Coping with medical threat: An evaluation of the Threatening Medical Situations Inventory (TMSI)

The Dutch Threatening Medical Situations Inventory (TMSI) has been developed to measure cognitive confrontation (‘monitoring’) and cognitive avoidance (‘blunting’) within the domain of medical threat. It consists of four scenarios of threatening medical situations, followed by monitoring and blunting alternatives. Its psychometric properties are investigated in students (N = 123), dental (N = 80), HIV-(N = 42) and surgery patients (N = 123). For both scales, internal consistencies proved to be satisfactory. Slight sex and age effects are found. Furthermore, there is a strong situation effect: the scenario highest in controllability shows relatively high monitoring and low blunting scores. Factor structure is stable across samples and shows a good fit with the predicted factor solution. Both scales are found to converge and diverge in a theoretically meaningful manner with a variety of coping style and anxiety measures. In two samples, a sample specific stress scenario was added, but the psychometric qualities of such an extension should not be taken for granted. In an additional sample of working people (N = 48) test-retest reliability proved to be good. It is concluded that the TMSI is a useful instrument for assessing cognitive confrontation and avoidance in medical patients. An English as well as a German translation are available.