Applications of the monitoring process model to coping with severe long-term medical threats.

Abstract

Guided by the monitoring process model (MPM), the authors explored the illness responses of 2 samples: high monitors (who are cognitively vigilant to and amplify threat-related cues) and low monitors (who avoid them and blunt their impact). Both samples-101 women with human papillomavirus-related precancerous cervical dysplasia and 75 HIV-infected gay men-were undergoing long-term medical follow-up and management. Structural equation analysis showed an adequate fit of the MPM to the data within each sample, supporting the model's heuristic value: High monitors experienced greater disease-related intrusive ideation, which triggered greater avoidant ideation to forestall panic, particularly in the more threatened HIV-positive sample. However, efforts to avoid disturbing intrusive thoughts were ineffective, requiring increasingly extreme defensive strategies (i.e., denial and mental and behavioral disengagement).

Monitoring coping style moderates emotional reactions to genetic testing for hereditary nonpolyposis colorectal cancer: a longitudinal study

“…Monitoring was unrelated to depressive symptoms, adding to previous findings associating monitoring with anxiety but not with depression [45,57]. Our findings also demonstrated that while high monitors who received positive or indeterminate test results experienced greater distress, those who were non-carriers were not more distressed than low monitors.…”

“…Similar monitoring  test result interactions were obtained among women undergoing trans-vaginal ultrasound: high monitors responded only to an abnormal test result with elevated distress [58]. These findings are also consistent with predictions of the Monitoring Process Model [36,45], whereby high monitors' distress is activated only when threatened with an aversive event and is not present when stress is low or absent. This results from their tendency to perceive personal risks as higher; to experience more intrusive ideation; and to encode threats as catastrophic [34,37,41,43,44,59,60].…”

“…High monitors may be especially likely to opt for predictive genetic testing for cancer because of their threat-related vigilance and information-seeking style [39][40][41][42]. However, the paradox is that they are those most adversely affected by it: high monitors were found more likely than low monitors to experience distress when provided with information about increased genetic risk for cancer or in response to indeterminate results [30,40,[43][44][45][46][47][48]. Accordingly, we expected that high monitors testing for HNPCC would show higher distress levels in general, and especially when receiving positive or indeterminate results.…”

Cervical cancer

“…12,13 In response to cervical cancer risk feedback and other health stressors, patients considered high monitors tend to respond with heightened and more sustained perceived vulnerability, greater negative expectations about their health, less satisfaction with health-related information, more disease-specific distress and physiologic arousal, and diminished selfefficacy regarding their ability to cope with the health threat. This pattern of response to diagnostic feedback can lead to intrusive ideation that triggers avoidant thoughts and behaviors, which ultimately may be detrimental to health behaviors and adherence over the long term, 14,15 particularly when less information and support are available. Patients considered low monitors (blunters) are more likely to ignore and psychologically distance themselves from cancer threats and tend to be less distressed in the face of diagnostic feedback, particularly when not presented with voluminous information, but they also are less adherent from the onset.…”

Cognitive-Affective Predictors of the Uptake & Sustained Adherence to Lymphedema Symptom Minimization Practices in Breast Cancer Survivors

“…Yet, little is currently known about women's knowledge and practice of precautionary behaviors to prevent or lessen the impact of this condition (Coward, 1999;Clark, Wasilewska, et al, 1997). Guided by the Cognitive-Social Health Information Processing (C-SHIP) model (Miller, Shoda, et al, 1996;Miller & Rodoletz, 1996;Miller & Diefenbach, 1998), the overarching objective of the present study is to explore the cognitive-affective factors associated with knowledge about LE symptom-minimization practices, their initiation, and the sustained maintenance of these practices among breast cancer survivors currently unaffected by LE.…”