Psychological reactions to radiation therapy: reconsideration of the adaptive aspects of anxiety.

A common form of cancer treatment is radiation therapy. In this investigation individual differences in the psychological reactions of 45 patients undergoing external treatment were examined in the context of the Janis (1958) and linear decline models (e.g., Spielberger, Auerbach, Wadworth, Dunn, & Taulbee, 1973) of medical stressor anxiety. Evaluation included pre- and postradiation assessments of the subjects' state and trait anxiety, somatic complaints, and treatment side effects. Technologists administering the daily treatments assessed behavioral indicants of affective distress. Data analyses revealed that increases in complaints and side effects were reported by all patients at treatment conclusion. More interesting, significant changes in state anxiety were obtained from pre- to posttreatment: (a) Patients with an initial high level of anxiety reported a significant reduction, although they remained the most anxious subgroup; (b) patients with a moderate level of pretreatment anxiety reported no change; and (c) patients with low levels of anxiety reported significant increases in state anxiety. No change in trait anxiety was found for any group, suggesting that the foregoing changes in state anxiety were not simply attributable to regression. Data trends suggested that patients who were either low or high in state anxiety were also characterized by more anger or hostility than patients moderate in anxiety. The findings are consistent with the Janis model, which posits that in threatening situations the level of fear can potentially determine the adequacy of adaptation.