Skip to main content
Erschienen in: International Journal of Behavioral Medicine 1/2020

01.02.2020 | Full length manuscript

The Intervening Roles of Psychological Inflexibility and Functional Impairment in the Relation between Cancer-related Pain and Psychological Distress

verfasst von: Sarah L. Brown, Jared F. Roush, Andrew J. Marshall, Catherine Jones, Charlene Key

Erschienen in: International Journal of Behavioral Medicine | Ausgabe 1/2020

Einloggen, um Zugang zu erhalten

Abstract

Background

Psychological distress is a significant problem among patients with a diagnosis of cancer and is associated with elevated risk for mortality; however, not all patients with a diagnosis of cancer experience significant psychological distress. Cancer-related pain has been associated with greater psychological distress among patients with a cancer diagnosis (current or previous). The current study aimed to examine potential theoretical mechanisms (i.e., cognitive fusion, experiential avoidance, and functional impairment) as proposed by the psychological flexibility model, for the association between cancer-related pain and psychological distress. We hypothesized that cancer-related pain would be indirectly positively associated with psychological distress among patients with a cancer diagnosis (current or previous) through psychological inflexibility (i.e., cognitive fusion and experiential avoidance) related to pain and functional impairment, in serial.

Method

Sixty-one adult outpatients diagnosed with cancer completed self-report assessments of cancer-related pain, psychological inflexibility related to pain, pain-related functional impairment, and psychological distress.

Results

Cancer-related pain was positively associated with psychological distress indirectly through greater pain-related psychological inflexibility (i.e., cognitive fusion and experiential avoidance) and functional impairment, in serial. Alternative models were explored but unsupported.

