title: Coping with ovarian cancer risk: the moderating effects of perceived control on coping and adjustment.
abstract: OBJECTIVE
  Although perceived control and coping have been studied across various health conditions, these relationships have been less well studied in the context of coping with cancer risk over time. The present study was a longitudinal study of the effects of perceived control and problem-focused coping on changes in psychological adjustment and behavioural outcomes among women at increased risk for ovarian cancer.
  
  
  METHODS
  Eighty women enrolled in a familial cancer risk assessment programme participated in this study. Assessments of problem-focused coping, perceived control and distress were collected upon entry into the programme and again at 3-month follow-up. Behavioural adherence to screening during the 12-month period following programme entry was obtained from clinic records.
  
  
  RESULTS
  Using hierarchical regression analysis, we observed a significant interaction between perceived control and problem-focused coping for psychological distress, beta=0.94, p<.05. Specifically, problem-focused coping was associated with increasing distress over time among women who perceived high control. A significant control by coping interaction was also observed for behavioural adherence to pelvic ultrasound and CA125 screening, such that women who perceived high control and utilized problem-focused coping were less likely to undergo screening.
  
  
  CONCLUSIONS
  Under conditions of high perceived control, problem-focused coping was associated with increasing distress as well as poorer behavioural adherence. Thus, perceived control and problem-focused coping may not always yield positive psychological or behavioural health outcomes. These findings contribute to a greater understanding of how problem-focused coping and perceived control may influence the course of adjustment to cancer risk over time.
authors.affiliation: Division of Population Science, Fox Chase Cancer Center, Philadelphia, PA 19012, USA. carolyn.fang@fccc.edu
authors.forename: Carolyn Y
authors.initials: CY
authors.lastname: Fang
authors.forename: Mary B
authors.initials: MB
authors.lastname: Daly
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Miller
authors.forename: Tana
authors.initials: T
authors.lastname: Zerr
authors.forename: John
authors.initials: J
authors.lastname: Malick
authors.forename: Paul
authors.initials: P
authors.lastname: Engstrom
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D003710:Demography; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D008403:Mass Screening; D010051:Ovarian Neoplasms / Q000523:psychology*; D012307:Risk Factors; D020377:Self Efficacy; D011795:Surveys and Questionnaires