Psychological coping and cancer

BMJ 2003; 326 doi: https://doi.org/10.1136/bmj.326.7389.598/a (Published 15 March 2003) Cite this as: BMJ 2003;326:598

Study results should not have been dismissed

  1. Maggie Watson, consultant clinical psychologist,
  2. Janis Davidson-Homewood, research assistant,
  3. Jo Haviland, statistician,
  4. Judith Bliss, team leader
  1. Royal Marsden Hospital NHS Trust, Sutton, Surrey SM2 5PT
  2. Institute of Cancer Research, Clinical Trials and Statistics Unit, Sutton, Surrey SM2 5NG
  3. University of Leeds, St James's University Hospital, Leeds LS9 7TF
  4. MRC Social and Public Health Sciences Unit, Glasgow G12 8RZ
  5. Department of Epidemiology and Public Health, Medical School, University of Newcastle on Tyne, Newcastle on Tyne NE2 4HH
  6. Community Health and Epidemiology, Abramsky Hall, Queen's University, Kingston, ON, Canada K7L 3N6

    EDITOR—The review by Petticrew et al is flawed.1

    Firstly, they do not compare like with like and ignore differing methods. Different instruments assess coping styles differently and may not be comparable. Thus conclusions cannot be drawn convincingly. Out of 28 studies, 13 had less than three years' follow up (shortest eight weeks). However, in relation to early breast cancer less than five years of follow up produces inconclusive results.

    Secondly, our study was relegated to the realms of irrelevance by saying that the recent large UK study (n=578), while of higher quality, reported mixed findings: helplessness or hopelessness predicted recurrence when patients with high and low scores were compared but not when it was the predominant coping style.2 The main importance of our clearly stated findings concerning helplessness and hopelessness was missed. Mixed findings were not reported.

    Although predominant coping style was arbitrarily defined, helplessness or hopelessness is robust across many studies. A high score on this subscale is a valid measure, reflecting a response …

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