Stress And Hopelessness In The Promotion Of Cervical Intraepithelial Neoplasia To Invasive Squamous Cell Carcinoma Of The Cervix

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Degree Name

Doctor of Philosophy (Ph.D.)




Stress and hopelessness have been variably associated with the development of invasive squamous cell carcinoma of the cervix by previous research. Subjects were recruited for this study voluntarily at the Jackson Memorial Hospital from patients in a colposcopy clinic awaiting work-up of an abnormal Pap Smear and from those admitted to an in-patient gynecology ward. The in-patients were admitted for a cone biopsy to rule out invasive cervical cancer or for a hysterectomy to treat a symptomatic pelvic mass thought to be uterine leiomyomas. All seventy-three subjects were unaware of their pathological diagnoses at the time of their participation. A semi-structured interview was conducted and followed by the administration of the Beck Hopelessness Scale, the Life Experience Survey and the Millon Behavioral Health Inventory. After data collection pathology reports and colposcopic findings were used to determine group assignment.The experimental groups consisted of thirty-one patients with cervical intraepithelial neoplasia divided into three groups--nine with CIN I, six with CIN II, and sixteen with CIN III--and a fourth group of fifteen patients with invasive cervical cancer, stage I. The control group consisted of twenty-seven patients with uterine leiomyomas. The Pearson product-moment correlation coefficient between negative life change and the promotion of cervical intraepithelial neoplasia was 0.25 (p < .05). This correlation was strengthened by several moderator variables tested by median split analyses using the Z('2) statistic. Significant interactions with stress in enhancing the promotion of CIN were obtained for low levels of cooperative coping style and sexual satisfaction and for high levels of premorbid pessimism, future despair, social alienation, somatic anxiety, life threat reactivity and self-expectation. A non-significant trend was observed for a high general level of stress. Although these findings are preliminary in nature and require replication, it may be suggested that women with CIN and high negative recent life change, especially with any number of the foregoing moderators, suffer an immune system deficit--possibly a decrement in secretory IgA or TCGF which enhances promotion of CIN to invasive squamous cell carcinoma of the cervix.


Psychology, Clinical

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