Coping with a breast cancer diagnosis: A prospective study.
Abstract
Employing the stress and coping theory of Lazarus and Folkman, this study followed 117 women age 40 or over regarding personality, cognitive appraisal, coping, and mood variables before breast biopsy, after diagnosis, and, for those who had cancer, after surgery. Upon biopsy, 36 received a cancer diagnosis, and 81 received a benign diagnosis. The 2 groups did not differ on appraisals, coping, or affect before diagnosis. With prebiopsy affect controlled, cancer patients reported more negative affect postbiopsy than did benign patients. Postsurgery, cancer patients expressed less vigor and more fatigue than benign patients, but the groups did not differ on other negative emotions. Prebiopsy, psychosocial predictors accounted for 54% and 29% of the variance in negative and positive emotion, respectively. Prebiopsy variables also predicted postbiopsy and postsurgery mood; cognitive avoidance coping was a particularly important predictor of high distress and low vigor.
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M-ACT specifies putative mechanisms of change including increasing active acceptance, reducing avoidance of internal experiences, and clarifying values and sources of meaning.
“based on the broader ACT model, M-ACT specifies putative mechanisms of change including increasing active acceptance and reducing avoidance of internal experiences (i.e., difficult thoughts and emotions) and clarifying values and sources of meaning (e.g., [29–31])”
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Carver, C. S., & Connor-Smith, J. (2010) · Annual Review of Psychology · doi:10.1146/annurev.psych.093008.100352 · Cited by 2,424 · see citing works
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Coping Resources, Coping Processes, and Mental Health
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“…surrounding persistent stressors predicts elevated distress across such samples as impoverished women (Rayburn et al. 2005), cancer patients (e.g., Stanton & Snider 1993), caregivers for individuals with chronic disease (Billings et al. 2000), hospitalized burn patients (Fauerbach et al. 2002),…”
BackgroundSelf-citationDispositional Optimism and Coping: A Meta-Analytic Review
Nes, L. S., & Segerstrom, S. C. (2006) · Personality and Social Psychology Review · doi:10.1207/s15327957pspr1003_3 · Cited by 1,000 · see citing works
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Emotionally expressive coping predicts psychological and physical adjustment to breast cancer
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“As we have done in other studies (Stanton & Snider, 1993; Stanton et al., 1998), we constructed a distress index by summing items on the Anger, Depression, Tension, Fatigue, and Confusion subscales.”
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Stanton, A. L., Revenson, T. A., & Tennen, H. A. (2006) · Annual Review of Psychology · doi:10.1146/annurev.psych.58.110405.085615 · Cited by 688 · see citing works
“For example, in comparison with less avoidant women, breast cancer patients who were high on cognitive avoidance prior to breast biopsy reported more distress at that point, after cancer diagnosis, and after surgery (Stanton & Snider 1993; see also Hack & Degner 2004, Lutgendorf et al. 2002).”
BackgroundResultSelf-citationBeyond unfavorable thinking: the illness cognition questionnaire for chronic diseases
Evers, A. W. M., Kraaimaat, F. W., van Lankveld, W., Jongen, P. J. H., Jacobs, J. W. G., & Bijlsma, J. W. J. (2001) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.69.6.1026 · Cited by 657 · see citing works
The first year after breast cancer diagnosis: hope and coping strategies as predictors of adjustment
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“At study entry, participants reported somewhat lower distress and higher vigor than another group of breast cancer patients who completed these measures in the 24 h prior to surgery (Stanton and Snider, 1993).”
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Self-citationPsychological Sequelae of Cancer Diagnosis
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“A confronting coping style, optimism, or a fighting spirit were found to be positively related to psychological adjustment in five studies (23, 37, 38, 69, 75), whereas passive acceptance, helplessness, anxious preoccupation, avoidance, denial, the appraisal of cancer as a threat, a feeling of loss of control, asking”
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“For example, Stanton and Snider (1993) followed a group of women undergoing breast biopsy.”
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“An extensive body of research documents that this measure is a reliable predictor of behavioural and psychological outcomes (Scheier & Carver, 1992; Scheier et al., 2001), including adaptation to breast cancer (Carver et al., in press; Epping-Jordan et al., 1999; Stanton & Snider, 1993).”