Conclusion

Consistent with the psychological flexibility model, psychological inflexibility and functional impairment may be potential mechanisms underlying the association between cancer-related pain and psychological distress among patients with a cancer diagnosis (current or previous).
Literatur
1.
Zurück zum Zitat American Cancer Society. Cancer facts & figures 2016. Atlanta: American Cancer Society; 2016. American Cancer Society. Cancer facts & figures 2016. Atlanta: American Cancer Society; 2016.
2.
Zurück zum Zitat Wool MS, Mor V. A multidimensional model for understanding cancer pain. Cancer Investig. 2005;23:727–34. Wool MS, Mor V. A multidimensional model for understanding cancer pain. Cancer Investig. 2005;23:727–34.
3.
Zurück zum Zitat Zabora J, BrintzenhofeSzoc K, Curbow B, Hooker C, Piantadosi S. The prevalence of psychological distress by cancer site. Psycho-oncology. 2001;10:19–28.PubMed Zabora J, BrintzenhofeSzoc K, Curbow B, Hooker C, Piantadosi S. The prevalence of psychological distress by cancer site. Psycho-oncology. 2001;10:19–28.PubMed
4.
Zurück zum Zitat Hamer M, Chida Y, Molloy GJ. Psychological distress and cancer mortality. J Psychosom Res. 2009;66:255–8.PubMed Hamer M, Chida Y, Molloy GJ. Psychological distress and cancer mortality. J Psychosom Res. 2009;66:255–8.PubMed
5.
Zurück zum Zitat Brown KW, Levy AR, Rosberger Z, Edgar L. Psychological distress and cancer survival: a follow-up 10 years after diagnosis. Psychosom Med. 2003;65:636–43.PubMed Brown KW, Levy AR, Rosberger Z, Edgar L. Psychological distress and cancer survival: a follow-up 10 years after diagnosis. Psychosom Med. 2003;65:636–43.PubMed
6.
Zurück zum Zitat Adler, N. E., Page, A. E., & Institute of Medicine (US) Committee on Psychosocial Services to Cancer Patients/Families in a Community Setting. (2008). The psychosocial needs of cancer patients. In cancer care for the whole patient: meeting psychosocial health needs. National Academies Press (US). Adler, N. E., Page, A. E., & Institute of Medicine (US) Committee on Psychosocial Services to Cancer Patients/Families in a Community Setting. (2008). The psychosocial needs of cancer patients. In cancer care for the whole patient: meeting psychosocial health needs. National Academies Press (US).
7.
Zurück zum Zitat Holland JC, Bultz BD. The NCCN guideline for distress management: a case for making distress the sixth vital sign. J Natl Compr Cancer Netw. 2007;5:3–7. Holland JC, Bultz BD. The NCCN guideline for distress management: a case for making distress the sixth vital sign. J Natl Compr Cancer Netw. 2007;5:3–7.
8.
Zurück zum Zitat Berger AM, Visovsky C, Hertzog M, Holtz S, Loberiza FR Jr. Usual and worst symptom severity and interference with function in breast cancer survivors. J Support Oncol. 2012;10:112–8.PubMed Berger AM, Visovsky C, Hertzog M, Holtz S, Loberiza FR Jr. Usual and worst symptom severity and interference with function in breast cancer survivors. J Support Oncol. 2012;10:112–8.PubMed
9.
Zurück zum Zitat Keefe FJ, Abernethy AP, Campbell C, L. Psychological approaches to understanding and treating disease-related pain. Annu Rev Psychol. 2005;56:601–30.PubMed Keefe FJ, Abernethy AP, Campbell C, L. Psychological approaches to understanding and treating disease-related pain. Annu Rev Psychol. 2005;56:601–30.PubMed
10.
Zurück zum Zitat Van den Beuken-van Everdingen, M. H. J., De Rijke, J. M., Kessels, A. G., Schouten, H. C., Van Kleef, M. (n.d.). Van den Beuken-van Everdingen, M. H. J., De Rijke, J. M., Kessels, A. G., Schouten, H. C., Van Kleef, M. (n.d.).
11.
Zurück zum Zitat Bodurka-Bevers D, Basen-Engquist K, Carmack CL, Fitzgerald MA, Wolf JK, de Moor C, et al. Depression, anxiety, and quality of life in patients with epithelial ovarian cancer. Gynecol Oncol. 2000;78:302–8.PubMed Bodurka-Bevers D, Basen-Engquist K, Carmack CL, Fitzgerald MA, Wolf JK, de Moor C, et al. Depression, anxiety, and quality of life in patients with epithelial ovarian cancer. Gynecol Oncol. 2000;78:302–8.PubMed
12.
