Recent research suggests that psychological and behavioral disposition can influence a variety of cancer early detection behaviors. A growing body of evidence suggests that individuals who are low in """"""""Threat Reactivity,"""""""" a fundamental disposition that derives from a neurologically based Threat Response system, are: 1) slower to respond to the onset of symptoms, 2) less likely to engage in screening, and 3) less likely to get tested for genetic susceptibility. However, much of this evidence comes from studies that did not test these relationships directly or that were limited by methodological issues. The proposed program of research was conceived and designed for two purposes. The first is to explicitly test the central hypothesis, that individual differences in Threat Reactivity predict early detection behaviors. It is also hypothesized that the behavior that follows the recognition of threat will be influenced by Coping Style. Thus the second purpose of this research is to clarify the role of such moderating influences. Taken together, it is hypothesized that timely and appropriate early detection behaviors will occur only when the threat of cancer is accurately perceived and when an adaptive coping strategy is then implemented. These hypotheses will be tested with the following three Specific Aims: 1) determine the relationship between dispositional characteristics and response to symptoms in patients with recently diagnosed colorectal cancer, 2) determine the influence of dispositional characteristics in a prospective study of screening, and 3) implement a program of research that will extend this work and inform future clinical and translational studies. This research will add significantly to existing knowledge by focusing on stable individual characteristics that impede early detection behaviors. The overall goal of this research is to converge recent developments in psychological theory with key problems in cancer prevention and control, and specifically to learn more about the dispositional characteristics of those individuals who would be slower or less inclined to engage in early detection behaviors. With this information, we will be better equipped to design communication strategies that will capture the attention of, and adequately motivate, those individuals who demonstrate such characteristics. This research will also contribute to the construction of a theoretical model that will provide direction for future research, translational studies, and community interventions.
