Coping with breast cancer over time and situation

doi:10.1016/0022-3999(93)90008-4

Journal of Psychosomatic Research

Volume 37, Issue 5, July 1993, Pages 523-542

https://doi.org/10.1016/0022-3999(93)90008-4 Get rights and content

Abstract

This study examines the variability and stability of coping in cancer subjects over time and situation. In a prospective longitudinal design 74 breastcancer patients have been followed for 3–5 yr at 3–6 monthly intervals. A variety of measures related to coping and adjustment were taken. This report limits itself to the findings of an instrument developed for this study, the Bernese Coping Modes in which 26 coping modes were rated by observers. Results confirm arguments in favour of both variability and stability in coping activity over time and situation. Two measures support stability: rank values and a multivariate measure (MDS) with three constant dimensions: (1) support and acceptance; (2) denial; (3) diversion by thought and action. Evidence for variability is: the potential range of coping modes and a large variety of additional modes at most observation times. Subsequently time measures of coping were attributed to eight predefined illness stages as distinct clinical situations. Thus variability or richeness of coping further increased. The implications of these findings for measurement in coping research are discussed.

References (37)

C Dean et al.
Do psychological factors predict survival in breast cancer?
J Psychosom Res
(1989)
C Thomas et al.
Coping and the outcome of stoma surgery
J Psychosom Res
(1988)
T Morris et al.
Development of a method for rating cognitive responses to a diagnosis of cancer
Soc Sci Med
(1985)
C Buddeberg et al.
Coping strategies and course of disease of breast cancer patients
Psychother Psychosom
(1991)
C Buddeberg
Brustkrebs-Psychische Verarbeitung und somatischer Verlauf
(1992)
S-H Filipp
Could it be worse? The diagnosis of cancer as a prototype of traumatic life events
W Schain
Psychological impact of the diagnosis of breast cancer on the patient
Front Radiat Ther Onc
(1976)
JL Katz et al.
Stress, distress and ego defenses
Arch Gen Psychiat
(1970)
JG Gorzynski et al.
Stability of ego defenses and endocrine responses in women prior to breast biopsy and ten years later
Psychosom Med
(1980)
S Greer et al.
Mental adjustment to cancer: Its measurement and prognostic importance
Cancer Surveys
(1987)

U Rüger et al.

Coping

(1990)

E Heim

Coping und Adaptivität: Gibt es geeignetes oder ungeeignetes Coping?

Psychother med Psychol

(1988)

KB Matheny et al.

Stress coping: A qualitative and quantitative synthesis with implications for treatment

The Counseling Psychologist

(1986)

E Heim et al.

Krankheitsbewältigung (Coping)—ein integriertes Modell

Psychother Psychosom Med Psychol

(1983)

E Heim et al.

Psychosoziale Medizin, 2. Klinik und Praxis

(1986)

E Heim

Coping and adaptation in cancer

RS Lazarus et al.

Stress, Appraisal and Coping

(1984)

S Folkman et al.

If it changes it must be a process

J Pers Soc Psychol

(1985)

Cited by (78)

