No abstract

Terms derived from psychoanalytic theory such as the concepts of ego defences and affects, have often been regarded as inaccessible to operational analysis and measurement and therefore devoid of empirical meaning. However, these explanatory terms are frequently employed in hypotheses concerning the determinants of behaviour and outcome in naturally occurring illnesses, such as breast cancer as well as other life crises and stress situations. The results of the present study demonstrate not only that it is possible to operationally define and measure the ego defences and affects associated with the crisis induced by finding a breast symptom suggesting cancer and awaiting biopsy, but also that on the basis of such measurement, behaviour related to breast cancer can be predicted and hypotheses concerning the relevance of these variables to aetiology put to the test. The operational definitions and measurement methods described could also be modified for application in other crisis situations to which ego defences and affects are thought to be pertinent and the results of these operations compared empirically to determine the extent of their convergence. the methods can be used by independent observers with different theoretical and professional backgrounds. The delay by women in reporting breast symptoms to their doctors was strongly related to a combination of non-rational, unconscious psychological factors. Those who delayed used the ego defences of denial and suppression, not intellectualization-isolation, and verbally expressed depression but not anxiety while showing behavioural manifestations of anxiety. Conscious factors such as fear and education were unrelated to the length of delay. These findings have important implications for educators and doctors concerned with the early detection of breast cancer.

TODD3By the use of the methods of behavioural science, a study of women's attitzldes to breast cancer and to breast surgery was carried out to provide firm data which might begin to settle the argument regarding conservative surgery f o r breast cancer. Conscious fears, including that of mastectomy, were found to have no significant influence on the time that a woman takes to report the presence of a breast lump to her doctor, or to commence the practice of breast self-examination. The length of delay i s determined by icnconscious, nonrational processes, and other factors beyond her control. Rational argument, therefore, such us that earlier diagnosis will permit more conservative surgery including partial mastectomy, will not influence women to present any earlier or to practise breast self-examination.