Department of Health Sciences, University Medical Center Groningen, University of Groningen, The Netherlands.
Psychol Health. 2010 Nov;25(9):1023-40. doi: 10.1080/08870440902935921.
This prospective study examines the cognitive and behavioural mediators of the relation between personal control and the initial response to a breast cancer diagnosis as well as subsequent psychological adjustment. A total of 143 patients participated immediately after diagnosis (T1), after surgery (T2) and 2 months after the end of treatment (T3), of whom 92 also completed a questionnaire pre-diagnosis (T0). The buffering effect of personal control on psychological distress shortly after diagnosis was mediated by cancer-specific cognitions, i.e. threat appraisal and coping self-efficacy. Moreover, a strong sense of personal control predicted lower levels of anxiety 2 months after the end of treatment, but was unrelated to distress at T3. The adaptive effect on anxiety was mediated by threat appraisal and active engagement in social life after surgery, but not by active patient participation or coping self-efficacy. These results confirm and explain the adaptive effect of control. Apparently, women with a low sense of control appraise cancer and their personal coping skills more negatively, which makes them vulnerable to distress in response to diagnosis. Furthermore, women with a strong sense of control might regulate anxiety by remaining engaged in social life.
本前瞻性研究考察了个人控制与乳腺癌诊断初始反应以及随后心理适应之间关系的认知和行为中介。共有 143 名患者在诊断后立即（T1）、手术后（T2）和治疗结束后 2 个月（T3）参加，其中 92 名患者还在诊断前完成了问卷（T0）。个人控制对诊断后短期心理困扰的缓冲作用是通过癌症特异性认知来介导的，即威胁评估和应对自我效能。此外，强烈的个人控制感预测治疗结束后 2 个月时焦虑程度较低，但与 T3 时的困扰无关。对焦虑的适应作用是通过手术后的威胁评估和积极参与社会生活来介导的，但与积极的患者参与或应对自我效能无关。这些结果证实并解释了控制的适应作用。显然，控制感低的女性对癌症及其个人应对技能的评价更为消极，这使她们在诊断时容易受到困扰。此外，控制感强的女性可能通过保持积极参与社会生活来调节焦虑。
