The interacting effects of coping styles and situational variables in gynecologic settings: Implications for Research and treatment

The present paper reviews the determinants of patients' medical and psychological outcomes in gynecologic contexts. Traditionally, 2 main theoretical perspectives have been proposed to account for these effects: (1) the Situational approach and (2) the Trait approach. The problems and weaknesses of these approaches are documented. An alternative 'Interactional' model, the Person By Situation approach, is advanced and its fit to the data is examined. Results show that the interactional framework predicts particularly vulnerable populations when faced with aversive diagnostic procedures. Specifically, high monitors and low blunters (individuals who typically cope by scanning for or failing to distract from threatening cues) show greater physiologic, subjective, and behavioral distress than low monitors/high blunters (individuals who typically cope by ignoring or distracting themselves from threatening cues). Further, individuals generally fare better when the level of preparatory information they receive is consistent with their coping style: i.e., high blunters/low monitors fare better with minimal information and low blunters/high monitors tend to fare better with more voluminous information. Finally, the clinical and educational implications of the interactional approach are discussed.