Abstract
Higher rates of recurrence-free survival at 5- and 10-year follow-up have been reported for breat cancer patients who initially responded to cancer with attitudes of “fighting spirit” or denial. We report here a factor analytic attempt, utilizing questionnaire data, to objectify these attitudes. A reliable factor structure replicated in breast and mixed cancer samples, yielding three factors: (1) Fighting Spirit or belief in the ability to fight back, conquer, and recover from cancer; (2) Information-Seeking behavior; and (3) Denial. Adequate 1-month test-retest correlations were obtained for Fighting Spirit and Information Seeking factor scores. A pattern of differential correlations with other measures (affect, coping, and optimism) distinguished Fighting Spirit and Information Seeking. The Denial factor appeared to be less stable and did not correlate significantly with other measures.
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Billings, A. G., and Moos, R. H. (1981). The role of coping responses and social resources in attenuating the stress of life events.J. Behav. Med. 4: 139–157.
Cassileth, B. R., Lusk, E. J., Miller, D. S., Brown, L. L., and Miller, C. (1985). Psychosocial correlates of survival in advanced malignant disease?N. Engl. J. Med. 312: 1551–1555.
Cella, D. F. (1985). Psychological adjustment and cancer outcome: Levy versus Taylor.Am. Psychol. 40: 1275–1276.
Derogatis, L. R. (1975).The Affect Balance Scale, Clinical Psychometric Research, Baltimore.
Derogatis, L. R. (1980). Psychological assessment of psychosexual functioning.Psychiat. Clin. N. Am. 3: 113–131.
Derogatis, L. R., Meyer, J. K., and Vazquez, N. (1978). A psychological profile of the transsexual. I. The male.J. Nerv. Ment. Dis. 166: 234–254.
Derogatis, L. R., Abeloff, M. D., and Melisaratos, N. (1979). Psychological coping mechanisms and survival time in metastatic breast cancer.JAMA 242: 1504–1508.
Friedman, L. C., Baer, P. E., Lewy, A., Lane, M., and Smith, F. E. (1989). Predictors of psychosocial adjustment to breast cancer.J. Psychosoc. Oncol. (in press).
Greer, S., Morris, T., and Pettingale, K. W. (1979). Psychological response to cancer: Effect on outcome.Lancet 2: 785–787.
Kline, P., and Storey, R. (1977). A factor analytic study of the oral character.Br. J. Soc. Clin. Psychol. 16: 317–328.
Moos, R. H., Cronkite, R. C., Billings, A. G., and Finney, J. W. (1986).Health and Daily Living Form Manual (rev. version), Social Ecology Laboratory, Department of Psychiatry and Behavioral Sciences, Veterans Administration and Stanford University Medical Centers, Stanford, CA.
Morris, T., Blake, S., and Buckley, M. (1985). Development of a method for rating cognitive responses to a diagnosis of cancer.Soc. Sci. Med. 20: 795–802.
Nachmias, D., and Nachmias, C. (1987).Research Methods in the Social Sciences (3rd ed.), St. Martin's Press, New York.
Pettingale, K. W., Philalithis, A., Tee, D. E. H., and Greer, H. S. (1981). The biological correlates of psychological responses to breast cancer.J. Psychosom. Res. 25: 453–458.
Pettingale, K. W., Morris, T., Greer, S., and Haybittle, J. L. (1985). Mental attitudes to cancer: An additional prognostic factor.Lancet 2: 750.
Rogentine, G. N., van Kammen, D. P., Fox, B. H., Docherty, J. P., Rosenblatt, J. E., Boyd, S. C., and Bunney, W. E., Jr. (1979). Psychological factors in the prognosis of malignant melanoma: A prospective study.Psychosom. Med. 41: 647–655.
Scheier, M. F., and Carver, C. S. (1985). Optimism, coping, and health: Assessment and implications of generalized outcome expectancies.Health Psychol. 4: 219–247.
Temoshok, L., and Heller, B. W. (1984). On comparing apples, oranges and fruit salad: A methodological overview of medical outcome studies in psychosocial oncology. In Cooper, C. L. (ed.),Psychosocial Stress and Cancer, John Wiley & Sons, Chichester, pp. 231–260.
Webb, E. J., Campbell, D. T., Schwartz, R. D., and Sechrest, L. (1966).Unobtrusive Measures: Nonreactive Research in the Social Sciences, Rand McNally, Chicago.
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Preparation of this article was facilitated in part by grants from the Psychology Division, Baylor College of Medicine, and Fondren Foundation to Lois C. Friedman.
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Nelson, D.V., Friedman, L.C., Baer, P.E. et al. Attitudes to cancer: Psychometric properties of fighting spirit and denial. J Behav Med 12, 341–355 (1989). https://doi.org/10.1007/BF00844928
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DOI: https://doi.org/10.1007/BF00844928