Measuring multiple dimensions of perceived control in women with newly diagnosed breast cancer.

A multidimensional approach to the study of focus of perceived control (FPC) can provide a more specific understanding of associations between FPC and adjustment to cancer. We developed and tested a measure to capture multiple dimensions of FPC and examined FPC dimensions in relation to positive expectancies and three indices of psychosocial adjustment in 219 women with breast cancer. Confirmatory factor analysis supported a 6-factor model of FPC (chi(2)(284 df) = 433.67, p < 0.001; CFI = 0.94; RMSEA = 0.049, 90% C.I. = 0.040, 0.058) that included PC over physical symptoms, emotions, relationships, medical care, cancer outcomes and life in general. Specific associations between FPC and adjustment were observed: more emotional PC was associated with less emotional distress, more physical PC was associated with better physical quality of life (QOL), and more medical PC was associated with better medical QOL. Positive expectancies were also associated with better outcomes. These results indicate dimensions of FPC as differentially associated with indices of adjustment, suggesting multiple targets of interventions aimed at benefiting breast cancer survivors.

Measurement of coping and stress responses in women with breast cancer.

The development of the Responses to Stress Questionnaire-cancer version (RSQ-CV) to assess coping with and responses to the stress of breast cancer is described. The RSQ-CV was completed by 232 women with breast cancer near the time of their diagnosis. Confirmatory factor analyses verified a model that includes three voluntary coping factors (primary control engagement coping, secondary control engagement coping, disengagement coping) and two involuntary stress response factors (involuntary engagement, involuntary disengagement). Internal consistency reliability, and stability over 12 weeks for the five factors were adequate to excellent. Convergent and discriminant validity was examined through correlations with measures of intrusive thoughts, avoidance, and dimensions of perceived control. Significant correlations with symptoms of anxiety and depression are also reported. Applications of the RSQ-CV for research with breast cancer patients are discussed.

Self-blame and distress among women with newly diagnosed breast cancer.

This study examined relations between behavioral and characterological self-blame attributions for breast cancer and psychological distress in the year following a diagnosis. One hundred fifteen women with newly diagnosed breast cancer participated. First, we predicted that both forms of self-blame would be associated with distress shortly after diagnosis (i.e., at 4 months). Second, we predicted that only characterological self-blame would be related to distress at 7 and 12 months post-diagnosis because behavioral self-blame would enhance perceptions of control, thereby protecting against distress. Results supported the first hypothesis; both forms of self-blame were related to symptoms of anxiety and depression at 4 months post-diagnosis. Findings did not support the second hypothesis because both forms of self-blame continued to be related to distress at 7 and 12 months post-diagnosis. Furthermore, perceptions of control did not mediate the self-blame/distress relation. Implications for social cognitive processes in adaptation to breast cancer are discussed.