Skip to main content
×
Home
    • Aa
    • Aa

Maladaptive coping and affective disorders among cancer patients

  • M. Parle (a1), B. Jones (a1) and P. Maguire (a1)
Synopsis
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.

Copyright
Corresponding author
1Address for correspondence: Dr Peter Maguire, Cancer Research Campaign Psychological Medicine Group, Stanley House, Christie Hospital, wilmslow Road, Manchester M20 4BX.
References
Hide All
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, 337348.
American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders (DSM-III), 3rd edn.American Psychiatric Association: Washington DC.
Baker R. J. & Nelder J. A. (1978). The GLIM System, Release 3. The Numerical Algorithms Group: Oxford.
Bandura A. (1982). Self-efficacy mechanism in human agency. American Psychologist 37, 122147.
Bandura A. (1988). Self-efficacy conception of anxiety. Anxiety Research 1, 7798.
Beck A. T. & Clark D. A. (1988). Anxiety and depression: an information processing perspective. Anxiety Research. 1, 2336.
Beck A. T. & Emery G. (1985). Anxiety Disorders and Phobias: A Cognitive Perspective. Basic Books: New York.
Breslow N. E. & Day N. E. (1980). Statistical Methods in Cancer Research: Vol I-The Analysis of Case–Control Studies. IARC Scientific Publications: Lyon.
Butler G. & Matthews A. (1987). Anticipatory anxiety and risk perception. Behaviour Research and Therapy 11, 551565.
Croyle R. T. (1992). Appraisal of health threats: cognition, motivation and social comparison. Cognitive Therapy and Research 16, 165182.
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, 503507.
Dean C., Surtees P. G. & Sashidharan S. P. (1983). Comparison of research diagnostic systems in an Edinburgh community sample. British Journal of Psychiatry 142, 247256.
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, 751757.
Devlen J. (1984). Psychological and Social Aspects of Hodgkin's Disease and Non-Hodgkin's Lymphoma. Ph.D. thesis, University of Manchester.
Devlen J., Phillips P. & Maguire P. (1991). Development of a Classification of Coping Strategies. Unpublished manuscript: CRC Psychological Medicine Group.
Dunkel-Schetter C., Feinstein L. G., Taylor S. E. & Falke R. L. (1992). Patterns of coping with cancer. Health Psychology 11, 7987.
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, 173180.
Jarrett S. R., Ramirez A. J., Richards M. A. & Weinman J. (1992). Measuring coping in breast cancer. Journal of Psychosomatic Research 36, 593602.
Kendall P. (1992). Healthy thinking. Behaviour Therapy 23, 111.
Lazarus R. S. (1992). Coping with the stress of illness. WHO Regional Publications European Service 44, 1131.
Lazarus R. S. (1993). Coping theory and research: past, present and future. Psychosomatic Medicine 55, 234247.
Lazarus R. S. & Folkman S. (1984). Stress Appraisal and Coping. Springer: New York.
Leventhal H. & Nerenz D. (1985). The assessment of illness cognition. In Measurement Strategies in Health Psychology (ed. Karoly P.), pp. 517554. Wiley: New York.
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, 151161.
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. 1530. Churchill Livingstone: Edinburgh.
Marx E. M., Williams J. M. G. & Claridge G. C. (1992). Depression and social problem solving. Journal of Abnormal Psychology 101, 7886.
Office of Population Census and Surveys (1980). Classification of Occupations and Coding Index. Her Majesty's Stationery Office: London.
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. 4457. Oxford University Press: New York.
Somerfield M. & Curbow B. (1992). Methodological issues and research strategies in the study of coping with cancer. Social Science and Medicine 34, 12031261.
Stein S., Hermanson K. & Spiegal D. (1993). New directions in psycho-oncology. Current Opinion in Psychiatry 6, 838846.
Tallis F. & Eysenck M. (1994). Worry: mechanisms and modulating influences. Behavioural and Cognitive Psychotherapy 22, 3756.
Taylor S. E. & Brown J. D. (1988). Positive illusions and well being: a social psychological perspective. Psychological Bulletin 103, 193210.
Taylor S. E. & Brown J. D. (1994). Positive illusions and well being revisited: separating fact from fiction. Psychological Bulletin 116, 2127.
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, 5157.
Williams J. M. G., Watts F. N., MacLeod C. & Matthews A. (1988). Cognitive Psychology and Emotional Disorders. Wiley: Chichester.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 22 *
Loading metrics...

Abstract views

Total abstract views: 363 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 23rd October 2017. This data will be updated every 24 hours.