Study results should not have been dismissed

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 …