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“Coping efforts have been shown to mediate between the experience of stress and mental health outcomes in community samples (e.g., Aldwin and Revenson, 1987) as well as samples contending with various illness conditions (e.g., Carver et al., 1993; Felton and Revenson, 1984; Stanton and Snider, 1993).”
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“Stanton and Snider (1993) found that cognitive avoidance/denial was detrimental to women with breast cancer prebiopsy, postbiopsy, and at follow-up.”
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“The presurgery time point was selected to test the proposed hypotheses because the presurgical period surrounding diagnosis and surgery appears to particularly stressful for cancer patients and their partners (e.g. Carver et al., 1993; Stanton and Snider, 1993).”
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“Although the diagnosis and treatment of breast cancer can be stressful at a number of levels, there is evidence that effectively working through this crisis may have positive psychological effects [3–5].”
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“This is consistent with Stanton and Snider (1993) who found that cognitive avoidance coping prior to breast biopsy predicted more distress at that point, after cancer diagnosis, and after surgery Coping with Prostate Cancer: A Meta-Analytic Review 289”
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“Avoidance-based coping responses are associated with increased psychological distress (McCaul et al., 1999; Shapiro et al., 1997; Stanton and Snider, 1993), and have been found to predict fear of cancer recurrence among women with breast cancer across the first year post-diagnosis (Stanton et al.,…”
BackgroundResultCulver, J. L., Arena, P. L., Antoni, M. H., & Carver, C. S. (2002) · Psycho-Oncology · doi:10.1002/pon.615 · Cited by 241 · see citing works
“Studies of coping have generally found that engaged forms of coping, directed at addressing the problem and coming to terms with it, relate to lower distress (Carver et al., 1993; Dunkel-Schetter et al., 1992; Epping-Jordan et al., 1999; Friedman et al., 1988; Friedman et al., 1990; Moyer and Salovey, 1996; Stanton an…”
BackgroundResultInfluentialAdherence and psychological adjustment among women at high risk for breast cancer
Lerman, C. E., & Schwartz, M. D. (1993) · Breast Cancer Research and Treatment · doi:10.1007/bf00666427 · Cited by 243 · see citing works
“person's coping efforts (e.g., information-seeking vs. avoidance) [ 35 ].”
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“Furthermore, studies of cancer patients at diagnosis and re-entry document the utility of approach-oriented coping (eg, active acceptance, seeking social support, emotional expression).(33,36,37,46,47) In addition to providing information regarding what to expect during re-entry, the interventions were designed to inc…”
BackgroundSelf-citationThe Relation of Social Support and Coping to Positive Adaptation to Breast Cancer
Dukes Holland, K., & Holahan, C. K. (2003) · Psychology & Health · doi:10.1080/0887044031000080656 · Cited by 236 · see citing works
“Stanton and Snider (1993) found that cognitive avoidance coping was associated with negative affect both before and after surgery.”
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“Prospective studies reveal that optimism (11), coping strategies such as positive reframing and acceptance (11, 12), and social support (13) yield less distress in the months after treatment.”
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“Coping efforts predict psychological adjustment to cancer [23–25], and most studies suggest active rather than avoidant forms of coping are associated with better adjustment [26–28].”
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Vos, M. S., & de Haes, J. C. J. M. (2006) · Psycho-Oncology · doi:10.1002/pon.1051 · Cited by 221 · see citing works
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“There are a myriad of studies concerning the effect of coping on emotional well-being in various stressful situations such as exams (18,19), surgery (20, 21 ), and adjustment to college (22).”
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“…(Aspinwall & Taylor, 1992; Carver et al., 1993; Epping-Jordan et al., 1999; Scheier & Carver, 1992; Segerstrom, Taylor, Kemeny, & Fahey, 1998; Stanton & Snider, 1993) and also might be associated with better physical health via relationships to the cardiovascular and immune systems…”
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“…stressors, including positive HIV status (Taylor et al., 1992), adaptation to college (Aspinwall et al., 1992), myocardial infarction (Desharnais et al., 1990) breast cancer biopsy (Stanton and Snider, 1993), breast cancer surgery (Carver et al., 1993) and immune changes (Segerstr m et al., 1998).”