Can we make a portrait of women with inoperable locally advanced breast cancer?
2017, Breast
Citation Excerpt :
On the other hand, according to the stress and coping model, denial can be seen as a normal protective response against overwhelming events and feelings [44]. Several longitudinal studies have investigated denial during the course of BC [45−47], but data on the impact of denial on patient delay are limited [48–50]. Data on the impact of treatment delay (by patients, providers or both) on BC outcomes are mixed.
Delay between clinical presentation and treatment of breast cancer (BC) can significantly impact mortality. We aimed at drawing a picture of women with locally advanced breast cancer (LABC) treated at our Breast Unit and at investigating factors associated with treatment delay.
A retrospective descriptive analysis, using a specific 28-item semi-structured questionnaire, was conducted in 67 patients diagnosed with T4 BC.
Nearly a third of our patients had at least one known predisposing factor for LABC. 42% of patients did not perform routine medical breast checks, 49% reported indifference as the first feeling and 47% waited at least 3 months before seeking medical attention. The reasons for diagnostic delay were different in the various age groups. Doctor's delay in making the right diagnosis occurred in 60% of younger patients (≤40 years, n = 5), whereas among women aged 41–69years (n = 34) 50% suffered from psychiatric comorbidities. In patients ≥70 years (n = 28) social factors such as isolation, being widowed and living in a retirement home were present in most of the cases. Delay in seeking medical care was also associated with increasing age. Across all age groups, coping factors such as denial and indifference were also associated with an increase in the odds of delayed presentation, as opposed to fear.
Factors possibly explaining late medical consultation seem to differ according to age. Psychological factors are crucial in patients' delay whereas age and social factors are relevant in doctors' and system's delay.
Stability of coping and the role of self-efficacy in the first year following mild traumatic brain injury
2017, Social Science and Medicine
Citation Excerpt :
This stability might also indicate that without an intervention, a high use of passive coping style will persist. Although different from previous studies, which found maladaptive styles to increase over time in TBI patients (Gregorio et al., 2014; Tomberg et al., 2007; Wolters et al., 2010), our finding that the passive coping style is rather stable over time illustrates the long-standing ‘personality versus situation’, and ‘state versus trait’ debate (Heim et al., 1993). On the one hand, dispositional stabilities may exist, and on the other hand, the requirements of a specific situation can affect the choice of coping style (Taylor and Stanton, 2007).
Coping, the psychological adaptation to stressors and serious life events, has been found to have a great influence on the development and persistence of posttraumatic complaints. Coping has received much attention for having been found to be modifiable in treatment following mild traumatic brain injury (mTBI) and for its potential to identify the Patients who are at risk of suffering from long-term complaints. Currently, coping styles are assumed to be stable over time. Although interventions to facilitate adaptive coping are given at different time intervals after the injury, little is known about spontaneous changes in preferred strategies over time following mTBI. This study aimed to investigate the stability of different coping styles over a one-year period following mTBI (at two weeks', six and twelve months’ post-injury) and to investigate the relation between coping styles and feelings of self-efficacy.
We included 425 mTBI patients (Glasgow Coma Scale [GCS] score 13–15) admitted to three Level-1 trauma centers in the Netherlands as part of a prospective follow-up study. All participants filled out The Utrecht Coping List (UCL) to determine their position on seven coping subscales.
Most coping styles showed a decrease over time, except for positive reframing, which showed a decrease and then increased. Interestingly, the passive coping style was found to stabilize over time within the year after injury. High feelings of self-efficacy were related to a high active coping style (r = 0.36), and low feelings of self-efficacy with passive coping (r = -0.32).
These results hold important possibilities for the use of the passive coping strategy as an inclusion criterion for intervention studies and an entry point for treatment itself. Considering the intertwinement of coping with self-efficacy, improving feelings of self-efficacy could form an effective part of an intervention to improve outcome.
Coping strategies in epilepsy: 50 drug-resistant and 50 seizure-free patients
2007, Seizure
Citation Excerpt :
In particular, Lazarus identified two main coping categories: the problem-focused, based on specific strategies to find a direct resolution for the situation, and the emotion-focused, which deals mainly with the emotional responses to stressors. More recently, some authors have begun to analyze the coping modes in a variety of chronic disorders, such as Parkinson's disease,7 rheumatoid arthritis,8 diabetes,9 cancer,10 and finally, epilepsy.11 Regarding this pathology, research findings highlight that one of the most adaptive coping patterns is the problem-focused strategy, which is generally linked to increased mental health/psychological well-being,12 and better psycho-social adaptation,13–15 while disengagement styles, such as avoidance and denial of personal clinical conditions, seem to cause greater distress.16,17
We investigated the coping styles and their correlation to psycho-social functioning in two groups of patients, the first group with drug-resistant epilepsy and the second with well-controlled epilepsy.
The instruments administered were the following: the Raven's Coloured Progressive Matrices (non-verbal intelligence), the Echelle Toulousaine de Coping, ETC (coping styles), the Self-esteem Questionnaire (self-esteem), the Self-efficacy Questionnaire (social self-efficacy), a Quality of Life Measure and a semi-structured interview on psycho-social adjustment.
We found a significant difference in coping responses between the two groups: drug-resistant patients seemed to adopt the “denial” and the “exclusion” strategies more (P < 0.05). On the contrary, seizure-free subjects used the “control” strategy more (P < 0.05).
A significant correlation between disengagement patterns and poorer social outcomes was pointed out, while “control” was associated with better social adaptation.
Our findings provide evidence of the importance of coping assessment, considering the influence of these strategies on the well being of patients. Offering psychological support to epilepsy patients should be considered when orientating the effectiveness of the patients’ coping styles.
Computer-mediated and face-to-face communication in metastatic cancer support groups
2014, Palliative and Supportive Care
Transitions in coping profiles after breast cancer diagnosis: implications for depressive and physical symptoms
2021, Journal of Behavioral Medicine
Stress and somatic symptoms: Biopsychosociospiritual perspectives
2018, Stress and Somatic Symptoms: Biopsychosociospiritual Perspectives

View all citing articles on Scopus

View full text

Coping with breast cancer over time and situation

Abstract

J Psychosom Res

J Psychosom Res

Soc Sci Med

Coping strategies and course of disease of breast cancer patients

Psychother Psychosom

Brustkrebs-Psychische Verarbeitung und somatischer Verlauf

Could it be worse? The diagnosis of cancer as a prototype of traumatic life events

Psychological impact of the diagnosis of breast cancer on the patient

Front Radiat Ther Onc

Stress, distress and ego defenses

Arch Gen Psychiat

Stability of ego defenses and endocrine responses in women prior to breast biopsy and ten years later

Psychosom Med

Mental adjustment to cancer: Its measurement and prognostic importance

Cancer Surveys