Appraisal theory and emotional sequelae of first visit to colposcopy following an abnormal cervical screening result.
OBJECTIVE
Attendance at colposcopy following an abnormal cervical smear is potentially a highly distressing event. This study evaluates the role of cognitive appraisal components (Lazarus, 1991; Smith et al., 1993) in explaining emotional reactions to this event. We also compare the psychological sequelae of immediate treatment at first colposcopy (See and Treat, ST) vs. colposcopy with treatment deferred to a later date (Diagnose and Defer, DD).


METHODS
One thousand and eighty-five women referred for colposcopy completed a questionnaire assessing appraisal and emotion following their attendance. Clinical data were abstracted from medical records and social deprivation scores were estimated from postal code information based on normative data.


RESULTS
Diagnosis and cognitive appraisals were each significantly associated with emotion, together accounting for between 3 and 15% of variance in different emotions. Specific patterns of appraisal explained specific emotions in line with theoretical predictions. Women with Cervical Intraepithelial Neoplasia (CIN) 2 or CIN 3 undergoing 'ST' were less anxious, less embarrassed and significantly more relieved compared with a matched sample of women undergoing 'DT', and perceived their first appointment as more motivationally congruent.


CONCLUSIONS
Diagnosis, motivationally incongruent experiences and low emotion-focused coping potential are the most important determinants of anxiety after colposcopy. 'See and Treat' appears to have a positive psychological impact by increasing motivational congruence.
Orbell
Sheina
S
Department of Psychology, University of Essex, Colchester, UK. sorbell@essex.ac.uk
Hagger
Martin
M
Brown
Val
V
Tidy
John
J
D000293:Adolescent; D000328:Adult; D000339:Affect; D000368:Aged; D001294:Attitude to Health; D003071:Cognition; D003127:Colposcopy / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009819:Office Visits; D011582:Psychological Theory; D011795:Surveys and Questionnaires; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*