about oneself) correlated with higher anxiety. In HCs, higher Trail Making Test scores-thus lower cognitive flexibility-correlated with lower Questionnaire of Self-Representation scores and higher anxiety. In BC patients, higher levels of self-certainty were associated with a statistically positive anxiety-cognitive flexibility relationship (i.e., higher anxiety linked to poorer cognitive flexibility), while lower levels of self-certainty were associated with a statistically negative anxiety-cognitive flexibility relationship (lower anxiety linked to better cognitive flexibility).
These findings suggest that, in BC patients, self-certainty moderates the relationship between anxiety and cognitive flexibility in BC patients. The results highlight the relevance of self-representation in the neuropsychological evaluation of BC patients. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

PMID:
42831828
Bibliographic data and abstract were imported from PubMed on 05 Oct 2026.

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