Comparing psychological versus pharmacological treatment in emotional disorders: A network analysis.

Transdiagnostic group cognitive behavioural therapy (TD-GCBT) is more effective in improving symptoms and severity of emotional disorders (EDs) than treatment as usual (TAU; usually pharmacological treatment). However, there is little research that has examined the effects of these treatments on specific symptoms. This study used Network Intervention Analysis (NIA) to investigate the direct and differential effects of TD-GCBT + TAU and TAU on specific symptoms of anxiety and depression. Data are from a multicentre randomised clinical trial (N = 1061) comparing TD-GCBT + TAU versus TAU alone for EDs. The networks included items from the PHQ-9 (depression) and GAD-7 (anxiety) questionnaire and mixed graphical models were estimated at pre-treatment, post-treatment and 3-, 6- and 12-month follow-up. Results revealed that TD-GCBT + TAU was associated with direct effects, mainly on several anxiety symptoms and depressed mood after treatment. New direct effects on other depressive symptoms emerged during the follow-up period promoted by TD-GCBT compared to TAU. Our results suggest that the improvement of anxiety symptoms after treatment might precipitate a wave of changes that favour a decrease in depressive symptomatology. NIA is a methodology that can provide fine-grained insight into the likely pathways through which treatments exert their effects.

Feasibility study of a mobile application (ACT-ON) to complement acceptance and commitment therapy (ACT) intervention in cancer patients.

OBJECTIVE: Psychological and physical distress commonly affect cancer patients. Acceptance and commitment therapy (ACT) has shown promising results when it comes to ameliorating symptoms that may develop as a result of this. Meanwhile, it has come to light that the impact of psychological interventions may be enhanced by the use of mobile applications. However, to date no mobile applications have been developed to support ACT-based interventions in cancer patients. The aim of the present study is to develop and test the usability of a mobile application designed to complement face-to-face ACT-based therapy in a group of cancer patients undergoing treatment. MATERIALS AND METHODS: A total of thirty-nine patients were recruited to participate in this pilot study. Participants had to be: 18 years of age or over, currently undergoing treatment for breast, lung or colorectal cancer, in stage I-III, a smartphone user with daily internet access. The intervention sessions were administered for a period of eight weeks, one hour per week to groups of four to six participants. Patients had the ACT-ON mobile application at their disposal, which provided them with access to therapy-related activities: mindfulness, metaphors and exercises to clarify values. RESULTS: The application obtained adequate adoption (61.54%) and usage (54.17%) rates. Usability and ease of learning scores were as follows: good usability (M = 79.81, SD = 11.87); high usability (M = 80.53, SD = 14.04); ease of learning (M = 37.5, SD = 23.85). DISCUSSION: This is the first study to develop and evaluate the usability of an application designed to support ACT-based interventions in cancer patients undergoing treatment. The results show that the ACT-ON app is a feasible tool which achieves high levels of usability. However, said results ought to be confirmed by studies that include a larger number of cancer patients.

Psychological distress predicts quality of life in the first months of cancer diagnosis in cancer caregivers.

In cancer caregivers, anxiety and depression may negatively impact quality of life. Information regarding correlations and the predictive capacity of anxiety and depression with regard to the domains of quality of life of caregivers 6 months after a patient's cancer diagnosis is sparse. Sixty-seven caregivers of cancer patients were recruited and completed the Hospital Anxiety and Depression Scale (HADS) and the Short-Form Health Survey (SF-36) 30-45 days (T1) and 180-200 days (T2) after diagnosis. Depression and anxiety (T1) correlated with quality of life in terms of general health, vitality, social functioning, as well as role limitations due to emotional problems, and mental health (T2). Depression scores at T1 predicted general health, vitality, social functioning, role limitations due to emotional problems and mental health. Although these results are interesting, it must be noted that the sample size was somewhat limited and that the patients' cancer types may have influenced the results obtained. Psychological distress, particularly depression, correlated with and acted as a predictor for changes in the different domains of quality of life, highlighting the relevance of the evaluation of psychological distress in cancer caregivers shortly after cancer diagnosis. These results underscore the importance of differentiating between the different domains in the evaluation of impairments of quality of life in cancer caregivers.