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“Threat, challenge, and controllability appraisals were measured by three scales used in similar research (e.g., Stanton and Snider, 1993).”
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“For example, while avoidant coping is typically associated with negative emotional outcomes [13,28,38], there are instances, such as when a stressor cannot be actively controlled, in which avoidant coping provides some emotional benefit [39].”
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“Lazarus’s cognitive appraisal theory [37–40] provides additional support to the above assertion.”
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Engagement and Arousal: Optimism’s Effects During a Brief Stressor
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“Optimism has been associated with better psychological well-being (e.g., Carver et al., 1993; Segerstrom et al., 1998; Stanton & Snider, 1993) as well as physiological well-being as reflected in qualities of the cardiovascular (Räikkönen, Matthews, Flory, Owens, & Gump, 1999) and immune (F. Cohen…”
BackgroundCoping in marital dyads: A contextual perspective on the role of gender and health
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“The other two studies reported a decrease in depression scores after diagnosis in cancer patients [34] or an increase, but also a decrease again after surgery [43].”
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Lutgendorf, S. K., Anderson, B., Ullrich, P., Johnsen, E. L., Buller, R. E., Sood, A. K., Sorosky, J. I., & Ritchie, J. (2002) · Cancer · doi:10.1002/cncr.10155 · Cited by 142 · see citing works
“ability to face the reality of their life situation and to develop more adaptive coping responses.(27,39) Disen-”
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“…diagnosis of breast cancer (Antoni et al., 2001; Bellizzi, 2004; Bellizzi & Blank, 2006; Cordova, Cunningham, Carlson, & Andrykowski, 2001; Fromm, Andrykowski, & Hunt, 1996; Sears, Stanton, & Danoff-Burg, 2003; Stanton & Snider, 1993; Swickert & Hittner, 2009; Tomich & Helgeson, 2004; Weiss, 2004).”
BackgroundSocial Relations, Coping, and Psychological Distress Among Persons With HIV/AIDS1
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“Conversely, avoidance coping, exemplified by denial and disengagement, generally had effects opposite to those of active coping, being associated with increased distress, poorer mental health (Aldwin and Revenson, 1987; Carver et al., 1993; Folkman and Lazarus, 1986; Stanton and Snider, 1993; Stephens et al., 1988), a…”
BackgroundFactors of complicated grief pre‐death in caregivers of cancer patients
Tomarken, A., Holland, J. C., Schachter, S. R., Vanderwerker, L. C., Zuckerman, E. L., Nelson, C. J., Coups, E. J., RAMIREZ, P. M., & Prigerson, H. G. (2007) · Psycho-Oncology · doi:10.1002/pon.1188 · Cited by 139 · see citing works
Wolf, M. S., Chang, C., Davis, T. C., & Makoul, G. T. (2004) · Patient Education and Counseling · doi:10.1016/j.pec.2004.09.005 · Cited by 137 · see citing works
“These patients contend with extensive physical and psychological ramifications of both the disease and associated treatment regimens, which cause significant strains on their existing personal and social resources [2–7].”
