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07.06.2018 | Original Article

Medical, demographic and psychological correlates of fear of cancer recurrence (FCR) morbidity in breast, colorectal and melanoma cancer survivors with probable clinically significant FCR seeking psychological treatment through the ConquerFear study

verfasst von: Allan ‘Ben’ Smith, Louise Sharpe, Belinda Thewes, Jane Turner, Jemma Gilchrist, Joanna E. Fardell, Afaf Girgis, Stephanie Tesson, Joseph Descallar, Melanie L. Bell, Jane Beith, Phyllis Butow, the ConquerFear Authorship Group

Erschienen in: Supportive Care in Cancer | Ausgabe 12/2018

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Abstract

Purpose

Despite the prevalence of fear of cancer recurrence (FCR), understanding of factors underlying clinically significant FCR is limited. This study examined factors associated with greater FCR morbidity, according to a cognitive processing model, in cancer survivors who screened positively for clinically significant FCR seeking psychological treatment through the ConquerFear trial.

Methods

Participants had completed treatment for breast, colorectal or melanoma cancer 2 months to 5 years previously and scored ≥ 13/36 on the Fear of Cancer Recurrence Inventory-Short Form (FCRI-SF). Hierarchical regression analyses examined associations between demographic, medical and psychological variables, namely metacognitions (MCQ-30), post-traumatic stress symptoms (IES-R) and FCR (FCRI total score).

Results

Two hundred and ten (95%) of the 222 cancer survivors who consented to the ConquerFear trial completed the baseline questionnaire. Participants were predominantly (89%) breast cancer survivors. The final regression model accounted for 68% of the variance in FCR (demographic and medical variables 13%, metacognitions 26%, post-traumatic stress symptoms 28%). Negative metacognitive beliefs about worry and intrusive post-traumatic stress symptoms were significant individual correlates of FCR, but negative beliefs about worry did not significantly moderate the impact of intrusions on FCR morbidity.

Conclusions

Results provide partial support for the cognitive processing model of FCR. Psychological factors were found to play an important role in FCR morbidity after controlling for demographic/medical factors. More intrusive thoughts and negative beliefs about worry were strong independent predictors of FCR morbidity. Cancer survivors with clinically significant FCR may benefit from assessment for intrusive thoughts and metacognitions and delivery of trauma- and/or metacognitive-based interventions accordingly.

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Lebel S, Ozakinci G, Humphris G, Mutsaers B, Thewes B, Prins J, Dinkel A, Butow P (2016) From normal response to clinical problem: definition and clinical features of fear of cancer recurrence. Support Care Cancer 24(8):3265–3268. https://doi.org/10.1007/s00520-016-3272-5 CrossRef

Simard S, Thewes B, Humphris G, Dixon M, Hayden C, Mireskandari S, Ozakinci G (2013) Fear of cancer recurrence in adult cancer survivors: a systematic review of quantitative studies. J Cancer Surviv 7(3):300–322CrossRef

Costa DSJ (2017) Screening for clinical levels of fear of cancer recurrence. Psychooncology 26:2002–2003. https://doi.org/10.1002/pon.4390 CrossRefPubMed

Costa DSJ, Smith AB, Fardell JE (2016) The sum of all fears: conceptual challenges with measuring fear of cancer recurrence. Support Care Cancer 24(1):1–3. https://doi.org/10.1007/s00520-015-2943-y CrossRefPubMed

Sharpe L, Thewes B, Butow P (2017) Current directions in research and treatment of fear of cancer recurrence. Curr Opin Support Palliat Care Publish Ahead of Print

Mutsaers B, Jones G, Rutkowski N, Tomei C, Séguin Leclair C, Petricone-Westwood D, Simard S, Lebel S (2016) When fear of cancer recurrence becomes a clinical issue: a qualitative analysis of features associated with clinical fear of cancer recurrence. Support Care Cancer 24(10):4207–4218. https://doi.org/10.1007/s00520-016-3248-5 CrossRefPubMed

Crist JV, Grunfeld EA (2013) Factors reported to influence fear of recurrence in cancer patients: a systematic review. Psychooncology 22(5):978–986. https://doi.org/10.1002/pon.3114 CrossRefPubMed

Simard S, Savard J (2015) Screening and comorbidity of clinical levels of fear of cancer recurrence. J Cancer Surviv 9(3):481–491. https://doi.org/10.1007/s11764-015-0424-4 CrossRefPubMed

Butow P, Kelly S, Thewes B, Hruby G, Sharpe L, Beith J (2014) Attentional bias and metacognitions in cancer survivors with high fear of cancer recurrence. Psychooncology 24:416–423. https://doi.org/10.1002/pon.3659 CrossRefPubMed

10.

