This study examined patients' perceptions that having cancer led to positive life changes, or benefit-finding (BF), e.g. improved relationships, enhanced appreciation of life, increased resilience and self-reliance. We investigated the relations between BF, sociodemographic (e.g. gender, age, marital status, education, income) and disease-related variables (e.g. severity of disease or cancer stage, time since diagnosis). The sample was comprised of 83 men and women with various types of cancer, and all 4 stages of disease were represented. Participants were most likely to be Caucasian (90%), married (66%) and well-educated (68% partial college/specialized training). Of the demographic variables investigated, younger age was associated with greater BF scores. As hypothesized, BF also differed by stage of disease in a curvilinear fashion. Individuals with stage II disease had significantly higher BF scores than those with Stage IV or Stage I cancer. Time since diagnosis and treatment status (i.e. currently in treatment, completed treatment, no treatment) were not related to BF. Findings suggest that stage of disease is an important factor to consider when investigating positive perceptions of disease in individuals with cancer.

The aims of the present study were to examine whether written emotional disclosure would reduce distress among cancer patients and whether it would buffer the effects of high levels of social constraint (negative social responses to patients' expressions of emotion regarding their cancer) on distress. Cancer patients (N=104) were randomly assigned to write about their emotions regarding their cancer 20 min a day for 3 days or to write about a nonemotional topic. They completed questionnaires at baseline and 6 months postintervention. Results showed that written disclosure buffered the effects of social constraints on stress at the 6-month follow-up and that avoidance partly mediated these effects. The present data reinforce the notion that interventions should be tailored to patients' needs.

Healthy people who believe they are at risk for a life-threatening disease appear to carry a substantial stress burden because of threat of disease and uncertainty of risk. Testing for risk factors may be helpful by reducing this uncertainty, but diseases with multiple causes, like breast cancer, appear to be determined by genetic factors and by age, reproductive behavior, exposure to environmental toxins, or unknown antecedents. For diseases caused by inherited genetic defects, testing brings different benefits and stressors. A model is proposed that predicts long-term distress when risk analysis suggests a very high risk, when uncertainty is not reduced, when results of testing are at odds with preventive actions already taken, and when people who receive a positive, risk-increasing result lack strong social support, coping skills, other psychosocial resources, or all of these.

Recent studies in the oncology literature have shown that spirituality, defined as the combination of existential and religious well-being (RWB), is related to both emotional well-being and quality of life. Indeed, spirituality may be particularly important in coping with the potential life threat of the disease. Based on Frankl's (1963) existential theory, in this study, we examined whether the relations between spirituality and emotional well-being are moderated by degree of perceived life threat (PLT). In addition, in this study, we examined the relative importance of religious versus existential well-being in relation to psychological adjustment. Patients diagnosed with various types of cancer (N = 95) completed questionnaires assessing spirituality, PLT, quality of life, and distress. Contrary to theoretical predictions, spirituality was associated with less distress and better quality of life regardless of PLT. Interestingly, existential but not RWB accounted for a major portion of the variance in these outcomes. Taken together, these findings suggest that spirituality, particularly the existential component, may be associated with reduced symptoms of distress in cancer patients regardless of life threat.

Lazarus and Folkman proposed one of the most comprehensive theories of stress and coping in the psychology literature, but many of their postulates have received little empirical attention, and some of the existing research hasyielded contradictory findings. This longitudinal study sought to clarify the associations among control appraisal, coping, and stress within this theoreticalframework. The theory postulates that coping strategies used tend to match the level of appraised controllability of the stressor (matching hypothesis). It further states that the effects of problem-focused versus emotion-focused coping are moderated by the appraised controllability of the stressor (goodness-of-fit hypothesis). An alternative to the latter is the main-effects hypothesis, which states that problem-focused coping is generally more effective in reducing distress regardless of appraisal. These hypotheses were tested on 72 adults who completed questionnaires on coping and control appraisal. Stress was assessed using self-report (Symptom Checklist-90-Revised) and a behavioral measure (proofreading task) at two times approximately 2 months apart. Appraised control significantly predicted type of coping such that greater control was associated with more problem-focused and less emotion-focused coping. Although the main-effects hypothesis was not supported, the goodness-of-fit hypothesis was partly confirmed by a significant control by emotion-focused coping interaction predicting both self-report and behavioral measures of stress.