Gli stili comportamentali di monitoring e blunting nella gestione delle minacce alla salute: l'esempio del rischio e della malattia oncologica

Over the past decade, health psychology research has successfully applied basic psychological concepts to furthering our understanding of the role of individual differences in dealing with heath-related challenges and stressors (e.g., Lazarus, 1991; Rothman & Salovey, 1997; Taylor, 1990). In this paper, we will apply to health psychology a comprehensive theoretical framework, the "cognitive-affective" approach to individual differences (Miller, Shoda & Hurley, 1996d), that integrates cumulative findings and theorizing from diverse areas of cognitive-behavioral science and evidence-based counseling and communication interventions (e.g., Carver & Scheier, 1981; Sarason, 1979). First, we provide an overview of our cognitive-affective framework, which delineates how individuals cognitively and affectively process information about health threats (Miller & Schnoll, 2000). In particular, we highlight two distinctive cognitive-affective signatures ("monitoring" versus "blunting") in response to health threats, using the cancer context as an exemplar. Cancer provides an ideal paradigm for studying the response to health-related challenges, since cancer-related threats are often probabilistic and complex. Hence, they require sustained decision making, adherence, and modulation of anxiety over time (Miller & Diefenbach, 1998a). Further, cancer spans the spectrum of healthy individuals with average cancer risk, to individuals with high risk (e.g., due to genetic predisposition, prior exposure to carcinogens, or socio-demographic disadvantage), to individuals already diagnosed with cancer, to cancer survivors.