Literature regarding cancer adaptation has stressed the central role of coping strategies in reducing psychological symptoms. On the other hand, recent studies have indicated that distress and emotions might influence the use of coping strategies (Khosla & Hangal, 2004; Classen et al., 1996). However, little research has explored the latter possibility. The current study aims to explore whether coping strategies used among newly-diagnosed cancer patients predict latter distress or early distress predicts the use of coping strategies. This issue provides important information on whether we should focus on teaching coping strategies or reducing distress in the early intervention for cancer patients.
A longitudinal study was conducted with 113 breast cancer patients at the third month after the cancer surgery (T1) and the sixth month after the surgery (T2). The Chinese version of the brief COPE (Carver, 1997) and the Chinese version of the Hospital Anxiety and Depression scale (HADS) were assessed at both T1 and T2.
Hierarchical regression analyses were performed to examine the relative contribution of coping strategies to distress (anxiety and depression), controlling for age, marital status, income, cancer stage and the distress level at T1. For the reverse direction of predictions, the same steps were adopted.
Approach coping at T1 significantly predicted level of anxiety at T2 (β=-0.22, p=.019). On the other hand, the level of anxiety and depression at T1 significantly predicted the use of approach coping at T2 (β=0.22, -0.49; p=.011, p<.001), and T1 depression predicted the use of disengagement coping at T2 (β=0.26, p=.016).
Our findings emphasized the significance of early distress level. While depression at early stage seems to be a sign for less use of adaptive coping, anxiety has bidirectional meanings- a suffering sign that predicts disengaged coping and a warning to motive the use of adaptive coping.