Cost-effectiveness of transdiagnostic group cognitive behavioural therapy versus group relaxation therapy for emotional disorders in primary care (PsicAP-Costs2): Protocol for a multicentre randomised controlled trial.

Several randomised controlled trials (RCT) have demonstrated the superiority of transdiagnostic group cognitive-behavioural therapy (TD-CBT) to treatment as usual (TAU) for emotional disorders in primary care. To date, however, no RCTs have been conducted to compare TD-CBT to another active intervention in this setting. Our aim is to conduct a single-blind RCT to compare group TD-CBT plus TAU to progressive muscle relaxation (PMR) plus TAU in adults (age 18 to 65 years) with a suspected emotional disorder. We expect that TD-CBT + TAU will be more cost-effective than TAU + PMR, and that these gains will be maintained at the 12-month follow-up. Seven therapy sessions (1.5 hours each) will be offered over a 24-week period. The study will be carried out at four primary care centres in Cantabria, Spain. The study will take a societal perspective. Psychological assessments will be made at three time points: baseline, post-treatment, and at 12-months. The following variables will be evaluated: clinical symptoms (anxiety, depression, and/or somatic); functioning; quality of life (QoL); cognitive-emotional factors (rumination, worry, attentional and interpretative biases, emotion regulation and meta-cognitive beliefs); and satisfaction with treatment. Data on health service use, medications, and sick days will be obtained from electronic medical records. Primary outcome measures will include: incremental cost-effectiveness ratios (ICER) and incremental cost-utility ratios (ICURs). Secondary outcome measures will include: clinical symptoms, QoL, functioning, and treatment satisfaction. Bootstrap sampling will be used to assess uncertainty of the results. Secondary moderation and mediation analyses will be conducted. Two questionnaires will be administered at sessions 1, 4, and 7 to assess therapeutic alliance and group satisfaction. If this trial is successful, widespread application of this cost-effective treatment could greatly improve access to psychological treatment for emotional disorders in the context of increasing demand for mental healthcare in primary care. Trial registration: ClinicalTrials.gov: Cost-effectiveness of a Transdiagnostic Psychological Treatment for Emotional Disorders in Primary Care (PsicAP). NCT05314920.

Effectiveness of the Unified Barlow Protocol (UP) and neuropsychological treatment in cancer survivors for cognitive impairments: study protocol for a randomized controlled trial.

BACKGROUND: Cancer survivors frequently develop cognitive impairment, which negatively affects their quality of life and emotional well-being. This study compares the effectiveness of a well-established treatment (neuropsychological treatment) with the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) to reduce these cognitive deficits and evaluate the effect of both treatments on anxiety-depressive symptoms and the quality of life of cancer survivors. METHODS: A three-arm, randomized superiority clinical trial with a pre-post and repeated follow-up measures intergroup design using a 1:1:1 allocation ratio will be performed. One hundred and twenty-three cancer survivors with mild to moderate cognitive impairment will be randomly assigned to one of the study interventions: a cognitive rehabilitation intervention group, an intervention group with UP intervention, or a control group on the waiting list. The primary outcome is to observe a significant improvement in cognitive function in both intervention groups and a significant decrease in emotional impairments in comparison with the waitlist group. Improvements in anxiety, depression, and quality of life are also expected as secondary outcomes. These results will be maintained at 6 months of follow-up. DISCUSSION: The aim of this trial is to test the efficacy of the UP intervention in reducing cognitive deficits in breast cancer survivors. The results of this trial may be useful in reducing the presence of cognitive problems in cancer survivors and improving their emotional state and quality of life. TRIAL REGISTRATION: ClinicalTrials.gov NCT05289258. Registered 12 March 2022, v01.

Efficacy of a Combined Acceptance and Commitment Intervention to Improve Psychological Flexibility and Associated Symptoms in Cancer Patients: Study Protocol for a Randomized Controlled Trial.

