Hypotheses and methodological issues

 As Crisp (1970) pointed out, studies that investigated

premorbid, or precancerous, personality factors leaned

heavily upon theory and speculation which was far beyond what

was immediately suggested by the data. The early studies

tended to search for specific personality types associated

with specific cancer types. As one group of reviewers

(Surawicz, Brightwell, Weitzel, & Othmer, 1976) pointed out,

personality was frequently defined in terms of psychodynamic

variables. Despite the great variety of hypotheses advanced,

according to Wellisch and Yager (1983) "no good hypotheses

exist that specify which personality factors might lead to

cancer for what specific reasons" (p. 145). In their

thorough analysis of this literature, they asserted that "the

best that those dealing in psychodynamics have been able to

do thus far is to offer interpretations as to why people who

already developed cancer have done so, but not why they

rather than others have the disease" (p. 146). Early studies

in this area are also characterized by serious methodological

problems. As Surawicz et al. (1976) pointed out, the dif-

ficulties with the approaches taken resulted in part

from the lack of carefully designed longitudinal studies.

As recognized in this review (1976), most studies did not

have control groups but were based on clinical obser-

vation of small numbers of cancer patients; the