Biopsychosocial Correlates of Adjustment to Cancer during Chemotherapy: The Key Role of Health-Related Quality of Life

Background. Patients adjust to cancer in a continuous process that follows the course of the disease. Previous research has considered several illness-related variables and demographics, quality of life, personality, and social factors as predictors of adjustment to cancer, which can be maladaptive (e.g., helplessness-hopelessness and anxious preoccupation) or adaptive (e.g., fighting spirit). Aims. Assuming a biopsychosocial view, we test an empirical model in which disease stage, patient’s age, and gender are viewed as the distal antecedents of positive and negative adjustment to cancer for chemotherapy patients. Health-related quality of life (HRQoL) has a key role, interposing between the distal antecedents and adaptational outcomes. Social support and positive thinking are also included in the model as related to adjustment. Methods. One-hundred-sixty-two consecutive cancer patients receiving adjuvant or standard chemotherapy participated in the study. Patients completed the Mini-Mental Adjustment to Cancer, the Brief-COPE, the Social Provision Scale, and the SF-12 Health Survey. Partial least squares structural equation modeling (PLS-SEM) was applied for model building and hypotheses testing. Results. We found a negative association between advanced stage and physical functioning, a strong positive link between physical functioning and mental health, and significant relations between mental health and helpless-hopelessness, anxious preoccupation, and cognitive avoidance. Social support and positive thinking were related to fighting spirit and fatalism. Cancer stage and female gender were indirectly associated with adaptational outcomes through HRQoL. The patient’s age had no significant relationships in the model. Discussion. HRQoL (both physical and mental) is a key factor for preventing maladjustment in chemotherapy patients. Social support and positive thinking coping style fosters fighting spirit and fatalism on health outcomes. Two potential lines of action seem promising: preventing maladaptive and promoting adaptive adjustments working on patient’s mental health individually and involving significant others in supportive care, respectively.

Personality, Cognitive Coping Strategies, and Adaptational Outcomes in a Sample from the General Spanish Population

The relationship among scores on two personality dimensions, Emotional Stability and Extraversion, and on two cognitive coping strategies, Positive Thinking and Wishful Thinking, and on the Consequences of Coping scale were examined in 169 Spanish persons (78 men and 91 women; Mage = 36.3 yr., SD = 12.1). Positive Thinking was associated with high scores on the two personality dimensions and positive consequences, whereas Wishful Thinking was associated with low scores on both Emotional Stability and Extraversion and with negative consequences.

Age Differences and Changes of Coping Behavior in Three Age Groups: Findings from the Georgia Centenarian Study

With increasing age, older adults are more likely to be challenged by an increasing number of physical, functional and social losses. As a result, coping with losses becomes a central theme in very late life. This study investigated age differences and age changes in active behavioral, active cognitive and avoidance coping and related coping to adaptational outcomes, such as physical and mental health. Sixty-one sexagenarians, 46 octogenarians, and 47 centenarians from the Georgia Centenarian Study participated in this longitudinal study to assess coping with health and family events. The results indicated age group differences in active behavioral coping, suggesting that centenarians were less likely to use this mode of coping. Centenarians and octogenarians were also more likely to experience decreases in active behavioral coping over time, while sexagenarians were more likely to experience increases in this coping mode. No significant differences in coping with health versus family events were obtained suggesting that coping is consistent across life domains. Moderate levels of stability were obtained for coping in all age groups. Active behavioral and active cognitive coping predicted functional health, active behavioral coping predicted social relations, and avoidance coping predicted negative affect.

Situational and dispositional coping: an examination of their relation to personality, cognitive appraisals, and psychological distress

Reliable data on the relationships between situational and dispositional coping strategies are sparse. In order to address this gap in the literature, this study examined the determinants and adaptational outcomes of both types of coping. Two hundred and thirty‐three students completed, along with measures of situational and dispositional coping, measures of personality, cognitive appraisals, and psychological distress, the latter variable being evaluated concurrently and prospectively (10 weeks). Results showed that personality shared as much variance with situational as with dispositional coping, but the patterns of relationships were rather different. In addition, cognitive appraisals were found to add significant incremental validity in predicting situational coping beyond trait coping, but primary appraisals were redundant with personality traits, in particular neuroticism. Finally, in spite of the significant amount of variance shared between the two types of coping, they both accounted for individual differences in concomitant and prospective psychological distress, and the relation between dispositional coping and distress was partially mediated by situational coping. The implications of these findings for understanding the relationships between the two types of coping strategy are discussed. Copyright © 2004 John Wiley & Sons, Ltd.

The Effects of Dispositional and Situational Coping, Perceived Social Support, and Cognitive Appraisal on Immediate Outcome

Summary: The effects of coping styles and strategies, perceived social support, and primary and secondary cognitive appraisal on immediate outcome were examined in this study. Two theoretical models were tested via linear structural equation modelling (LISREL VI) on a sample of 116 women. The first model was derived from the structural approach to stress and coping, while the second was based primarily on a theoretical position of the transactional approach to stress and coping process. Both models were tested twice, by taking into account appraisal of threat and appraisal of controllability. The results indicate the importance of cognitive appraisals and their effects on adaptational outcomes, situational coping efforts as well as their mediating role between some coping resources and adaptational outcomes. The main differences obtained in the models tested account for the type of cognitive appraisal included in the analyses. The appraisal of threat proved to be a more central component of stressful experience than appraisal of controllability. The results also show that dispositional as well as situational coping strategies exert relatively weak effects on immediate outcome.

Experiencing the Presence of the Dead: Discrepancies in “The Sensing Experience” and Their Psychological Concomitants

Relationships between experiencing “the presence of the dead” and psychological outcome parameters were studied in thirty-nine widows, early in bereavement and twelve months later. Self-evaluation of coping, expectancies about future coping, and scores on psychological standard questionnaires (“Spielberger State-Trait Anxiety Scale” (STAI), “Goldberg Health Questionnaire” (GHQ), “General Well-Being Schedule” (GWB), “Sjõberg Measurement of Mood” (SJO) and “Life Style Index” (LSI) were used as indicators of outcome. A majority of the widows reported “sensing experiences” at both occasions. The sensing experiences were categorized as being “neutral to slightly positive,” “extremely positive,” and “extremely negative.” “Extremely positive,” and “extremely negative” experiences were found to be associated with poor adaptational outcomes, whereas “neutral to slightly positive experiences” and no sensing experiences were associated with good outcomes. The nature of the sensing experience, therefore, seems to predict adaptation after bereavement.

The Moderating Effect of Optimism on the Relation between Hassles and Somatic Complaints

The relations between hassles, dispositional optimism, and prospective reports of physical symptoms were examined in a group of 90 Hong Kong undergraduates. Given that most hassle scales are confounded by physical and psychological symptomatology, a decontaminated scale specifically tailored to the experiences of college students was used. Multiple regression analyses indicated that hassle scores and the interaction of hassles and optimism uniquely and reliably predicted symptom reporting. Optimism, however, did not reliably predict symptom reports when effects of hassles and the interaction of hassles and optimism were controlled. Inspection of the interaction showed that optimism predicted symptom scores only at high levels of hassles. The underlying mechanisms were discussed in the light of previous data linking optimism and adaptational outcomes via coping. It was suggested that further pursuit of the connection between optimism and coping in relation to measures of life stress would be worthwhile.