ABSTRACT
This influential paper was the first report from a prospective longitudinal study of an initial sample of 69 women with early-stage breast cancer, examining the relationship between psychological response to diagnosis and treatment and survival. Women were assessed at 3 and 12 months postoperatively, then annually for a further 4 years. Standardized psychological tests were used to determine depression (Hamilton Rating Scale), hostility (Caine & Foulds), personality (Eysenck Personality Inventory), intelligence (Mill Hill Vocabulary Scale). Women were also interviewed 3 months postoperatively and asked about their perceptions of the seriousness of their disease, attitudes to breast cancer and how their lives had been affected. The authors grouped the psychological responses to this into four mutually exclusive categories:
Denial. Women appeared to reject that they had breast cancer, exemplified by responses such as ‘it wasn’t serious, they took off my breast as a precaution’. They seemed reluctant to discuss the subject but were not overtly distressed.
