Coping with a breast cancer diagnosis: A prospective study.

Abstract

Employing the stress and coping theory of Lazarus and Folkman, this study followed 117 women age 40 or over regarding personality, cognitive appraisal, coping, and mood variables before breast biopsy, after diagnosis, and, for those who had cancer, after surgery. Upon biopsy, 36 received a cancer diagnosis, and 81 received a benign diagnosis. The 2 groups did not differ on appraisals, coping, or affect before diagnosis. With prebiopsy affect controlled, cancer patients reported more negative affect postbiopsy than did benign patients. Postsurgery, cancer patients expressed less vigor and more fatigue than benign patients, but the groups did not differ on other negative emotions. Prebiopsy, psychosocial predictors accounted for 54% and 29% of the variance in negative and positive emotion, respectively. Prebiopsy variables also predicted postbiopsy and postsurgery mood; cognitive avoidance coping was a particularly important predictor of high distress and low vigor.

Adjustment to a low-control situation: Reexamining the role of coping responses.

“…In a student sample, Masel et al (1996) found that the use of escapism in response to low control stress was negatively associated with adjustment, even when the event was categorized as being in the acute stage. Stanton and Snider (1993) reported similar results. In a study of women adjusting to a breast cancer diagnosis, prebiopsy cognitive avoidance was negatively associated with both postbiopsy affect (on average, 6 days after prebiopsy assessment) and postsurgery affect (on average, 18 days later).…”

“…Specifically, it is proposed that, contrary to the original goodness-of-fit model of coping effectiveness, the use of avoidant type strategies in response to low-control stress will be maladaptive. Findings from previous tests of the goodness-of-fit model of coping effectiveness have generally found that strategies such as escapism and wishful thinking are negatively associated with adjustment to this type of stress (e.g., Conway & Terry, 1992;Vitaliano et al, 1990), as have studies examining the relationships between the use of such strategies and adjustment to specific low-control stressors, including infertility (Stanton, Tennen, Affleck, & Mendola, 1992) and a failed IVF attempt (Hynes et al, 1992;Litt, Tennen, Affleck, & Klock, 1992).…”

“…The level of effort involved in avoiding the reality of an event and the use of escapist strategies (e.g., drinking more alcohol) may deplete a person's resources (Stanton & Snider, 1993;Wegner, Shortt, Blake, & Page, 1990), interfere with eventual assimilation and acceptance of the situation (Roth & Cohen, 1986), and increase the frequency of undesired intrusions of thoughts about the event (Stanton & Snider, 1993;Wegner et al, 1990).…”

Baseline psychosocial predictors of survival in localised breast cancer

“…The patients were interviewed 3 -4 months after diagnosis according to a specific structural format and by the same (Folkman and Lazarus, 1988;Lazarus, 1993), developed 'to identify the thoughts and actions an individual has used to cope with a specific stressful encounter' (here any aspect of breast cancer) using an item structure proposed to form a WOC-CA cancer-specific scale (Dunkel-Schetter et al, 1992;Stanton and Snider, 1993) comprising the coping patterns Focusing on the Positive, Distancing, Seeking and Using Social Support, Cognitive Escape-Avoidance, and Behavioural Escape-Avoidance.…”

Predictors of patients' mental adjustment to cancer: patient characteristics and social support

“…Mental adjustment to cancer may be defined as the cognitive and behavioural responses made by an individual to the diagnosis of cancer (Greer and Watson, 1987). Many studies have suggested that cancer patients' mental adjustment is one of the important factors correlating with quality of life and degree of psychological distress (Watson et al, 1984(Watson et al, , 1991Dunkel-Shetter et al, 1992;Evans et al, 1993;Grassi et al, 1993;Stanton and Snider, 1993;Ferrero et al, 1994;Lampic et al, 1994;Thomas and Marks, 1995;Wagner et al, 1995). Furthermore, some studies have revealed that mental adjustment to cancer may even affect patient's physical outcome.…”