Appraisals, coping, and stress in breast cancer screening: A longitudinal investigation of causal structure

The cognitive-appraisal model of Lazarus and Folkman (1984) is one of the most prominent theories of stress. As integral elements in this model, Appraisal and Coping have both been proposed as mediators of the stress response. The purpose of this study was to test the predictive power of the theoretical model based on two competing formulations using structural equation modeling techniques. One conceptual model proposed that coping influences stress through appraisal; the other proposed that appraisals impact on stress via coping. Women (n = 506) undergoing breast cancer screening completed measures of appraisal, coping, and stress. Support was found for both hypothesized causal structures. The implications of these findings are discussed in terms of Lazarus' theoretical perspective.