Coping with a threat to life: a longitudinal study of self-concept, social support, and psychological distress.

The relationship of self-concept (self-esteem and mastery) and social support to psychological distress was studied among 68 Israeli women immediately prior to undergoing biopsy for suspected cancer (acute stress) and 3 months later for the noncancer group (everyday stress). It was predicted that women with stronger self-concepts and more social support would experience less state depression and state anxiety during the acute crisis than women with weaker self-concepts and less social support. It was further predicted that self-concept would be more critical than social support due to the acute nature of the event. Finally, self-concept was predicted to be related to psychological distress both during the acute and everyday stress situations (a direct effect), while social support was predicted to be related to psychological distress only during the acute stress situation (a buffering effect). The hypotheses were generally confirmed. However, self-concept and social support were seen as complexly related to psychological distress during the acute phase, one not necessarily being more critical than the other. The selective employment of available resistance resources to fit the situation and implications for preventive intervention were discussed.