Zurück zum Zitat Syrjala KL, Chapko ME. Evidence for a biopsychosocial model of cancer treatment-related pain. Pain. 1995;61:69–79.PubMed Syrjala KL, Chapko ME. Evidence for a biopsychosocial model of cancer treatment-related pain. Pain. 1995;61:69–79.PubMed
13.
Zurück zum Zitat Syrjala KL, Jensen MP, Mendoza ME, Yi JC, Fisher HM, Keefe FJ. Psychological and behavioral approaches to cancer pain management. J Clin Oncol. 2014;32:1703.PubMedPubMedCentral Syrjala KL, Jensen MP, Mendoza ME, Yi JC, Fisher HM, Keefe FJ. Psychological and behavioral approaches to cancer pain management. J Clin Oncol. 2014;32:1703.PubMedPubMedCentral
14.
Zurück zum Zitat Spiegel D, Sands S, Koopman C. Pain and depression in patients with cancer. Cancer. 1994;74:2570–8.PubMed Spiegel D, Sands S, Koopman C. Pain and depression in patients with cancer. Cancer. 1994;74:2570–8.PubMed
15.
Zurück zum Zitat Zaza C, Baine N. Cancer pain and psychosocial factors: a critical review of the literature. J Pain Symptom Manag. 2002;24:526–42. Zaza C, Baine N. Cancer pain and psychosocial factors: a critical review of the literature. J Pain Symptom Manag. 2002;24:526–42.
16.
Zurück zum Zitat Hayes SC, Strosahl KD, Wilson KG. Acceptance and commitment therapy: the process and practice of mindful change. New York: Guilford Press; 2012. Hayes SC, Strosahl KD, Wilson KG. Acceptance and commitment therapy: the process and practice of mindful change. New York: Guilford Press; 2012.
17.
Zurück zum Zitat Scott W, McCracken LM. Psychological flexibility, acceptance and commitment therapy, and chronic pain. Curr Opin Psychol. 2015;2:91–6. Scott W, McCracken LM. Psychological flexibility, acceptance and commitment therapy, and chronic pain. Curr Opin Psychol. 2015;2:91–6.
18.
Zurück zum Zitat Levin ME, Hildebrandt MJ, Lillis J, Hayes SC. The impact of treatment components suggested by the psychological flexibility model: a meta-analysis of laboratory-based component studies. Beh Therapy. 2012;43:741–56. Levin ME, Hildebrandt MJ, Lillis J, Hayes SC. The impact of treatment components suggested by the psychological flexibility model: a meta-analysis of laboratory-based component studies. Beh Therapy. 2012;43:741–56.
19.
Zurück zum Zitat González-Fernández S, Fernández-Rodríguez C, Mota-Alonso MJ, García-Teijido P, Pedrosa I, Pérez-Álvarez M. Emotional state and psychological flexibility in breast cancer survivors. Eur J Oncol Nurs. 2017;30:75–83.PubMed González-Fernández S, Fernández-Rodríguez C, Mota-Alonso MJ, García-Teijido P, Pedrosa I, Pérez-Álvarez M. Emotional state and psychological flexibility in breast cancer survivors. Eur J Oncol Nurs. 2017;30:75–83.PubMed
21.
Zurück zum Zitat Ferrell BR, Dean G. The meaning of cancer pain. Semin Oncol Nurs. 1995;11:17–22.PubMed Ferrell BR, Dean G. The meaning of cancer pain. Semin Oncol Nurs. 1995;11:17–22.PubMed
22.
Zurück zum Zitat Turner JA, Jensen MP, Warms CA, Cardenas DD. Catastrophizing is associated with pain intensity, psychological distress, and pain-related disability among individuals with chronic pain after spinal cord injury. Pain. 2002;98:127–34.PubMed Turner JA, Jensen MP, Warms CA, Cardenas DD. Catastrophizing is associated with pain intensity, psychological distress, and pain-related disability among individuals with chronic pain after spinal cord injury. Pain. 2002;98:127–34.PubMed
23.
Zurück zum Zitat Breivik H, Cherny N, Collett B, De Conno F, Filbet M, Foubert AJ, et al. Cancer-related pain: a pan-European survey of prevalence, treatment, and patient attitudes. Ann Oncol. 2009;20:1420–33.PubMed Breivik H, Cherny N, Collett B, De Conno F, Filbet M, Foubert AJ, et al. Cancer-related pain: a pan-European survey of prevalence, treatment, and patient attitudes. Ann Oncol. 2009;20:1420–33.PubMed
24.
Zurück zum Zitat Mystakidou K, Tsilika E, Parpa E, Katsouda E, Galanos A, Vlahos L. Psychological distress of patients with advanced cancer: influence and contribution of pain severity and pain interference. Cancer Nurs. 2006;29:400–5.PubMed Mystakidou K, Tsilika E, Parpa E, Katsouda E, Galanos A, Vlahos L. Psychological distress of patients with advanced cancer: influence and contribution of pain severity and pain interference. Cancer Nurs. 2006;29:400–5.PubMed
