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Relationships between emotional control, adjustment to cancer and depression and anxiety in breast cancer patients

Published online by Cambridge University Press:  09 July 2009

Maggie Watson*
Affiliation:
Cancer Research Campaign Psychological Medicine Research Group and the Section of Epidemiology, Institute of Cancer Research and the Royal Marsden Hospital, Sutton, Surrey
Steven Greer
Affiliation:
Cancer Research Campaign Psychological Medicine Research Group and the Section of Epidemiology, Institute of Cancer Research and the Royal Marsden Hospital, Sutton, Surrey
Linda Rowden
Affiliation:
Cancer Research Campaign Psychological Medicine Research Group and the Section of Epidemiology, Institute of Cancer Research and the Royal Marsden Hospital, Sutton, Surrey
Christine Gorman
Affiliation:
Cancer Research Campaign Psychological Medicine Research Group and the Section of Epidemiology, Institute of Cancer Research and the Royal Marsden Hospital, Sutton, Surrey
Bernadette Robertson
Affiliation:
Cancer Research Campaign Psychological Medicine Research Group and the Section of Epidemiology, Institute of Cancer Research and the Royal Marsden Hospital, Sutton, Surrey
Judith M. Bliss
Affiliation:
Cancer Research Campaign Psychological Medicine Research Group and the Section of Epidemiology, Institute of Cancer Research and the Royal Marsden Hospital, Sutton, Surrey
Robert Tunmore
Affiliation:
Cancer Research Campaign Psychological Medicine Research Group and the Section of Epidemiology, Institute of Cancer Research and the Royal Marsden Hospital, Sutton, Surrey
*
1Address for correspondence: Dr Maggie Watson, CRC Psychological Medicine Group, The Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT.

Synopsis

The possible relationship between psychological responses among breast cancer patients and discase outcome continues to be an area of controversy and debate. Two parallel findings are reported separately in the literature: first, that emotional control is more common among women with breast cancer than in women with benign breast disease or in healthy controls and second, that a helpless attitude towards the disease is related to a poor prognosis.

These previously unrelated psychological responses are examined here in a group of women (N = 359) with early stage breast cancer, who were seen one to three months after diagnosis. The relationships between emotional control, adjustment to cancer and psychological morbidity were examined. Prevalence levels of 16 and 6% were observed for anxiety and depression respectively, which are lower than reported more generally in the literature. The results indicated a highly significant association between scores for the tendency to control emotional reactions and a fatalistic attitude toward cancer. A significant association was observed between anger control and a helpless attitude. Psychological morbidity was also linked to type of adjustment to cancer. The data are interpreted in terms of a process model of psychological responses which suggests that emotional control (an important component of the Type C behaviour pattern) fatalism, helplessness and psychological morbidity are linked.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1991

