Psychological response to cancer diagnosis--II. Evidence for coping styles (coping styles and cancer diagnosis).

One hundred and seventy-eight newly diagnosed patients with breast cancer, non-Hodgkin's or Hodgkin's lymphoma were studied with respect to their cognitive responses to cancer diagnosis. These were examined in relation to anxiety, depression and health locus of control as well as to clinical-pathological variables. Data analysis of cognitive responses alone did not confirm the existence of mutually exclusive categories of response. Analysis of cognitive responses and the other psychological variables combined, however, revealed that four broad coping 'styles' could be delineated: 'positive/confronting', 'fatalistic', 'hopeless-helpless' and 'denial/avoidance', which corresponded to our previously described categories. Lower psychological morbidity was associated with a positive/confronting response to diagnosis and with high internal locus of control, while higher anxiety and depression scores were associated with a hopeless-helpless response to diagnosis and with low internal locus of control. The evidence for coping 'styles' is discussed as well as the implications of the results for the psychological management of cancer patients.