BackgroundAdjustment to breast cancer: age‐related differences in coping and emotional distress
Compas, B. E., Stoll, M. F., Thomsen, A. H., Oppedisano, G., Epping‐Jordan, J. E., & Krag, D. N. (1999) · Breast Cancer Research and Treatment · doi:10.1023/a:1006164928474 · Cited by 134 · see citing works
“This relationship has been found for women ranging from 30 to over 80 years old who were assessed prior to and following a breast biopsy [5] and several days after initial surgery [6]; the size of the correlation between age and emotional”
InfluentialAppraisals and coping in people living with cancer: a meta‐analysis
Franks, H. M., & Roesch, S. C. (2006) · Psycho-Oncology · doi:10.1002/pon.1043 · Cited by 132 · see citing works
Bozo, Ö., AKTÜRK, E., & Büyükaşik-Çolak, C. (2009) · Journal of Health Psychology · doi:10.1177/1359105309342295 · Cited by 132 · see citing works
A Review of Age Differences in Psychological Adjustment to Breast Cancer
Mosher, C. E., & Danoff‐Burg, S. (2005) · Journal of Psychosocial Oncology · doi:10.1300/j077v23n02_07 · Cited by 131 · see citing works
“…the Profile of Mood States (POMS; McNair, Lorr, & Droppelman, 1971) (Levy et al., 1992; Stanton et al., 2000; Stanton, Danoff-Burg, & Huggins, 2002; Stanton & Snider, 1993), the Center for Epidemiologic Studies Depression Scale (CES-D; Radloff, 1977) (Broeckel, Jacobsen, Balducci, Horton, & Lyman,…”
BackgroundInfluentialPsychosocial sequelae of breast cancer and its treatment
Moyer, A., & Salovey, P. (1996) · Annals of Behavioral Medicine · doi:10.1007/bf02909583 · Cited by 129 · see citing works
Spouse support, coping, and mood among individuals with cancer
Manne, S. L., Pape, S. J., Taylor, K. L., & Dougherty, J. (1999) · Annals of Behavioral Medicine · doi:10.1007/bf02908291 · Cited by 124 · see citing works
Matthews, E. E., & Cook, P. F. (2008) · Psycho-Oncology · doi:10.1002/pon.1461 · Cited by 124 · see citing works
“Optimists have been shown to report more PFC responses than pessimists in dealing with breast cancer [60], breast biopsy procedures [45], and areas of health promotion [64,65].”
Uncertainty and Anxiety During the Diagnostic Period for Women With Suspected Breast Cancer
Liao, M.-N., Chen, M., Chen, S., & Chen, P. (2008) · Cancer Nursing · doi:10.1097/01.ncc.0000305744.64452.fe · Cited by 121 · see citing works
“This distress, along with the uncertainty of possibly acquiring breast cancer, affects not only patients’ thinking and information-processing abilities(7) but also their coping behaviors.(8,9) Furthermore, level of uncertainty in this population of women has been positively correlated with anxiety level.”
BackgroundReid‐Arndt, S. A., Yee, A., Perry, M. C., & Hsieh, C. (2009) · Journal of Psychosocial Oncology · doi:10.1080/07347330903183117 · Cited by 114 · see citing works
“These findings are in line with some of the literature on coping, which has suggested that social support seeking as a coping style may have a significant impact on emotional well-being ( Holland & Hollahan, 2003 ; Stanton & Snider, 1993 ).”
ResultCoping and quality of life among women extensively treated for gynecologic cancer
Costanzo, E. S., Lutgendorf, S. K., Rothrock, N. E., & Anderson, B. (2006) · Psycho-Oncology · doi:10.1002/pon.930 · Cited by 114 · see citing works
“Effects of using particular strategies to cope with cancer on mood and quality of life have been well-documented (Ben-Zur et al., 2001; Carver et al., 1993; Classen et al., 1996; Epping-Jordan et al., 1999; Heim et al., 1997; Manne et al., 1999; Stanton and Snider, 1993).”
BackgroundGender differences in coping: A further test of socialization and role constraint theories
Sigmon, S. T., Stanton, A. L., & Snyder, C. R. R. (1995) · Sex Roles · doi:10.1007/bf01547718 · Cited by 113 · see citing works
Self-citationCarver, C. S., Lehman, J. M., & Antoni, M. H. (2003) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.84.4.813 · Cited by 114 · see citing works
Peterson, J. L., Folkman, S., & Bakeman, R. A. (1996) · American Journal of Community Psychology · doi:10.1007/bf02506793 · Cited by 112 · see citing works
“Optimism has been found to be related to coping (Aspinwall & Taylor, 1992; Carver et al., 1993; Carver, Scheier, & Weintraub, 1989; Friedman et al., 1992; Litt, Tennen, Afflect, & Klock, 1992; Scheier & Carver, 1985; Scheier, Matthews, et al., 1989; Scheier, Weintraub, & Carver, 1986; Stanton & Snider, 1993; Taylor et…”
Innes, K. E., Selfe, T. K., Khalsa, D. S., & Kandati, S. (2016) · Journal of Alzheimer s Disease · doi:10.3233/jad-151106 · Cited by 108 · see citing works
“Likewise, mean participant scores on all domains of the POMS, a well established and widely used measure of mood disturbance, were significantly worse than reported norms for older adults [120], and similar to or higher than those in adults with HIV, cancer, heart failure, and other serious chronic disorders [121–126].”
