The relationship between coping strategies and anxiety in women from families with familial breast-ovarian cancer in the absence of demonstrated mutations.

This is a cross-sectional study of coping strategies in 174 healthy women who fulfill clinical criteria for familial breast/ovarian cancer in the absence of demonstrated mutations (ADM) compared to 68 healthy women with BRCA1 carrier status. Both groups got a mailed questionnaire after genetic counseling and testing, respectively. The questionnaire included demographic and cancer-related variables as well as the Hospital Anxiety and Depression Scale (HADS) and the Coping Orientation to Problems Experienced Scale (COPE). In both groups 24% of the women had an anxiety disorder. Coping strategies which helped the women to accept and make the best out of their situation were most frequently applied in both the ADM and the carrier groups. Compared to the carrier group, the ADM group had higher mean levels on both emotion-focused and problem-focused strategies. The emotion-focused strategies were all significantly associated with presence of HADS-defined anxiety disorder in the ADM group. In the carrier group problem-focused strategies were significantly associated with increased prevalence of such anxiety disorder. In multivariate analysis 'focus on emotions' was significantly associated with increased prevalence of HADS-defined anxiety disorder in both groups, and 'acceptance' was associated with reduced prevalence in both groups.