At diagnosis, 59 breast cancer patients reported on their overall optimism about life; 1 day presurgery, 10 days postsurgery, and at 3-, 6-, and 12-month follow-ups, they reported their recent coping responses and distress levels. Optimism related inversely to distress at each point, even controlling for prior distress. Acceptance, positive reframing, and use of religion were the most common coping reactions; denial and behavioral disengagement were the least common reactions. Acceptance and the use of humor prospectively predicted lower distress; denial and disengagement predicted more distress. Path analyses suggested that several coping reactions played mediating roles in the effect of optimism on distress. Discussion centers on the role of various coping reactions in the process of adjustment, the mechanisms by which dispositional optimism versus pessimism appears to operate, third variable issues, and applied implications.

How coping mediates the effect of optimism on distress : a study of women with early stage breast cancer

The authors tested effects of a 10-week group cognitive-behavioral stress management intervention among 100 women newly treated for Stage 0-II breast cancer. The intervention reduced prevalence of moderate depression (which remained relatively stable in the control condition) but did not affect other measures of emotional distress. The intervention also increased participants' reports that having breast cancer had made positive contributions to their lives, and it increased generalized optimism. Both remained significantly elevated at a 3-month follow-up of the intervention. Further analysis revealed that the intervention had its greatest impact on these 2 variables among women who were lowest in optimism at baseline. Discussion centers on the importance of examining positive responses to traumatic events--growth, appreciation of life, shift in priorities, and positive affect-as well as negative responses.

Cognitive-behavioral stress management intervention decreases the prevalence of depression and enhances benefit finding among women under treatment for early-stage breast cancer.

• We evaluated the immediate and long-term effects on psychological distress and coping methods of a 6-week, structured, psychiatric group intervention for postsurgical patients with malignant melanoma. The intervention consisted of health education, enhancement of problem-solving skills, stress management (eg, relaxation techniques), and psychological support. In spite of good prognosis, most patients had high levels of psychological distress at baseline, comparable with other patients with cancer. However, at the end of brief psychiatric intervention, the experimental subjects (n = 38), while not without some distress, exhibited higher vigor and greater use of active-behavioral coping than the controls (n = 28). At 6 months' follow-up, the group differences were even more pronounced. The intervention-group patients then showed significantly lower depression, fatigue, confusion, and total mood disturbance as well as higher vigor. They were also using significantly more active-behavioral and active-cognitive coping than the controls. These results indicate that a short-term psychiatric group intervention for patients with malignant melanoma effectively reduces psychological distress and enhances longer-term effective coping.

A structured psychiatric intervention for cancer patients: I. Changes over time in methods of coping and affective disturbance.

T need for a large variety of psychosocial interventions is enhanced as increasing numbers of patients with cancer have longer survival. This article reviews the four interventions used most commonly: (1) education, (2) behavioral training, (3) individual psychotherapy, and (4) group interventions. It examines the outcomes of each type of intervention. This comprehensive review of the intervention literature reveals the availability of a wide range of options for patients with cancer and their potential psychological and physical health benefits.

Critical review of psychosocial interventions in cancer care.

Health is one of the many areas in which there has been a significant amount of interest in relating locus of control (LOCI beliefs to a variety of relevant behaviors. Much of the earlier work in this area has already been reviewed and is available elsewhere (see Strickland, 1978; Wallston, & Wallston, 1978). In this chapter we will not review this material again but will focus on work that has used the health-specific scales we developed, the Health Locus of Control (HLC] Scale and the Multidimensional Health Locus of Control (MHLC] Scales.2 This chapter will review our own program of research and the programs of others across the country who have been using these scales.3 We have tried to be as complete as possible in covering such work, but much of it is unpublished, and numerous studies are in progress. Thus, although this chapter reflects our current views on the utility and validity of

6 – health locus of control scales1

Efficacy of psychosocial intervention with cancer patients.

Up until several years ago, little systematic effort was directed at developing an empirically based understanding of issues pertinent to psychosocial aspects of living with cancer. Recently, howev...

Psychosocial aspects of living with cancer: a review of the literature.

ABSTRACT A methodology for the systematic assessment and treatment of psychosocial problems of cancer patients was developed by a research team investigating the psychosocial impact of cancer on the adult patient. The assessment instrument is a structured problem-oriented interview designed to reveal a patient's self-report of 122 cancer-related psychosocial problems which was administered at several points during the course of a patient's disease. Psychosocial intervention was based on the results of this assessment and was delivered by “oncology counselors.” Actual contacts with the patient were recorded in a “Problem Oriented Record.” A case study is presented in order to demonstrate the usefulness of this approach to both psychosocial assessment and intervention with the cancer patient.

Assessment and treatment of psychosocial problems of the cancer patient: a case study.

Based on 50 interviews with patients attending the New York University Skin and Cancer Clinic for cutaneous malignancies, an impression was gained of the psychosocial impact of cutaneous cancer upon those afflicted. On the basis of this impression, guidelines for physicians in psychological management of such patients are offered.

Ingrid Freidenbergs

Papers

Efficacy of psychosocial intervention with cancer patients.

Psychosocial aspects of living with cancer: a review of the literature.

Assessment and treatment of psychosocial problems of the cancer patient: a case study.

Psychosocial management of patients with cutaneous cancers: a preliminary report.