Montgomery, G. H., Schnur, J. B., Erblich, J., Diefenbach, M. A., & Bovbjerg, D. H. (2010) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2009.11.318 · Cited by 111 · see citing works
Baseline psychosocial predictors of survival in localized melanoma.
Lehto, U., Ojanen, M., Dyba, T., Aromaa, A., & Kellokumpu-Lehtinen, P. (2007) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2007.01.001 · Cited by 68 · see citing works
“In cancer, various divisions into separate coping patterns have been presented [7,28,29].”
BackgroundHo, S. M. Y., Fung, W. K., Chan, C., Watson, M., & Tsui, Y. K. Y. (2003) · Psycho-Oncology · doi:10.1002/pon.672 · Cited by 108 · see citing works
“Many studies in Western countries have demonstrated the association between the coping responses and the psychological outcomes of cancer patients (Jenkins and Pargament, 1995; Parle and Maguire, 1995; Stanton and Snider, 1993).”
BackgroundA Prospective Study of Coping, Perceived Control, and Psychological Adaptation to Breast Cancer
Osowiecki, D. M., & Compas, B. E. (1999) · Cognitive Therapy and Research · doi:10.1023/a:1018779228432 · Cited by 106 · see citing works
“Stanton and Snider (1993) , in a prospe ctive study of women before and after a breast biopsy, found that cognitive avoidance was the only unique predictor of emotional distress over time.”
BackgroundInfluentialSevere fatigue and related factors in cancer patients before the initiation of treatment
Goedendorp, M. M., Gielissen, M. F. M., Verhagen, C. A. H. H. V. M., Peters, M. E. W. J., & Bleijenberg, G. (2008) · British Journal of Cancer · doi:10.1038/sj.bjc.6604739 · Cited by 107 · see citing works
“Receiving the diagnosis cancer can inflict strong feelings of anxiety (Stanton and Snider, 1993; Cimprich, 1999), although these high levels appeared to decrease within 2 weeks (Shepherd and Fisher, 2004).”
BackgroundCoping with a possible breast cancer diagnosis: demographic factors and social support
Drageset, S., & Lindstrøm, T. C. (2005) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.2005.03495.x · Cited by 107 · see citing works
Changes in Optimism Are Associated With Changes in Health Over Time Among Older Adults
Chopik, W. J., Kim, E. S., & Smith, J. (2015) · Social Psychological and Personality Science · doi:10.1177/1948550615590199 · Cited by 104 · see citing works
Williamson, G. (2000) · Health Psychology · doi:10.1037/0278-6133.19.4.339 · Cited by 110 · see citing works
- Authors
- Stanton, A. L., & Snider, P. R.
- Affiliations
- University of Kansas (US)
- ORCID
- Stanton, Annette L.
- Venue
- Health Psychology
- Published
- 1993
- Volume
- 12
- Issue
- 1
- Pages
- 16-23
- ISSN
- 0278-6133 (ISSN-L)
- 1930-7810
- OpenAlex
- W2167814667
- Cited by
- 574
- References
- 0
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 2 · 2023: 6 · 2022: 3 · 2021: 12 · 2020: 6 · 2019: 11 · 2018: 7 · 2017: 20 · 2016: 13 · 2015: 16 · 2014: 14 · 2013: 12 · 2012: 29
- FWCI
- 4.26
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Health Psychology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Social Sciences › Sociology and Political Science › Family Support in Illness
- Keywords
- breast cancer, coping, stress and coping theory, cognitive appraisal, negative affect, positive affect, breast biopsy, breast surgery, psychosocial predictors, fatigue, vigor, cancer diagnosis
- MeSH terms
- Adaptation, Psychological, Adult, Affective Symptoms, Aged, Aged, 80 and over, Biopsy, Breast, Breast Neoplasms, Female, Humans, Male, Middle Aged, Neoplasm Staging, Personality Inventory, Prospective Studies, Sick Role
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