Objective/Purpose: Head and neck cancers have a strong psychological impact but remain understudied, particularly regarding narrative coherence—a marker of psychological adjustment. This study explored narrative coherence in head and neck cancer survivors, examining its relation to attachment style, anxiety, depression, and recruitment context (hospital vs. patient association).
Sample and Setting: Forty-three survivors recounted their life stories using Habermas’ Life Story methodology, including seven significant life events.
Procedure: Two trained coders assessed local and global indicators of narrative coherence (ICCs = 0.773–0.981). Statistical analyses included bivariate correlations and multiple linear regressions.
Results: Patients recruited through a patient association showed significantly higher global causal-motivational coherence (p < .01) and local causal-motivational coherence (p < .01) than hospital patients. Thematic coherence was also higher but only approached significance (p = .056). Anxiety scores (HADS) correlated positively with global causal-motivational coherence (r = .35, p < .05) and thematic coherence (r = .39, p < .01). Attachment styles were not significantly related to narrative coherence. Regression analyses confirmed group membership as a significant predictor of causal-motivational coherence (p = .053) and anxiety explained part of the variance in thematic coherence (p = .09).
Conclusion: Contrary to expectations, attachment style was unrelated to narrative coherence, while anxiety was positively associated with better coherence, suggesting that a well-structured narrative can reflect psychological tension rather than resolution. Patient association involvement relates to greater narrative coherence, possibly reflecting social and educational differences. These findings emphasize the need to consider emotional and contextual factors when supporting cancer survivors' psychological adjustment.