Personality, coping style, emotion and cancer: towards an integrative model.

What this paper attempts, which may be different than previous reviews of the literature regarding the role of certain psychosocial factors and cancer initiation/progression, is to propose a model wherein seemingly discrepant findings may be integrated and understood. For this task, a representative but not an exhaustive review of studies was conducted, which revealed surprising consistencies, given the heterogeneity of designs, measures and cancer sites. Evidence converges on a constellation of factors that appears to predispose some individuals to develop cancer more readily or to progress more quickly through its stages. These factors include (a) certain personality traits or coping styles, which were discussed under the rubric of 'Type C'; (b) difficulty in expressing emotions; and (c) an attitude or tendency toward helplessness/hopelessness. Next, illustrative discrepancies across studies were presented. In order to make sense of these seemingly discrepant results, a process model of coping style and psychological-physiological homoeostasis was proposed. This model may be used to understand why some studies have found that Type C is associated with cancer outcome measures, while others have found that helplessness/hopelessness or emotional expression is related to outcome. We would expect that these differences are attributable to the point in the cancer and coping process at which psychological assessment was conducted.