Skip to main content
Log in

Using Disease-Related and Demographic Variables to Form Cancer-Distress Risk Groups

  • Published:
Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

The use of disease-related (i.e., stage, phase, perceived health) and demographic (i.e., age, education, income) variables to identify subgroups of cancer patients and survivors manifesting divergent risk for psychosocial adjustment problems was assessed. Clustering procedures distinguished three clusters across two subsamples. In each subsample, low-risk participants had a low stage, a later phase, high perceived health, an older age, and a high education and income; moderate-risk participants had a low stage, a later phase, high perceived health, a greater age, and a low education and income; and high-risk individuals had high stage, an earlier phase, low perceived health, an average age, and a low education and income. Mean difference analyses showed that low-risk participants had higher psychosocial adjustment than high- and moderate-risk participants. High-risk participants had lower psychosocial adjustment than moderate-risk participants. The risk for psychosocial adjustment problems may be influenced by disease-related and demographic variables, and implications for the targeting of interventions are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

REFERENCES

  • Allison, T. G., Williams, D. E., Miller, T. D., Pattern, C. A., Bailey, K. R., Squires, R. W., and Gau, G. T. (1995). Medical and economic costs of psychologic distress in patients with coronary heart disease. Mayo Clin. Proc. 70(8): 734–742.

    Google Scholar 

  • Anderson, B. L. (1992). Psychological interventions for cancer patients to enhance the quality of life. J. Consult. Clin. Psychol. 60: 552–568.

    Google Scholar 

  • Anderson, B. L., Anderson, B., and deProsse, C. (1989). Controlled longitudinal study of women with cancer: Sexual functioning outcomes. J. Consult. Clin. Psychol. 57: 683–691.

    Google Scholar 

  • Anderson, B. L., Kiecolt-Glaser, J. K., and Glaser, R. (1994). A biobehavioral model of cancer stress and disease course. Am. Psychol. 49: 389–404.

    Google Scholar 

  • Andrykowski, M. A., and Brady, M. J. (1994). Health locus of control and psychological distress in cancer patients: Interactive effects of context. J. Behav. Med. 17: 439–458.

    Google Scholar 

  • Andrykowski, M. A., and Cordova, M. J. (1998). Factors associated with PTSD symptoms following treatment for breast cancer: Test of the Anderson model. J. Traumatic Stress 11(2): 189–203.

    Google Scholar 

  • Bailey, K. D. (1994). Typologies and Taxonomies: An Introduction to Classification Techniques, Series: Quantitative Applications in the Social Sciences, Sage, Thousand Oaks, CA.

    Google Scholar 

  • Beder, J. (1995). Perceived social support and adjustment to mastectomy in socioeconomically disadvantaged Black women. Social Work Health Care 22(2): 55–71.

    Google Scholar 

  • Bovbjerg, D. H., and Valdimarrsdottir, H. B. (1998). Psychoneuroimmunology: Implications for psycho-oncology. In Holland, J. C. (ed.), Psycho-Oncology, Oxford University Press, New York.

    Google Scholar 

  • Cohen, J. (1992). A power primer. Psychol. Bull. 112: 155–159.

    Google Scholar 

  • Cordova, M. J., Andrykowski, M. A., Kennedy, D. E., McGrath, P. C., Sloan, D. A., and Redd, W. H. (1995). Frequency and correlates of post-traumatic-stress-disorder-like symptoms after treatment for breast cancer. J. Consult. Clin. Psychol. 63: 981–986.

    Google Scholar 

  • Derogatis, L. R. (1986). The Psychosocial Adjustment to Illness scale. J. Psychosom. Res. 30: 77–91.

    Google Scholar 

  • Edlund, B., and Sneed, N.V. (1989). Emotional responses to the diagnosis of cancer: Age-related comparisons. Oncol. Nurs. Forum 16: 691–697.

    Google Scholar 

  • Ferrero, J., Barreto, M. P., and Toledo, M. (1994). Mental adjustment to cancer and quality of life in breast cancer: An exploratory study. Psycho-Oncology 3: 223–232.

    Google Scholar 

  • Glanz, K., and Lerman, C. (1992). Psychological impact of breast cancer: A critical review. Ann. Behav. Med. 14: 204–212.

    Google Scholar 

  • Goodwin, J. C. (1995). Research in Psychology: Methods and Design, Wiley, New York.

