Matched and mismatched cognitive appraisals in patients with breast cancer and their partners: implications for psychological distress.

Background: The present study sought to identify couples' cognitive appraisals of breast cancer and the extent to which matched or mismatched appraisals within a couple contribute to distress.

Methods: Women with breast cancer (n = 57) and their partners completed the Cognitive Appraisals of Health Scale along with two self-report measures of distress, the Profile of Mood States and the Impact of Events Scale. Four groups were created based on their cognitive appraisals. Couples where both patient and partner scored highest on challenge or benign appraisals formed the positive outlook group (P+S+); when both scored highest on threat or harm/loss, they formed the negative outlook group (P-S-). In the mismatched groups, the patient had a positive outlook, and their partner had a negative outlook (P+S-), or vice versa (P-S+).

Results: In general, lower distress was related to participants' own positive outlook. Higher distress for patients was found in the matched group P-S-; for partners, it was found in the mismatched group P+S-.

Conclusions: These findings suggest partner effects for both patients and partners. When the patient had a negative outlook, a partner negative outlook was associated with the highest psychological distress. When the partner had a negative outlook, a patient positive outlook was associated with the highest psychological distress. There are several possible explanations for these findings, each with different implications for clinical practice. Future research with different groups of cancer patients and longitudinal, mixed methods designs may clarify their meaning.