Avoidant coping in children with cancer.

Compared coping styles in children with cancer (n = 66) and a normative control group of healthy children (n = 414), using a newly designed instrument, the Children's Behavioral Style Scale (CBSS). We hypothesized that children in the oncology group would make greater use of an avoidant coping style (blunting) than controls. Results confirmed the primary hypothesis; children with cancer endorsed greater use of blunting or avoidant coping than did healthy children. A new conceptual model of coping style was introduced utilizing CBSS scores to identify children as Monitors, Blunters, Active, or Passive copers. Using this model, a similar proportion of Active and Passive copers were found in both groups, while the shift towards Blunting in the oncology group was accentuated. Within the oncology group, a positive relationship between Blunting scores and time elapsed since diagnosis was observed, suggesting that the increased Blunting in children with cancer is a reactive phenomenon, at least partly a response to the contingencies of cancer and its' treatment. These findings may provide an alternative interpretation to previous reports of increased defensiveness and repression in children with cancer.