25.
Zurück zum Zitat Wicksell RK, Renöfält J, Olsson GL, Bond FW, Melin L. Avoidance and cognitive fusion–central components in pain related disability? Development and preliminary validation of the psychological inflexibility in pain scale (PIPS). Eur J Pain. 2008;12:491–500.PubMed Wicksell RK, Renöfält J, Olsson GL, Bond FW, Melin L. Avoidance and cognitive fusion–central components in pain related disability? Development and preliminary validation of the psychological inflexibility in pain scale (PIPS). Eur J Pain. 2008;12:491–500.PubMed
27.
Zurück zum Zitat Cleeland CS. Assessment of pain in cancer: measurement issues. In: Foley KM, editor. Advances in Pain Research and Therapy, vol. 16. New York: Raven Press; 1990. p. 47–55. Cleeland CS. Assessment of pain in cancer: measurement issues. In: Foley KM, editor. Advances in Pain Research and Therapy, vol. 16. New York: Raven Press; 1990. p. 47–55.
28.
Zurück zum Zitat Zelman DC, Gore M, Dukes E, Tai KS, Brandenburg N. Validation of a modified version of the brief pain inventory for painful diabetic peripheral neuropathy. J Vasc Nurs. 2005;23:97–104.PubMed Zelman DC, Gore M, Dukes E, Tai KS, Brandenburg N. Validation of a modified version of the brief pain inventory for painful diabetic peripheral neuropathy. J Vasc Nurs. 2005;23:97–104.PubMed
29.
Zurück zum Zitat National Comprehension Cancer Network. Distress management clinical practice guidelines. J Natl Compr Cancer Netw. 2003;1:344–74. National Comprehension Cancer Network. Distress management clinical practice guidelines. J Natl Compr Cancer Netw. 2003;1:344–74.
30.
Zurück zum Zitat Hayes AF. Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. New York: Guilford Press; 2013. Hayes AF. Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. New York: Guilford Press; 2013.
33.
Zurück zum Zitat R Core Team (2019). R: A language and environment for statistical computing (version 3.6.1) [Computer software]. Vienna, Austria: R Foundation for Statistical Computing. Retrieved from the comprehensive R archive network (CRAN): https://www.R-project.org/. Accessed 13 Aug 2019. R Core Team (2019). R: A language and environment for statistical computing (version 3.6.1) [Computer software]. Vienna, Austria: R Foundation for Statistical Computing. Retrieved from the comprehensive R archive network (CRAN): https://​www.​R-project.​org/​. Accessed 13 Aug 2019.
35.
Zurück zum Zitat Hayes SC, Barnes-Holmes D, Wilson KG. Contextual behavioral science: creating a science more adequate to the challenge of the human condition. J Contextual Behav Sci. 2012;1:1–16. Hayes SC, Barnes-Holmes D, Wilson KG. Contextual behavioral science: creating a science more adequate to the challenge of the human condition. J Contextual Behav Sci. 2012;1:1–16.
36.
Zurück zum Zitat Wetherell JL, Afari N, Rutledge T, Sorrell JT, Stoddard JA, Petkus AJ, et al. A randomized, controlled trial of acceptance and commitment therapy and cognitive-behavioral therapy for chronic pain. Pain. 2011;152:2098–107.PubMed Wetherell JL, Afari N, Rutledge T, Sorrell JT, Stoddard JA, Petkus AJ, et al. A randomized, controlled trial of acceptance and commitment therapy and cognitive-behavioral therapy for chronic pain. Pain. 2011;152:2098–107.PubMed
Metadaten
Titel
The Intervening Roles of Psychological Inflexibility and Functional Impairment in the Relation between Cancer-related Pain and Psychological Distress
verfasst von
Sarah L. Brown
Jared F. Roush
Andrew J. Marshall
Catherine Jones
Charlene Key
Publikationsdatum
01.02.2020
Verlag
Springer US
Erschienen in
International Journal of Behavioral Medicine / Ausgabe 1/2020
Print ISSN: 1070-5503
Elektronische ISSN: 1532-7558
DOI
https://doi.org/10.1007/s12529-019-09838-8

Weitere Artikel der Ausgabe 1/2020

International Journal of Behavioral Medicine 1/2020 Zur Ausgabe