Cognitive and emotional responses to cancer threat: An experimental model

Abstract

Breast cancer, the most common form of cancer in women in the United States, is a threat to most women. Reactions of fear and distress to cancer threat may result in increased cancer risks. The dual process theory of illness cognition posits that emotional and cognitive responses to health threats are parallel and partially independent. Based on previous imagery research, reactions to cancer-related imagery should be consistent with those in the real world. Further, experimental studies have shown that imagery-induced mood states may affect cognition, as people tend to make mood-congruent health appraisals. Therefore, it was hypothesized that cancer-related imagery would result in increased distress, increased perceived risk, and more severe perceived consequences of breast cancer.;A sample of 78 women completed an experimental protocol beginning with baseline questionnaires assessing mood, illness perceptions of breast cancer (IPQ), perceived lifetime risk of breast cancer, intrusive thoughts about breast cancer (IES), optimism and pessimism (LOT). Next, participants in the Experimental Group were given a neutral imagery scene and a cancer-related imagery scene, while participants randomly assigned to the Control Group were given two neutral scenes. After the imagery scenes, all participants completed questionnaires assessing mood, vividness of the scene, illness perceptions and perceived risk.;Analysis of Covariance (with baseline levels as covariates) revealed: (a) The Experimental Group had significantly higher levels of distress than the Control Group, (b) the Experimental Group had significant changes in their perceptions of illness, including stronger internal attribution for cancer and adverse effects of cancer and its treatment, and (c) perceived risk of breast cancer, and illness perceptions relating to cure and time-line remained stable post-imagery. Follow-up analysis showed: (a) Participants in the Experimental Group with higher levels of self-reported vividness of the imagery scene had greater post-imagery distress, (b) participants in the Experimental Group with higher levels of intrusive thoughts about breast cancer at baseline had greater postimagery distress, and (c) the immediate emotional response to the imagery mediated the post-imagery cognitive change in perceived consequences of breast cancer.;Future research should examine the lasting effects of the cognitive and emotional reactions and their relation to health behaviors.