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References

Anagnostopoulos, F. & Vassilaros, S. T. (1986). Personality attributes of women who develop breast cancer.Paper presented at the 16th European Conference on Psychosomatic Research,Athens, Greece.Google Scholar
Antoni, M. & Goodkin, K. (1988). Host moderator variables in the promotion of cervical neoplasia. I. Personality facets. Journal of Psychosomatic Research 32, 327338.CrossRefGoogle ScholarPubMed
Cox, T. & Mackay, C. (1982). Psychosocial factors and psychophysiological mechanisms in the aetiology and development of cancers. Social Science and Medicine 16, 381396.CrossRefGoogle ScholarPubMed
Collinge, W. (1987). Effects of a complementary cancer therapy program on coping and quality of life. Doctoral thesis of University of California, Berkeley, USA.Google Scholar
Derogatis, L., Morrow, G., Fetting, J., Penman, D., Piasetsky, S., Schmale, A. M., Henrichs, M. & Carnicke, C. (1983). The prevalence of psychiatric disorders among cancer patients. Journal of the American Medical Association 249, 751757.CrossRefGoogle ScholarPubMed
Di Clemente, R. J. & Temoshok, L. (1985). Psychological adjustments to having cutaneous malignant melanoma as a predictor of follow-up clinical status. Psychosomatic Medicine 47, 81.Google Scholar
Fox, B. H. (1978). Pre-morbid psychological factors as related to cancer incidence. Journal of Behavioral Medicine 1, 45133.CrossRefGoogle Scholar
Grassi, L., Watson, M. & Greer, S. (1985). Le Courtauld Emotional Control Scale (CEC) di Watson e Greer. Bollettino di Psicologia Applicata 176, 310.Google Scholar
Grassi, L., Nappi, G., Susa, A. & Molinari, S. (1986). Eventi stressanti supporto sociale e caratteristiche psicologiche in pazienti affecte da carcinoma della mammella. Revista di Psichiatria 21, 315328.Google Scholar
Greer, S. & Watson, M. (1985). Towards a psychobiological model of cancer: psychological considerations. Social Science and Medicine 20, 773777.CrossRefGoogle ScholarPubMed
Greer, S. & Watson, M. (1987). Mental adjustment to cancer: its measurement and prognostic importance. Cancer Surveys 6, 439453.Google ScholarPubMed
Greer, S., Morris, T. & Pettingale, K. (1979). Psychological response to breast cancer: effect on outcome. Lancet ii, 785787.CrossRefGoogle Scholar
Greer, S., Moorey, S. & Watson, M. (1989). Patient's adjustment to cancer: the Mental Adjustment to Cancer (MAC) Scale versus clinical ratings. Journal of Psychosomatic Research, 33, 373377.CrossRefGoogle Scholar
Gross, J. (1989). Emotional suppression in cancer onset and progression. Social Science and Medicine 12, 12391248.CrossRefGoogle Scholar
Heim, E., Augustiny, K., Blaser, A., Burki, C., Kuhne, D., Rothenbuhler, M., Schaffner, L. & Valach, L. (1987). Coping with breast cancer – a longitudinal prospective study. Psychotherapy and Psychosomatics 48, 4459.CrossRefGoogle ScholarPubMed
Hislop, T., Waxler, N., Coldman, A., Elwood, J. & Kan, L. (1987). The prognostic significance of psychosocial factors in women with breast cancer. Journal of Chronic Disease 40, 729735.CrossRefGoogle ScholarPubMed
Holland, J., Korzun, A., Tross, S., Cella, D., Norton, L. & Wood, W. (1986). Psychosocial factors and disease-free survival (DFS) in Stage II breast carcinoma.Proceedings of ASCO,5, March,237.Google Scholar
Jamison, R., Burish, T. & Wallston, K. (1987). Psychogenic factors in predicting survival of breast cancer patients. Journal of Clinical Oncology 5, 768772.CrossRefGoogle ScholarPubMed
Jensen, M. (1987). Psychobiological factors predicting the course of breast cancer. Journal of Personality 55, 317342.CrossRefGoogle ScholarPubMed
Jensen, M. & Muenz, L. (1984). A retrospective study of personality variables associated with fibrocystic disease and breast cancer. Journal of Psychosomatic Research 28, 3542.CrossRefGoogle Scholar
Morris, T., Greer, S., Pettingale, K. & Watson, M. (1981). Patterns of expression of anger and their psychological correlates in women with breast cancer. Journal of Psychosomatic Research, 25, 111117.CrossRefGoogle ScholarPubMed
Persky, V., Kempthorne-Rawson, J. & Shekelle, R. (1987). Personality and risk of cancer: 20 year follow-up of the Western Electric study. Psychosomatic Medicine 49, 435449.CrossRefGoogle ScholarPubMed
Pettingale, K. W., Morris, T., Greer, S. & Haybittle, J. (1985). Mental attitudes to cancer: an additional prognostic factor. Lancet i, 750.CrossRefGoogle Scholar
Razavi, D., Delvaux, N., Farvacques, C. & Robaye, E. (1989). The screening of adjustment disorders and major depressive disorders in hospitalized cancer patients. British Journal of Psychiatry 156, 7983.CrossRefGoogle Scholar
Schmale, A. & Iker, H. (1961). The affect of hopelessness and the development of cancer. Psychosomatic Medicine 28, 714721.CrossRefGoogle Scholar
Schwartz, C., Daltroy, L., Brandt, U. & Stolbach, L. (1989). A psychometric analysis of the Mental Adjustment to Cancer Scale. (Submitted for publication).Google Scholar
Temoshok, L. (1987). Personality, coping style, emotion and cancer: towards an integrative model. Cancer Surveys 6, 545567.Google ScholarPubMed
Watson, M. (1988). Psychological factors in cancer progression. Is there a case? Cancer Journal 2, 7677.Google Scholar
Watson, M. (1990). Breast cancer – is there a psychological risk factor in disease progression?Paper presented at the International Psychoneuroimmunology Symposium,Hannover, Germany. To be published by Hogrefe-Huber International.Google Scholar
Watson, M. & Greer, S. (1983). Development of a questionnaire measure of emotional control. Journal of Psychosomatic Research 27, 299305.CrossRefGoogle ScholarPubMed
Watson, M., Greer, S., Young, J., Inayat, Q., Burgess, C. & Robertson, B. (1988). Development of a questionnaire measure of adjustment to cancer. The MAC scale. Psychological Medicine 18, 203209.CrossRefGoogle ScholarPubMed
Wirsching, M., Stierlin, H., Hoffman, F., Weber, G. & Wirsching, B. (1982). Psychological identification of breast cancer patients before biopsy. Journal of Psychosomatic Research 26, 110.CrossRefGoogle ScholarPubMed
Zigmond, A. & Snaith, R. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica 67, 361370.CrossRefGoogle ScholarPubMed