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Psychological risk factors for colorectal cancer?

Facteurs de risque psychologiques du cancer colorectal ?

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Psycho-Oncologie

Abstract

The paper deals with personality correlates of colorectal cancer patients in the framework of the cognitive orientation theory. The cognitive-motivational approach and the construction and testing of a reliable and valid questionnaire for assessing the personality correlates of colorectal cancer are reviewed in the first part. In the second part in a new sample of 230 colorectal cancer patients the themes in the questionnaire are clustered and their structure is tested in a confirmatory factor analysis. Further, following the expectation that colorectal cancer is gender bound, the differences in the themes and belief types are applied to testing differences between men and women corresponding to the medical differences. Finally the questionnaire was applied to identifying the detected personality correlates in an attenuated form in a sample of Crohn’s disease patients who are known to be at risk for colorectal cancer. Discriminant analysis showed that the questionnaire provided a highly significant correct identification of cases of the three groups (165 healthy controls, 90 patients with Crohn’s disease and 230 colorectal cancer patients). The thematic clusters that constitute the personality correlates of colorectal cancer were found to be tendencies for compulsiveness, control of oneself and especially of anger, self effacement, pleasing others, self assertion, distancing oneself from others, keeping regulations, and performing to perfection all ones obligations. The three major foci of these tendencies are perfect duty performance, and two contradictory pairs: self effacement versus self assertion, and closeness to others versus distancing from others. The clusters and the contrasts constitute potentially sources of tension. It is suggested that the identified personality correlates be considered as psychological risk factors for colorectal cancer.

Résumé

Cet article traite des caractéristiques de personnalité des patients atteints de cancer colorectal (CCR) dans le cadre d’une théorie de la personnalité d’orientation cognitive. Cette approche dite motivationnelle-cognitive, ainsi que la construction d’un questionnaire validé et fiable pour mesurer les caractéristiques de personnalité liées au cancer colorectal, sont développées dans la première partie. Dans la seconde partie, à partir d’un nouvel échantillon de 230 patients atteints de CCR, les thèmes du premier questionnaire ont été rangés en clusters et leur structure a été validée par une nouvelle analyse factorielle. Ensuite, partant du fait que le CCR se manifeste sur un plan médical de manière différente en fonction du sexe, les différences dans les thèmes et les types de croyances, ont été mises en application pour tester des différences hommes/femmes correspondant à ces différences médicales. Enfin, le questionnaire a été appliqué pour identifier les mêmes caractéristiques de personnalité mises en évidence, dans une moindre mesure, chez des patients atteints de maladie de Crohn, connus pour être à risque de cancer colorectal. L’analyse statistique a montré que le questionnaire permettait d’identifier de manière significative les caractéristiques de personnalité de chaque groupe. Le modèle en structure thématique du questionnaire a été pertinent pour discriminer les différences entre les trois groupes ainsi qu’entre les hommes et les femmes (groupe contrôle, n = 165; patients atteints de maladie de Crohn, n = 90; patients atteints de cancer colorectal, n = 230). Les clusters thématiques trouvés (ou variables de personnalité du CCR), font ressortir les tendances à la compulsivité, au contrôle de soi et spécialement de la colère, l’auto-effacement, le fait de se rendre agréable aux autres, l’auto-affirmation, la distanciation des autres, l’attachement aux règles et le besoin de perfection dans les tâches. On peut dire que ces tendances se manifestent en trois tendances majeures: L’accomplissement d’un travail parfait et deux tendances contradictoires, l’auto-effacement et l’auto-affirmation d’une part, et d’autre part, la proximité des autres et la distanciation. Ces clusters et oppositions peuvent constituer des sources de tension. Il est proposé que les traits de personnalité identifiés puissent être considérés comme des facteurs de risque psychologique du CCR.

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Authors and Affiliations

  1. Department of Psychology, Tel Aviv University and Psycho-Oncology Research Center, Sheba Medical Center, Tel Hashomer, Israel

    S. Kreitler

  2. Psycho-Oncology Research Center, Sheba Medical Center, Tel Hashomer, Israel

    M. -M. Kreitler

  3. Surgery ward, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel

    A. Len

  4. Social Sciences faculty, Tel Aviv University, Tel Aviv, Israel

    Y. Alkalay

  5. Oncology Department, Barzilai Medical Center, Ashkelon, Israel

    F. Barak

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  1. S. Kreitler
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  2. M. -M. Kreitler
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  3. A. Len
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  4. Y. Alkalay
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  5. F. Barak
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Correspondence to S. Kreitler.

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Kreitler, S., Kreitler, M.M., Len, A. et al. Psychological risk factors for colorectal cancer?. Psycho Oncologie 2, 131–145 (2008). https://doi.org/10.1007/s11839-008-0094-9

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