The mental health of women with suspected breast cancer: the relationship between social support, anxiety, coping and defence in maintaining mental health.

Relationships between anxiety, social support, coping, and defence, in connection to mental health, were studied among patients with suspected breast cancer, awaiting diagnosis. Data were collected by questionnaires from 117 women, 25-76 years of age (mean: 53.6 years) who had undergone breast biopsy. Instruments used were: the Social Provisions Scale (SPS); the state scale of State-Trait Anxiety Scale (STAI); and CODE [based on the Utrecht Coping List (UCL) and Defence Mechanisms Inventory (DMI)]. The results showed that patients reported elevated levels of anxiety and high levels of social support. Yet, anxiety was strongest and negatively related to 'instrumental coping', followed by 'cognitive defence'. 'Defensive hostility' was unrelated to anxiety. Unexpectedly, 'emotion-focused coping' and social provisions were unrelated to anxiety. Social provisions were somewhat related to 'instrumental coping', but sparsely related to 'emotion-focused coping', unrelated to 'cognitive defence' and partly negatively related to 'defensive hostility'. Hence, social support and 'emotion-focused coping' did not in themselves repress anxiety. 'Instrumental coping' did, even in a situation where nothing could be done. Social support is suggested to be the product of an 'instrumental coping style', not necessarily contributing to it. Clinical consequences for professional information and support to patients with different coping styles are suggested.