Appraisals, coping responses, and attributions as predictors of individual differences in negative emotions among adolescents with cancer

This study was designed to account for individual differences in emotional responses to (a) the experience of having cancer and (b) a recent cancer-related hassle by applying two cognitive models of emotions: Lazarus's theory relating stress, appraisals, and coping to specific emotions, and Weiner's attributional model. Seventy-two adolescents (age 12 to 18) with cancer completed self-report measures of constructs implicated in the two models, and their parents reported behavior problems and clinical status. Contrary to Lazarus's theory, primary appraisals of threat, challenge and harm for cancer (and cancer related hassles) were nonspecifically positively correlated with anxiety, anger, and depressive symptoms. Likewise, secondary appraisals (e.g., self-and other-blame, perceived emotion-focused or problem-focused coping potential) showed little evidence of relating more specifically to the negative emotions with which they are theoretically linked. As predicted, both emotion-focused and problem-focused coping strategies were used. Support was found for the hypothesis that problem-focused coping would be positively related to beliefs about what could be done to change the stressor. However, no support was found for the hypothesis that emotion-focused coping would be negatively related to beliefs about how changeable the stressor was. Finally, causal attributions were not significantly associated with the mood states to which they correspond in Weiner's model. Thus, only primary appraisals were associated with emotion and symptoms measures. This relationship held even after controlling for indicators of the objective severity of subjects' medical condition. Sex differences were found on the utilization of coping strategies and on the relationships between coping and emotions. In general, girls used more coping strategies, and higher coping tended to be associated with low negative emotions, whereas higher coping in boys tended to be associated with high negative emotions. Several explanations for the failure to find support for other aspects of the cognitive models were considered, including: (1) attributions and secondary appraisals may be relatively uninformative when studying emotional responses to severe, uncontrollable events, and (2) specificity in cognition-emotion relations may be less evident in children and adolescents in general than in adults.