    Google Scholar 

  • Gotay, C. C., and Stern, J. D. (1995). Assessment of psychological functioning in cancer patients. J. Psychosoc. Oncol. 13: 123–160.

    Google Scholar 

  • Grassi, L., and Rosti, G. (1996). Psychosocial morbidity and adjustment to illness among long term cancer survivors: A six year follow up study. Psychosomatics 37: 523–532.

    Google Scholar 

  • Harlow, L. L., Rose, J. S., Morokoff, P. T., and Quina, K. (1993). Tests of reasonable solutions in cluster analysis: An AIDS risk example. Paper presented at the annual meeting of the Society of Multivariate Psychology, San Pedro, CA, Oct.

  • Harrison, J., and Maguire, P. (1994). Predictors of psychiatric morbidity in cancer patients. Br. J. Psychiatry 165: 593–598.

    Google Scholar 

  • Hobfall, S. E. (1989). Conservation of resources: A new attempt at conceptualizing stress. Am. Psychol. 44: 513–524.

    Google Scholar 

  • Holland, J. C. (1998). Psychooncology, Oxford University Press, New York.

    Google Scholar 

  • Holland, J. C., and Rowland, J. H. (1989). Handbook of Psycho-Oncology: Psychological Care of the Patient with Cancer, Oxford University Press, New York.

    Google Scholar 

  • Irvine, D., Brown, B., Crooks, D., Roberts, J., and Browne, G. (1991). Psychosocial adjustment in women with breast cancer. Cancer 67: 1097–1117.

    Google Scholar 

  • Iacovino, V., and Reesor, K. (1997). Literature on interventions to address cancer patients' psychosocial needs: What Does it tell us? J. Psychosoc. Oncol. 15: 47–71.

    Google Scholar 

  • Kornblith, A. B., (1998). Psychosocial adaptation of cancer survivors. In Holland, J. C. (ed.), Psychooncology, Oxford University Press, New York.

    Google Scholar 

  • Kornblith, A. B., Anderson, J., Cella, D. F., Tross, S., Zuckerman, E., Cherin, E., Henderson, E., Weiss, R. B., Cooper, M. R., Silver, R. T., Leone, L., Canellos, G. P., Gottlieb, A., and Holland, J. C. (1992a). Hodgkin Disease survivors at increased risk for problems in psychosocial adaptation. Cancer 70: 2214–2224.

    Google Scholar 

  • Kornblith, A. B., Anderson, J., Cella, D., Tross, S., Zuckerman, E., Cherin, E., Henderson, E., Canellos, G. P., Kosty, M. P., Cooper, M., Weiss, R., Gottleib, A., and Holland, J. C. (1992b). Comparison of psychosocial adaptation and sexual function of survivors of advanced Hodgkin disease treated by MOPP, ABVD or MOPP alternating with ABVD. Cancer 70: 2508–2516.

    Google Scholar 

  • Landis, S. H., Murray, T., Bolden, S., and Wingo, P. A. (1998). Cancer statistics, 1998. CA-A Cancer J. 48: 6–29.

    Google Scholar 

  • Lavery, J. F., and Clarke, V. A. (1996). Causal attributions, coping strategies, and adjustment to cancer. Cancer Nurs. 19: 20–28.

    Google Scholar 

  • Lazarus, R., and Folkman, S. (1984). Stress, Appraisal, and Coping, Springer, New York.

    Google Scholar 

  • Liang, L. P., Dunn, S. M., Gorman, A., and Stuart-Harris, R. (1990). Identifying priorities of psychosocial need in cancer patients. Br. J. Cancer 62: 1000–1003.

    Google Scholar 

  • Loscalzo, M., and Brintzenhofeszoc, K. (1998). Brief crisis counseling. In Holland, J. C. (Ed.), Psycho-oncology, Oxford University Press, New York.

    Google Scholar 

  • Lynch, M. E. (1995). The assessment and prevalence of affective disorders in advanced cancer. J. Palliat. Care 11: 10–18.

    Google Scholar 

  • Malcarne, V. L., Compas, B. E., Epping-Jordan, J. E., and Howell, D.C. (1995). Congnitive factors in adjustment to cancer: Attributions of self-blame and perceptions of control. J. Behav. Med. 18: 401–417.

    Google Scholar 

  • Marks, G., Richardson, J. L., Graham, J. W., and Levine, A. (1986). Role of health locus of control beliefs and expectations of treatment efficacy in adjustment to cancer. J. Person. Soc. Psychol. 51: 443–450.

