546 GARK

E.

SWAN et al.

Group Study 1 41. In addition, the R/ED Scale was administered to 1027 female spouses of these male participants. The inclu sion of women was considered important because the original Grossarth-Matice k er al. study 111 was biased towar d males (950 males, 350 females). Moreover, expect ed gender diff erences in the use of psychological defense mechanisms would suggest different meanings for the construct measured by this scale for men and women. Grossarth-Maticek

et al.

111 claimed that their R/A questionnair e measured a single entity t hat was highly predictive of cancer mortality. In support of this con- tention, they reporte d a factor analysis that revealed a large first factor accounting for 66% of the total variance, but no further data were presented regarding the internal structure of this questionnaire. In the present study, t he availabilit y of a large male and female sample provided a uniqu e opportunity to examine the factor structure of the R/ED Scale an d its stability, and to verify Spielberger’s original finding s from smaller samples of male and female subjects. The specific objectives of this investigat ion were to: (1) evaluate the internal con- sistency of the R/ED Scale items; (2) examine the factor structure of the R/ED Scale and its stability; and (3) explore the effect of gender, age and cancer status inter- actions on scores for the total R/ ED Scale and its two subscales

METHOD The subjects were participants in a 27.yr follow-up of the Western Collaborative Group Study

[41

and their spouses. The recently concluded 27.yr follow-up examination updated morbi dity and mortality for the original cohort of 3154 men who were evaluated initially in 1960-1961. For the survivors, current status on

a

wide array of physiological, cardiovascu lar, psycholo gical and behavioral variables. including the Type A behavior pattern and hostility, was determined. Questionnaires were mailed to all participants in the WCGS follow-up and their spouses. A total of 1393 men and 10 27 women responded to the questionnaire and psychometric scales that were mailed after the follow-up examination. The mailing included a survey of cancer events, Spielberger’s R/ED Scale, and several other scales known or suspected to have relevance to the psychosoci al prediction of cancer. The response rates after one follow-up reminder were 80% for the WCGS s ubjects and 60% for their spouses. Of the WCGS subjects, 1% had died since the previous examination and 2% indicated they were not interested in participating . We obtained no response from the remaining 17%. Of the 1393 male respondents, 157 reported that they had previously been diagnosed as having cancer other t han of the skin. Follow-up medical information and pathol ogy reports confirmed 97% of the self- reports. The remaining 1236 male subjects included those rep orting no cancer or only skin cancer. Of 1027 female respondents. 164 women reported some form of cancer other than of the skin. The final female noncancer sample for this analysis was 863. The mean age of the male noncance r sample used in this analysis was 71.8 yr

(SD =

4.9 yr); they reported an average of at least 2 years of college and w ere mostly retired at the time of assessment (89.3%). A majority of the men (63%) were cu rrently married, and 79.3% reported their primary occupation

as

either professional or managerial at the time of

retirement.

Males with

cancer were, on average,

older (M = 73.0 yr,

SD =

5.0 yr), than their male noncancer counterparts, but were otherwise similar with respect to education, occupation at the time of retirement, retirement and marital status. Female noncancer respondents were, on average, younge r (M = 68.5 yr,

SD =

5.9 yr) and slightly less educated. Seventy-six per cent considered themselves retired. F emale cancer respondents were, on average, older (M = 70.0 yr,

SD =

5.6 yr) than their noncancer counterparts, but were otherwise similar with respect to education and retirement status. The R/ED Scale consists of 12 item statements (see Appendix) to which subjects respond by rating themselves on a 4-point scale, with

I =