Custers JAE, Gielissen MFM, Janssen SHV, de Wilt JHW, Prins JB (2016) Fear of cancer recurrence in colorectal cancer survivors. Support Care Cancer 24(2):555–562. https://doi.org/10.1007/s00520-015-2808-4 CrossRef

11.

Fardell JE, Jones G, Smith AB, Lebel S, Thewes B, Costa D, Tiller K, Simard S, Feldstain A, Beattie S, McCallum M, Butow P (2017) Exploring the screening capacity of the fear of cancer recurrence inventory-short form for clinical levels of fear of cancer recurrence. Psychooncology 27:492–499. https://doi.org/10.1002/pon.4516 CrossRefPubMed

12.

Fardell JE, Thewes B, Turner J, Gilchrist J, Sharpe L, Smith AB, Girgis A, Butow P (2016) Fear of cancer recurrence: a theoretical review and novel cognitive processing formulation. J Cancer Surviv 10(4):663–673. https://doi.org/10.1007/s11764-015-0512-5 CrossRefPubMed

13.

Heathcote LC, Eccleston C (2017) Pain and cancer survival: a cognitive-affective model of symptom appraisal and the uncertain threat of disease recurrence. Pain 158(7):1187–1191. https://doi.org/10.1097/j.pain.0000000000000872 CrossRefPubMed

14.

Lebel S, Maheu C, Lefebvre M, Secord S, Courbasson C, Singh M, Jolicoeur L, Benea A, Harris C, Fung MFK, Rosberger Z, Catton P (2014) Addressing fear of cancer recurrence among women with cancer: a feasibility and preliminary outcome study. J Cancer Surviv 8(3):485–496CrossRef

15.

Simonelli LE, Siegel SD, Duffy NM (2016) Fear of cancer recurrence: a theoretical review and its relevance for clinical presentation and management. Psychooncology 26:1444–1454. https://doi.org/10.1002/pon.4168 CrossRefPubMed

16.

Wells A, Matthews G (1996) Modelling cognition in emotional disorder: the S-REF model. Behav Res Ther 34(11–12):881–888CrossRef

17.

Cook SA, Salmon P, Dunn G, Fisher P (2014) Measuring metacognition in cancer: validation of the metacognitions questionnaire 30 (MCQ-30). PLoS One 9(9):e107302. https://doi.org/10.1371/journal.pone.0107302 CrossRefPubMedPubMedCentral

18.

Thewes B, Bell ML, Butow P (2013) Fear of cancer recurrence in young early-stage breast cancer survivors: the role of metacognitive style and disease-related factors. Psychooncology 22(9):2059–2063CrossRef

19.

Butow P, Bell M, Smith A, Fardell J, Thewes B, Turner J, Gilchrist J, Beith J, Girgis A, Sharpe L, Shih S, Mihalopoulos C, members of the Conquer Fear Authorship Group (2013) Conquer fear: protocol of a randomised controlled trial of a psychological intervention to reduce fear of cancer recurrence. BMC Cancer 13(1):201CrossRef

20.

Butow PN, Turner J, Gilchrist J, Sharpe L, Smith AB, Fardell JE, Tesson S, O’Connell R, Girgis A, Gebski VJ, Asher R, Mihalopoulos C, Bell ML, Zola KG, Beith J, Thewes B (2017) Randomized trial of ConquerFear: a novel, theoretically based psychosocial intervention for fear of cancer recurrence. J Clin Oncol:JCO 2017.2073.1257. https://doi.org/10.1200/JCO.2017.73.1257 CrossRef

21.

Simard S, Savard J (2009) Fear of cancer recurrence inventory: development and initial validation of a multidimensional measure of fear of cancer recurrence. Support Care Cancer 17(3):241–251CrossRef

22.

