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Maladaptive coping and affective disorders among cancer patients

Published online by Cambridge University Press:  09 July 2009

M. Parle ,
B. Jones  and
P. Maguire
M. Parle
Affiliation:
Cancer Research Campaign Psychological Medicine Group, Christie Hospital, Manchester
B. Jones
Affiliation:
Cancer Research Campaign Psychological Medicine Group, Christie Hospital, Manchester
P. Maguire*
Affiliation:
Cancer Research Campaign Psychological Medicine Group, Christie Hospital, Manchester
*
1Address for correspondence: Dr Peter Maguire, Cancer Research Campaign Psychological Medicine Group, Stanley House, Christie Hospital, wilmslow Road, Manchester M20 4BX.
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Synopsis

Coping has attracted much attention in research as a possible mediator of the psychological impact of cancer. Yet, conceptual ambiguity and methodological limitations have resulted in weak and contradictory findings. A major shortcoming has been the use of designs which do not represent adequately the complexity or the diversity of demands which arise from the diagnosis and treatment of cancer. The neglect of appraisal in the assessment of the relationship between coping and mental health is of particular concern, given the role it has been found to play in the onset and maintenance of affective disorders.

In a prospective study 673 newly diagnosed cancer patients were interviewed 4 to 8 weeks and 1 year later to assess the effects of their appraisals, coping responses and resolution of any concerns on subsequent mental health. Logistic regression analyses, adjusted for possible confounding variables, were used to investigate the relationships between coping variables and affective disorders. When examined separately the degree of threat appraised, the reporting of a helpless response and perceived success of primary responses in resolving concerns all predicted subsequent affective disorder. However, in a multivariate model only appraisal and success of the response in resolving the concern were significant. No response was found to prevent affective disorders, however certain types of responses were associated with the resolution of specific concerns. The results highlight the importance of assessing the whole coping process and the need to address the complex and multifaceted characteristics of cancer demands. On the basis of our findings we describe a maladaptive cycle of coping, which we believe contributes to the later onset of affective disorders in cancer patients.

Type
Original Articles
Information
Psychological Medicine , Volume 26 , Issue 4 , July 1996 , pp. 735 - 744
Copyright
Copyright © Cambridge University Press 1996

