Relations between coping responses and optimism-pessimism in predicting anticipatory psychological distress in surgical breast cancer patients

Daniel David, Guy H. Montgomery and Dana H. Bovbjerg
Babes-Bolyai University, Romania & Ruttenberg Cancer Center, New York

Published in ?Personality and Individual Differences?, 40, 203-213, 2006

The purpose of this study was to investigate how optimism, pessimism, and coping methods are interrelated and whether or not they predict distress levels among patients requiring surgery for breast cancer.  Participants completed a 12-item questionnaire measuring dispositional optimism and pessimism, and an inventory used to assess a broad range of coping strategies that people are known to use when trying to manage stressful situations.  These included, active coping, planning, acceptance, humour, religion, venting, emotional support, denial, instrumental support, self-blame, emotion suppression, substance abuse, and self-distraction.

A sample of 60 women, aged between 19 and 76, took part in the study.  They were given the above questionnaires home to complete the day before surgery and they were asked to consider the extent to which they used these coping strategies in the few days before their surgery.  A further measurement of mood states was then administered by a research assistant in the pre-operative waiting area immediately before surgery.  This assessed tension-anxiety, depression-dejection, anger-hostility, vigour-activity, fatigue-inertia, and confusion-bewilderment.

The study found that optimism and pessimism significantly influenced distress levels of patients awaiting surgery for breast cancer.  Those with a higher tendency to be optimistic experienced less distress on the day of their surgery.  In contrast, those who tended to be more pessimistic displayed more distress during this time.  The results also indicated that certain coping strategies were related to increased distress levels prior to surgery and these were greater planning, denial, self-distraction, instrumental support, humour, emotional suppression, venting, self-blame, and substance abuse.  Interestingly, some of these coping strategies are considered to be adaptive (e.g. planning, humour, venting, instrumental support), as opposed to problematic (e.g. denial, self-blame, self-distraction), and yet they were still associated with greater levels of distress.  The researchers suggested that these methods may actually increase focus and awareness on the imminent surgery.  Moreover, appraising and reappraising the situation, for example through humour or venting, may actually trigger a vicious cycle of distress.  The findings also suggested that the impact of coping responses on psychological distress was mediated by optimism and pessimism however, the researchers emphasise that further research is necessary in order to understand this association more fully.  They also acknowledge several limitations to the study, including the correlational nature of the findings that prevent them from concluding that optimism and/or pessimism actually have a causal effect on distress levels.  Furthermore, it is unknown whether or not these findings could be generalised to a broader population sample.

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