Abstract
ABSTRACTPurpose/Objectives: Adolescent and young adults who have survived cancer are at an increased risk of psychological distress. This study investigated whether metacognitive beliefs are associated with emotional distress and trauma symptoms in adolescent and young adult (AYA) survivors of cancer independent of known covariates, including current physical health difficulties. Design: Cross-sectional survey using multiple self-report measures. Sample and Methods: Eighty-seven AYA survivors of cancer were recruited from follow-up appointments at an oncology unit and completed self-report questionnaires measuring emotional distress, posttraumatic stress symptoms, metacognitive beliefs, demographic information, and current physical health difficulties. Data were analysed using correlational and hierarchical multiple regression analyses. Findings: Metacognitive beliefs explained an additional 50% and 41% of the variance in emotional distress and posttraumatic stress symptoms, respectively, after controlling for known covariate effects, including current physical health difficulties. Conclusions/Implications for Psychosocial Providers or Policy: The metacognitive model of psychopathology is potentially applicable to AYA survivors of cancer who present with elevated general distress and/or posttraumatic stress symptoms. Prospective studies are required to determine whether metacognitive beliefs and processes have a causal role in distress in AYA survivors of cancer.
Highlights
Improvements in diagnosis and advances in treatment have increased survival in patients diagnosed with cancer in childhood, adolescence and young adulthood, P
Metacognitions Questionnaire-30 (MCQ-30) subscales were all positively correlated with Hospital Anxiety and Depression Scale (HADS) and Impact of Event Scale-Revised (IES-R) total scores, with the Negative Beliefs about Worry subscale of the MCQ-30 demonstrating the strongest correlation with both the HADS (r D 0.74, p < 0.01) and the IES-R (r D 0.70, p < 0.01) total scores
As in the emotional distress model, negative metacognitive beliefs showed the strongest association with posttraumatic stress symptoms. This is the first study to examine the association between metacognitive beliefs and emotional distress and trauma symptoms in AYA survivors of cancer, with the aim of testing predictions derived from the Self-Regulatory Executive Function (S-REF) model
Summary
Improvements in diagnosis and advances in treatment have increased survival in patients diagnosed with cancer in childhood, adolescence and young adulthood, P. Over 60% of long-term survivors are left with at least one chronic health condition, while at least 40% experience moderate-to-severe or life-threatening sequelae (Oeffinger et al, 2006, Skinner, Wallace, & Levitt, 2006, Woodward, Jessop, Glaser, & Stark, 2011). These physical health difficulties, coupled with the occurrence of cancer at a critical stage in identity formation and personal and social development, mean that AYA survivors of cancer are vulnerable to experiencing emotional distress (Abrams, Hazen, & Penson, 2007, Evan & Zeltzer, 2006, Zebrack & Landier, 2011). There are several robust predictors of emotional distress in AYA survivors of cancer, including being female, experiencing physical health problems, receiving a cancer diagnosis at a younger age, and being in the transition phase from end of acute medical treatment to survivorship (Kazak, DeRosa, & Schwartz, 2010, McCarthy, McNeil, & Drew, 2016, Michel, Rebholz, von der Weid, Bergstraesser, & Kuehni, 2010, Recklitis, Lockwood, Rothwell, & Diller, 2006, Wenninger et al, 2012)
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