    Google Scholar 

  • Miller, S. M., and Schnoll, R. A. (2000). When seeing is feeling: A cognitive-emotional approach to coping with health stress. In Lewis, M., and Haviland, J. (eds.), Handbook of Emotion, Plenum Press, New York.

    Google Scholar 

  • Mischel, W. (1973). Toward a cognitive social learning reconceptualization of personality. Psychol. Rev. 80: 252–283.

    Google Scholar 

  • Mischel, W., and Shoda, Y. (1995). A cognitive-affective system theory of personality: Reconceptualizing situations, dispositions, dynamics, and invariance in personality structures. Psychol. Rev. 102: 246–268.

    Google Scholar 

  • Moyer, A., and Salovey, P. (1996). Psychosocial sequalae of breast cancer and its treatment. Ann. Behav. Med. 18: 110–125.

    Google Scholar 

  • Nelson. D. V., Friedman, L. C., Baer, P. E., Lane, M., and Smith, F. E. (1994). Subtypes of psychosocial adjustment to breast cancer. J. Behav. Med. 17: 127–141.

    Google Scholar 

  • Norusis, M. J. (1990). SPSS Base System User's Guide, SPSS, Chicago, II.

    Google Scholar 

  • Padilla, G. V., Mishel, M. H., and Grant, M. M. (1992). Uncertainty, appraisal, and quality of life. Qual. Life Res. 1: 155–165.

    Google Scholar 

  • Roberts, C. S., Rossetti, K., Cone, D., and Cavanagh, D. (1992). Psychosocial impact of gynecological cancer: A descriptive study. J. Psychosoc. Oncol. 10: 99–109.

    Google Scholar 

  • Rodrigue, J. R., Behen, J. M., and Tumlin, T. (1994). Multidimensional determinants of psychological adjustment to cancer. Psycho-Oncology 3: 205–214.

    Google Scholar 

  • Rowland, J. H. (1989). Developmental, stage and adaptation: Adult model. In Holland, J. C., and Rowland, J. H. (eds.), Handbook of Psychooncology: Psychological Care of the Patient with Cancer, Oxford University Press, New York.

    Google Scholar 

  • Sarna L. (1993). Women with lung cancer: Impact on quality. of life. Qual. Life Res. 2: 13–22.

    Google Scholar 

  • Schnoll, R. A., Harlow, L. L., Stolbach, L. L., and Brandt, U. (1998). A structural model of the relationships among stage of disease, age, coping, and psychological adjustment. Psycho-Oncology 7: 69–77.

    Google Scholar 

  • Sokal, R., and Sneath, P. (1963). Principles of Numerical Taxonomy, W. H. Freeman, San Francisco, CA.

    Google Scholar 

  • Stanton, A. L., and Snider, P. R. (1993). Coping with a breast cancer diagnosis: A prospective study. Health Psychol. 12: 16–23.

    Google Scholar 

  • Thompson, S. C., Sobolew-Shubin, A., Galbraith, M. E., Schwankovsky, L., and Cruzen, D. (1993). Maintaining perceptions of control: Finding perceived control in low-control circumstances. J. Person. Soc. Psychol. 64: 293–304.

    Google Scholar 

  • Vinokur, A. D., Threatt, B. A., Vinokur-Kaplan, D., and Satariano, W. A. (1990). The process of recovery from breast cancer for younger and older patients. Cancer 65: 1242–1254.

    Google Scholar 

  • Wagner, M. K., Armstrong, D., and Laughlin, J. E. (1995). Cognitive determinants of quality of life after onset of cancer. Psychol. Rep. 77: 147–154.

    Google Scholar 

  • Watson, M., Greer, S., Pruyn, J., and Van den Borne, B. (1990). Locus of control and adjustment to cancer. Psychol. Rep. 66: 39–48.

    Google Scholar 

  • Wong, C. A., and Bramwell, L. (1992). Uncertainty and anxiety after mastectomy for breast cancer. Cancer Nurs. 15: 363–371.

    Google Scholar 

  • Zabora, J. R. (1998). Screening procedures for psychological distress. In Holland, J. C. (ed.), Psycho-oncology, Oxford University Press, New York.

    Google Scholar 

Download references

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schnoll, R.A., Harlow, L.L. Using Disease-Related and Demographic Variables to Form Cancer-Distress Risk Groups. J Behav Med 24, 57–74 (2001). https://doi.org/10.1023/A:1005686404723

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1005686404723

Navigation