Appraisal theory and emotional sequelae of first visit to colposcopy following an abnormal cervical screening result

<jats:p>Objectives: Attendance at colposcopy following an abnormal cervical smear is potentially a highly distressing event. This study evaluates the role of cognitive appraisal components (Lazarus, 1991; Smith<jats:italic>et al.</jats:italic>, 1993) in explaining emotional reactions to this event. We also compare the psychological sequelae of immediate treatment at first colposcopy (See and Treat, ST) vs. colposcopy with treatment deferred to a later date (Diagnose and Defer, DD).</jats:p><jats:p>Method: One thousand and eighty‐five women referred for colposcopy completed a questionnaire assessing appraisal and emotion following their attendance. Clinical data were abstracted from medical records and social deprivation scores were estimated from postal code information based on normative data.</jats:p><jats:p>Results: Diagnosis and cognitive appraisals were each significantly associated with emotion, together accounting for between 3 and 15% of variance in different emotions. Specific patterns of appraisal explained specific emotions in line with theoretical predictions. Women with Cervical Intraepithelial Neoplasia (CIN) 2 or CIN 3 undergoing ‘ST’ were less anxious, less embarrassed and significantly more relieved compared with a matched sample of women undergoing ‘DT', and perceived their first appointment as more motivationally congruent.</jats:p><jats:p>Conclusion: Diagnosis, motivationally incongruent experiences and low emotion‐focused coping potential are the most important determinants of anxiety after colposcopy. ‘See and Treat’ appears to have a positive psychological impact by increasing motivational congruence.</jats:p>