Psychological flexibility is a key concept of acceptation and commitment therapy (ACT). This factor has been linked with psychological wellbeing and associated factors, such as quality of life, in cancer patients. These and other positive results of acceptation and commitment therapy in cancer patients found in previous research could be enhanced by using mhealth tools. A three-arm randomized superiority clinical trial, with a pre-post-follow-up repeated measures intergroup design with a 1:1:1 allocation ratio is proposed. A hundred and twenty cancer patients will be randomly assigned to one of the following interventions: (1) face-to-face ACT + mobile application (app), (2) face-to-face ACT, and (3) Waitlist control group. The primary expected outcome is to observe significant improvements in psychological flexibility acceptance and action questionnaire- II (AAQ-II) in the face-to-face ACT + app group, after comparing baseline and post-treatment scores, and the scores will remain stable in the two assessment points, 3 and 6 months after the intervention. Secondary expected outcomes are significant increasing scores in quality of life (EORTC QLQ C-30) and post-traumatic-growth (PTGI-SF), and significant decreasing scores in anxiety and depression (HADS), insomnia (ISI) and fatigue (BFI) at the same assessment points. Also, it is expected that the scores of this group will be higher than the scores of the face-to-face ACT group and the waitlist control group. This study aims to assess the efficacy of a combined intervention (face-to face ACT + app) for psychological flexibility and associated symptoms in cancer patients. The results of this protocol may help to consider the use of acceptation and commitment therapy and mhealth applications in cancer settings as a valid therapeutic choice. Clinical Trial Registration: [www.ClinicalTrials.gov], identifier [NCT05126823].

Cost-effectiveness and cost-utility evaluation of individual vs. group transdiagnostic psychological treatment for emotional disorders in primary care (PsicAP-Costs): a multicentre randomized controlled trial protocol.

BACKGROUND: Emotional disorders are common, and they have become more prevalent since the COVID-19 pandemic. Due to a high attendance burden at the specialized level, most emotional disorders in Spain are treated in primary care, where they are usually misdiagnosed and treated using psychotropic drugs. This contributes to perpetuate their illness and increase health care costs. Following the IAPT programme and the transdiagnostic approach, the PsicAP project developed a brief group transdiagnostic cognitive-behavioural therapy (tCBT) as a cost-effective alternative. However, it is not suitable for everyone; in some cases, one-on-one sessions may be more effective. The objective of the present study is to compare, in cost-benefit terms, group and individual tCBT with the treatment usually administered in Spanish primary care (TAU). METHODS: A randomized, controlled, multicentre, and single-blinded trial will be performed. Adults with mild to moderate emotional disorders will be recruited and placed in one of three arms: group tCBT, individual tCBT, or TAU. Medical data and outcomes regarding emotional symptoms, disability, quality of life, and emotion regulation biases will be collected at baseline, immediately after treatment, and 6 and 12 months later. The data will be used to calculate incremental cost-effectiveness and cost-utility ratios. DISCUSSION: This trial aims to contribute to clinical practice research. The involvement of psychologists in primary care and the implementation of a stepped-care model for mental disorders are recommended. Group therapy and a transdiagnostic approach may help optimize health system resources and unblock waiting lists so that people can spend less time experiencing mental health problems. TRIAL REGISTRATION: ClinicalTrials.gov: NCT04847310; Protocols.io: bx2npqde. (April 19, 2021).

Anxiety, depression and quality of life: a longitudinal study involving cancer patient-caregiver dyads.