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References

REFERENCES

Aldwin, C. M. & Revenson, T. A. (1987). Does coping help? A reexamination of the relation between coping and mental health. Journal of Personality and Social Psychology 53, 337–348.CrossRefGoogle ScholarPubMed
American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders (DSM-III), 3rd edn.American Psychiatric Association: Washington DC.Google Scholar
Baker, R. J. & Nelder, J. A. (1978). The GLIM System, Release 3. The Numerical Algorithms Group: Oxford.Google Scholar
Bandura, A. (1982). Self-efficacy mechanism in human agency. American Psychologist 37, 122–147.CrossRefGoogle Scholar
Bandura, A. (1988). Self-efficacy conception of anxiety. Anxiety Research 1, 77–98.CrossRefGoogle Scholar
Beck, A. T. & Clark, D. A. (1988). Anxiety and depression: an information processing perspective. Anxiety Research. 1, 23–36.CrossRefGoogle Scholar
Beck, A. T. & Emery, G. (1985). Anxiety Disorders and Phobias: A Cognitive Perspective. Basic Books: New York.Google Scholar
Breslow, N. E. & Day, N. E. (1980). Statistical Methods in Cancer Research: Vol I-The Analysis of Case–Control Studies. IARC Scientific Publications: Lyon.Google Scholar
Butler, G. & Matthews, A. (1987). Anticipatory anxiety and risk perception. Behaviour Research and Therapy 11, 551–565.CrossRefGoogle Scholar
Croyle, R. T. (1992). Appraisal of health threats: cognition, motivation and social comparison. Cognitive Therapy and Research 16, 165–182.CrossRefGoogle Scholar
Croyle, R. T., Sun, Y. & Louie, D. H. (1993). Psychological minimization of cholesterol test results: Moderators of appraisal in college students and community residents. Health Psychology 12, 503–507.CrossRefGoogle ScholarPubMed
Dean, C., Surtees, P. G. & Sashidharan, S. P. (1983). Comparison of research diagnostic systems in an Edinburgh community sample. British Journal of Psychiatry 142, 247–256.CrossRefGoogle Scholar
Derogatis, L. R., Morrow, G. R., Fetting, J., Penman, D., Piatsetsky, S., Schmale, A. M., Henrichs, M. & Carnicke, C. L. (1983). The prevalence of psychiatric disorders amongst cancer patients. Journal of the American Medical Association 249, 751–757.CrossRefGoogle Scholar
Devlen, J. (1984). Psychological and Social Aspects of Hodgkin's Disease and Non-Hodgkin's Lymphoma. Ph.D. thesis, University of Manchester.Google Scholar
Devlen, J., Phillips, P. & Maguire, P. (1991). Development of a Classification of Coping Strategies. Unpublished manuscript: CRC Psychological Medicine Group.Google Scholar
Dunkel-Schetter, C., Feinstein, L. G., Taylor, S. E. & Falke, R. L. (1992). Patterns of coping with cancer. Health Psychology 11, 79–87.CrossRefGoogle ScholarPubMed
Harrison, J., Maguire, P., Ibbotson, T., Macleod, R. & Hopwood, P. (1994). Concerns, confiding and psychiatric disorder in newly diagnosed cancer patients: a descriptive study. Psycho-Oncology 3, 173–180.CrossRefGoogle Scholar
Jarrett, S. R., Ramirez, A. J., Richards, M. A. & Weinman, J. (1992). Measuring coping in breast cancer. Journal of Psychosomatic Research 36, 593–602.CrossRefGoogle ScholarPubMed
Kendall, P. (1992). Healthy thinking. Behaviour Therapy 23, 1–11.Google Scholar
Lazarus, R. S. (1992). Coping with the stress of illness. WHO Regional Publications European Service 44, 11–31.Google ScholarPubMed
Lazarus, R. S. (1993). Coping theory and research: past, present and future. Psychosomatic Medicine 55, 234–247.CrossRefGoogle ScholarPubMed
Lazarus, R. S. & Folkman, S. (1984). Stress Appraisal and Coping. Springer: New York.Google Scholar
Leventhal, H. & Nerenz, D. (1985). The assessment of illness cognition. In Measurement Strategies in Health Psychology (ed. Karoly, P.), pp. 517–554. Wiley: New York.Google Scholar
MacLeod, C. & Hagan, R. (1992). Individual differences in the selective processing of threatening information and emotional responses to a stressful life event. Behaviour Research and Therapy 30, 151–161.CrossRefGoogle ScholarPubMed
Maguire, P. (1991). Improving the recognition and treatment of affective disorders in cancer patients. In Recent Advances in Clinical Pychiatry (ed. Granville Grossman, K.), pp. 15–30. Churchill Livingstone: Edinburgh.Google Scholar
Marx, E. M., Williams, J. M. G. & Claridge, G. C. (1992). Depression and social problem solving. Journal of Abnormal Psychology 101, 78–86.CrossRefGoogle ScholarPubMed
Office of Population Census and Surveys (1980). Classification of Occupations and Coding Index. Her Majesty's Stationery Office: London.Google Scholar
Rowland, J. H. (1989). Intrapersonal resources: coping. In Handbook of Psycho-Oncology: Psychological Care of the Patient with Cancer (ed. Holland, J. C. and Rowland, J. H.), pp. 44–57. Oxford University Press: New York.Google Scholar
Somerfield, M. & Curbow, B. (1992). Methodological issues and research strategies in the study of coping with cancer. Social Science and Medicine 34, 1203–1261.CrossRefGoogle Scholar
Stein, S., Hermanson, K. & Spiegal, D. (1993). New directions in psycho-oncology. Current Opinion in Psychiatry 6, 838–846.CrossRefGoogle Scholar
Tallis, F. & Eysenck, M. (1994). Worry: mechanisms and modulating influences. Behavioural and Cognitive Psychotherapy 22, 37–56.CrossRefGoogle Scholar
Taylor, S. E. & Brown, J. D. (1988). Positive illusions and well being: a social psychological perspective. Psychological Bulletin 103, 193–210.CrossRefGoogle Scholar
Taylor, S. E. & Brown, J. D. (1994). Positive illusions and well being revisited: separating fact from fiction. Psychological Bulletin 116, 21–27.CrossRefGoogle ScholarPubMed
Watson, M., Greer, S., Rowden, L., Gorman, C., Robertson, B., Bliss, J. & Tunmore, R. (1991). Relationships between emotional control, adjustment to cancer and depression and anxiety in breast cancer patients. Psychological Medicine 21, 51–57.CrossRefGoogle ScholarPubMed
Williams, J. M. G., Watts, F. N., MacLeod, C. & Matthews, A. (1988). Cognitive Psychology and Emotional Disorders. Wiley: Chichester.Google Scholar