You know when the news media starts suggesting the book is closed on a topic, it’s a good time to take a good long look at the study that supposedly is responsible for such a broad and dramatic conclusion.

In this case, the topic is whether a positive emotional attitude has any effect on cancer survival rates. We reported on the story, Does Attitude Help Cancer Survival Rates?, earlier today. The mainstream media is just taking the press release of the study and reporting it as fact. A very few outlets have actually read the journal article, but still are reporting similar conclusions with little skepticism.

Our skepticism is based upon the main measure used to reach this conclusion — a measure of Quality of Life in cancer patients called the FACT-G. Originally published in 1993 and then revised in 1995, the entire data set for the current study relies on the report of 1,093 patients at a single point in time during their treatment in answer to — hold your breath now — a whole 6 questions.

Yes, you read that right. Six questions to assess one’s entire outlook and attitude toward life, treatment, and their emotional “well-being.”

If you think that’s a little surprising, you’d be joining the ranks of most psychologists who study emotional well-being, well, for a living. There isn’t a psychological mental health or emotional well-being scale in existence that is only 6 items long because it would be impossibly shallow in what it focuses on. Even robust and well-regarded measures for specific components of emotional wellness, such as the Beck Depression Inventory, are usually over 20 items long.

So the two major issues with this study are (1) that the subscale used to justify “psychological state” or “emotional well-being” is pitifully small to actually do any kind of justice to the complexity of the concept of emotional well-being and (2) the measure did so only at a single point in time (when mood is well-known to be a variable, ever-changing component, especially during something like cancer treatment).

The idea of doing justice to the complex human concept of emotional well-being should not be taken lightly. Entire texts have been written about optimism and the science behind the sense of ‘well-being.’

So while this study is a small datapoint that shows us something about people and cancer treatment, it’s not what most people are telling you.

It would be more fair to say the study found that, if you looked at a group of patients at a single point in time and examined a very brief, shallow measure of two traits of their emotional well-being — depression and anxiety — there is no direct correlation between having less of these traits and living longer with cancer (the study’s only outcome measure was morbidity, not quality of life or something else).

But since that’s not what the researchers said, I guess we’ll just have to live with another thing that becomes “common wisdom,” even though it’s not true.

Dr. John Grohol is the CEO and founder of Psych Central. He is an author, researcher and expert in mental health online, and has been writing about online behavior, mental health and psychology issues -- as well as the intersection of technology and human behavior -- since 1992. Dr. Grohol sits on the editorial board of the journal Cyberpsychology, Behavior and Social Networking and is a founding board member and treasurer of the Society for Participatory Medicine.

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  The Story Behind Whether Attitude Helps Cancer Survival Rates by medTRIALS.info (10/22/2007)

The Story Behind Whether Attitude Helps Cancer Survival Rates (12/23/2007)

    Last reviewed: By John M. Grohol, Psy.D. on 22 Oct 2007
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