title: Distancing, self-esteem, and subjective well-being in head and neck cancer.
abstract: BACKGROUND
  Distancing (i.e. construing oneself as dissimilar to a negatively-stereotyped group) preserves self-esteem and may benefit other domains of subjective well-being. Head and neck cancer (HNC) is stigmatized because major risk factors include avoidable lifestyle variables (smoking, alcohol consumption, and human papilloma virus). Because the benefits of coping efforts, such as distancing, are most evident when people are under stress, we hypothesize that the psychosocial benefits of distancing will be most pronounced when cancer and its treatment interfere substantially with participation in valued activities and interests (i.e. high illness intrusiveness).
  
  
  OBJECTIVE
  To test whether distancing preserves self-esteem and other domains of subjective well-being (SWB) in HNC, especially when illness intrusiveness is high.
  
  
  METHODS
  Five hundred and twenty-two HNC outpatients completed a semantic-differential measure of perceived similarity to the 'cancer patient' and measures of illness intrusiveness, self-esteem, depressive symptoms, and psychological well-being in structured interviews. Evaluations of the 'cancer patient' reflected cancer stereotypes.
  
  
  RESULTS
  A statistically significant interaction supported the central hypothesis: When people held negative stereotypes, those who construed themselves as similar to the 'cancer patient' reported lower self-esteem than those who construed themselves as dissimilar. Distancing did not benefit other SWB variables. Some results were counter-intuitive: e.g. Emotional distress increased with increasing illness intrusiveness when people did not hold negative cancer stereotypes, but when they held highly negative stereotypes, distress decreased with increasing illness intrusiveness.
  
  
  CONCLUSIONS
  Overall, distancing preserved self-esteem in people with HNC and was associated with benefits in other SWB domains.
authors: Princess Margaret Cancer Center and University of Toronto, Canada.
authors: Gerald M
authors: GM
authors: Devins
authors: University of Toronto, Canada.
authors: Janice C
authors: JC
authors: Wong
authors: University of Toronto, Canada.
authors: Ada Y M
authors: AY
authors: Payne
authors: University of Ottawa, Canada.
authors: Sophie
authors: S
authors: Lebel
authors: McMaster University Medical Centre and McMaster University, Canada.
authors: Ruth N F
authors: RN
authors: Lee
authors: Princess Margaret Cancer Center, Canada.
authors: Kenneth
authors: K
authors: Mah
authors: Princess Margaret Cancer Center and University of Toronto, Canada.
authors: Jonathan
authors: J
authors: Irish
authors: Princess Margaret Cancer Center and University of Toronto, Canada.
authors: Gary
authors: G
authors: Rodin
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D003863:Depression; D005260:Female; D006258:Head and Neck Neoplasms / Q000523:psychology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012929:Psychological Distance; D011788:Quality of Life / Q000523:psychology*; D012649:Self Concept; D013240:Stereotyping; D013315:Stress, Psychological / Q000523:psychology