Ego Strength and Psychosocial Adaptation to Cancer

Worden, J. William; Sobel, Harry

doi:10.1097/00006842-197812000-00001

Cited by 73 publications

(18 citation statements)

References 22 publications

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“…Mice which received an injection of tumor cells were subjected either to escapable or inescapable shock as well as kept unstressed in the home cage; appearance of tumors and death was earliest in the group which could not cope and was significantly delayed and equal in the coping and resting groups [19]. Similarly, rejection of implanted tumors into shocked rats was best in animals which could cope with the shock or were left unstressed in the home cage and least in the animals which could not cope with this stressor [24], This is similar to observations in humans where depressed patients with fewer and weaker coping mechanisms showed a higher incidence of cancer [22] or where pa tients who could cope with their neoplastic diseases showed less mood disturbances, less vulnerability and a better course of the disease [30], Again, a rather impres sive number of examples in which not the external or internal challenge per se determined the stress response and health consequences of the individual but the ability or inability to cope with the challenge.…”

Section: Other Effects Associated With the Ability Or Inability To Copesupporting

confidence: 73%

Coping, Stress, Stressors and Health Consequences

Vogel¹

1985

Neuropsychobiology

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The conventional sequence of stressful event (stressor) causing stress (biochemical and physiological changes) which, in turn, causes pathological consequences (diseases) is examined. A number of experiments are described which show that biochemical, physiological and/or pathological changes in an organism do not seem to be caused by the aversive or noxious nature of the stressor but by the ability or inability of the organism to deal with this stressor. If an individual can cope successfully with the environmental challenge, little or no stress is experienced, the challenge is viewed as only minimal stressful and no major health consequences seem to arise. If an individual cannot cope or needs a great deal of effort to cope, stress is experienced, the environmental event becomes stressful and major health consequences seem to arise. Thus, coping strategies available to and employed by an individual will determine whether or not stress is experienced, whether or not an event becomes stressful and whether or not pathological consequences will occur.

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Section: Other Effects Associated With the Ability Or Inability To Copesupporting

confidence: 73%

Coping, Stress, Stressors and Health Consequences

Vogel¹

1985

Neuropsychobiology

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“…The data additionally sustain the ascribed influence of personality features (e.g., 38,39) and such aspects as appraisal of the stressor (e.g., 23,40), expectancies (41), mood (e.g., 21,35), and perceived control (42) as allied factors accompanying coping strategy usage.…”

Section: Discussionsupporting

confidence: 61%

Coping strategies and associated features of medically ill patients.

Feifel¹,

Strack²,

Nagy³

1987

Psychosomatic Medicine

215

155

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This study examined the psychological and behavioral correlates of three major coping strategies used by medically ill patients in dealing with their illness; namely, confrontation, avoidance, and acceptance-resignation. The subjects consisted of 223 male medical patients with a variety of life-threatening and chronic illnesses. Coping responses were measured by the Medical Coping Modes Questionnaire, while other variables were tapped by a variety of self-report and test measures, as well as by interview data. Significant correlates were found for each of the coping strategies accounting for 10 to 53% of the variance. These included demographic, illness, and psychological variables. Employment of acceptance-resignation as a coping strategy was particularly evident in patients with little expectation of recovery and a lack of hope. Effectiveness of coping appeared to be negatively linked to frequent use of avoidance and acceptance-resignation in life-threatened patients. Overall, it seems that a variety of variables across several domains accompany the use of a particular coping strategy; that choice of a specific strategy is most likely multidetermined; and that the configuration of variables associated with a particular strategy is likely to be different for each coping strategy. Coping behavior is a subtle, multifashioned expression the complete grasp of which demands an integrative approach.

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“…Symptom Distress [33,34] is an objective measure of the physical impact of both cancer symptoms and treatment side-e ects. The Inventory of Current Concerns [35,36] measures the level of concern or anxiety about cancer and its consequences. The Enforced Social Dependency Scale [37] measures the extent to which patients have been forced to depend on others for physical and emotional needs.…”

Section: Multiple Endpoints In a Clinical Trialmentioning

confidence: 99%

General linear contrasts on latent variable means: structural equation hypothesis tests for multivariate clinical trials

Donaldson

2003

Statistics in Medicine

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Structural equation models articulate the assumed measurement and causal relations among variables, imposing discipline on otherwise unstructured and redundant associations that arise in correlational studies. Biomedical research has eschewed such methods, relying on the generally superior causal inference afforded by randomized controlled trials. Increasingly, however, clinical trials incorporate numerous covariates that are measured but unmanipulated. Most clinical trials now also include multiple correlated endpoints, which can generate ambiguous outcome patterns refractory to simple statistical analysis and interpretation. Modern clinical trials are really multivariate longitudinal studies with at best a component of randomized control; as such, structural equation approaches can add rigour and clarity. The analysis of latent variance (LANOVA) conception combines structural equation and experimental analysis of variance legacies. It allows, for any design that can be decomposed into between-group and within-person models, tests on latent means (that is, the means of the unobserved factors) that are directly analogous to their analysis of variance counterparts. LANOVA variables are either outcomes (which may have a time structure), varying covariates (which may have a time structure), or background covariates (which are static). Allowable causal relations are set-recursive: background covariates can affect all other variables; varying covariates can affect current outcomes and later outcomes and covariates; outcomes can affect only later outcomes. All standard ANOVA and ANCOVA hypotheses can then be tested by proper restrictions among the means and intercepts of these latent variables. Structural equation modelling programs can be used to estimate the models and test the hypotheses. I demonstrate the approach by expressing and testing hypotheses appropriate for two clinical studies that evaluate patient-reported outcomes in populations with solid and haematological malignancies.

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Ego Strength and Psychosocial Adaptation to Cancer

Cited by 73 publications

References 22 publications

Coping, Stress, Stressors and Health Consequences

Coping, Stress, Stressors and Health Consequences

Coping strategies and associated features of medically ill patients.

General linear contrasts on latent variable means: structural equation hypothesis tests for multivariate clinical trials

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