Harrel F (2001) Regression modeling strategies: with applications to linear models, logistic regression, and survival analysis. Springer, New YorkCrossRef

23.

Hair JFJ, Black WK, Babin BJ, Anderson RE (2014) Multivariate data analysis. Pearson Education Limited, Harlow, Essex

24.

Pedersen AF, Rossen P, Olesen F, von der Maase H, Vedsted P (2012) Fear of recurrence and causal attributions in long-term survivors of testicular cancer. Psychooncology 21(11):1222–1228. https://doi.org/10.1002/pon.2030 CrossRefPubMed

25.

Cook SA, Salmon P, Dunn G, Holcombe C, Cornford P, Fisher P (2015) The association of metacognitive beliefs with emotional distress after diagnosis of cancer. Health Psychol 34(3):207–215. https://doi.org/10.1037/hea0000096 CrossRefPubMed

26.

Fergus TA, Valentiner DP, McGrath PB, Gier-Lonsway S, Jencius S (2013) The cognitive attentional syndrome: examining relations with mood and anxiety symptoms and distinctiveness from psychological inflexibility in a clinical sample. Psychiatry Res 210(1):215–219. https://doi.org/10.1016/j.psychres.2013.04.020 CrossRefPubMed

27.

Wells A (2009) Metacognitive therapy for anxiety and depression. Guilford Press, New York

28.

Tran US, Gregor B (2016) The relative efficacy of bona fide psychotherapies for post-traumatic stress disorder: a meta-analytical evaluation of randomized controlled trials. BMC Psychiatry 16(1):266. https://doi.org/10.1186/s12888-016-0979-2 CrossRefPubMedPubMedCentral

29.

Dieng M, Butow PN, Costa DSJ, Morton RL, Menzies SW, Mireskandari S, Tesson S, Mann GJ, Cust AE, Kasparian NA (2016) Psychoeducational intervention to reduce fear of cancer recurrence in people at high risk of developing another primary melanoma: results of a randomized controlled trial. J Clin Oncol 34(36):4405–4414. https://doi.org/10.1200/JCO.2016.68.2278 CrossRefPubMed

30.

Lichtenthal WG, Corner GW, Slivjak ET, Roberts KE, Li Y, Breitbart W, Lacey S, Tuman M, DuHamel KN, Blinder VS, Beard C (2017) A pilot randomized controlled trial of cognitive bias modification to reduce fear of breast cancer recurrence. Cancer 123(8):1424–1433. https://doi.org/10.1002/cncr.30478 CrossRefPubMedPubMedCentral

31.

van de Wal M, Thewes B, Gielissen M, Speckens A, Prins J (2017) Efficacy of blended cognitive behavior therapy for high fear of recurrence in breast, prostate, and colorectal cancer survivors: the SWORD study, a randomized controlled trial. J Clin Oncol 35(19):2173–2183. https://doi.org/10.1200/JCO.2016.70.5301 CrossRefPubMed

32.

Brebach R, Sharpe L, Costa DSJ, Rhodes P, Butow P Psychological intervention targeting distress for cancer patients: a meta-analytic study investigating uptake and adherence

33.

Gefen D, Straub D, Boudreau M-C (2000) Structural equation modeling and regression:guidelines for research practice. Commun Assoc Inf Syst 4(1)

Titel: Medical, demographic and psychological correlates of fear of cancer recurrence (FCR) morbidity in breast, colorectal and melanoma cancer survivors with probable clinically significant FCR seeking psychological treatment through the ConquerFear study
verfasst von: Allan ‘Ben’ Smith
Louise Sharpe
Belinda Thewes
Jane Turner
Jemma Gilchrist
Joanna E. Fardell
Afaf Girgis
Stephanie Tesson
Joseph Descallar
Melanie L. Bell
Jane Beith
Phyllis Butow
the ConquerFear Authorship Group
Publikationsdatum: 07.06.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Supportive Care in Cancer / Ausgabe 12/2018
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-018-4294-y

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Medical, demographic and psychological correlates of fear of cancer recurrence (FCR) morbidity in breast, colorectal and melanoma cancer survivors with probable clinically significant FCR seeking psychological treatment through the ConquerFear study