BACKGROUND: The objective of this study was to analyse the relationships between anxiety, depression and quality of life in cancer patient-caregiver dyads during the first 6 months after the diagnosis using the actor-partner interdependence model (APIM). PARTICIPANTS AND PROCEDURE: Sixty-seven cancer patient-caregiver dyads completed the following questionnaires in a prospective longitudinal design, with two assessment points at a 6month interval, T1 (45-60) and T2 (180-200 days after diagnosis): the Hospital Anxiety and Depression Scale (HADS) and the Short Form Health Survey Questionnaire (SF-36). Descriptive statistics, t-test and bivariate correlations were applied. The APIM was used to analyse the influence of anxiety and depression (T1) on own (actor effect) and partner (partner effect) quality of life in T2. RESULTS: The results did not reveal any differences between T1 and T2 in anxiety and depression in caregivers and patients. Assessing the differences between T1 and T2 with respect to quality of life, the caregiver results showed an improvement in physical functioning and bodily pain, but lower social functioning and mental health scores. For patients, significantly lower scores were observed in general health and vitality scores. Dyadic analysis showed an actor effect of anxiety and depression on most of the quality of life domains and a partner effect in caregiver depression (T1) and general health in patients (T2). CONCLUSIONS: The early assessment of anxiety and depression may help to prevent declines in quality of life in the first few months following a diagnosis of cancer in patient-caregiver dyads.

Psychological and Non-Pharmacologic Treatments for Pain in Cancer Patients: A Systematic Review and Meta-Analysis.

CONTEXT: Pain is the most fearful symptom in cancer. Although there is a relationship between psychosocial variables and oncologic pain, psychological and non-pharmacological treatments for pain management in cancer patients are not very widespread. OBJECTIVES: To analyze the efficacy of psychological and non-pharmacological treatments for reducing pain in cancer patients. METHODS: We performed a systematic review following the PRISMA protocol. In January 2021, data were extracted from PubMed, Web of Science and Scopus, including randomised controlled trials (RCT) published in the last five years (from 28 January, 2015 to December 15, 2020), in the English language and whose sample was patients with cancer pain. The database search used the following keywords: cancer, cancer-related pain, psychological intervention, non-pharmacologic intervention. The Cochrane risk of bias assess ment for randomised trials (RoB 2) was used for quality appraisal. RESULTS: After the inclusion and exclusion criteria were applied, ten papers were fully screened. The evidence suggested that the most effective interventions to reduce cancer pain were mindfulness-based cognitive therapy, guided imagery and progressive muscle relaxation and emotional and symptom focused engagement (EASE). Music therapy and brief cognitive behavioral strategies (CBS) require more research, while coping skills training and yoga did not show positive effects. Overall, we obtained a moderate size effect (d = 0.642, 95% CI: 0.125-1.158) favourable to psychological and non-pharmacologic treatments at post-treatment, which increased at follow-up (k = 5, d = 0.826, 95% CI: 0.141-1.511). CONCLUSION: This study provides insight into psychological interventions which might be applied and contribute to cancer-related pain reduction in adults. Although the results are not completely consistent, they may shed light on psychology applications in the oncology environment.

Exploring the structure of the GAD-7 scale in primary care patients with emotional disorders: A network analysis approach.

OBJECTIVE: Anxiety symptoms are one of the most frequent manifestations in people attending primary care, although how the symptoms are associated is unclear. This study aimed to establish the symptom structure of the Generalized Anxiety Disorder scale (GAD-7) using a novel network approach in combination with traditional analytical tools. METHODS: A sample of 1704 primary care patients with emotional disorders (i.e., anxiety, depression, and/or somatization) completed the GAD-7 to report their anxiety symptoms. We examined the GAD-7 structure using exploratory graph analysis (EGA) compared to exploratory factor analysis (EFA) and confirmatory factor analysis. RESULTS: The EFA results showed a one-factor solution, but EGA revealed a two-factor solution (cognitive-emotional and somatic). "Worrying too much" and "difficulty relaxing" were the most relevant symptoms. CONCLUSIONS: The results support the possible distinction between the somatic and cognitive-emotional components of the GAD-7, thus permitting more specific screening in primary care settings.

The influence of family social support on quality of life of informal caregivers of cancer patients.

AIM: Caregivers of cancer patients are at high risk of experiencing impairments in terms of anxiety, depression and quality of life. This study examines the mediation capacity that perceived emotional support can have after diagnosis and six months later between depression and anxiety after diagnosis and quality of life in informal caregivers of cancer patients. DESIGN: A sample of 67 informal caregivers of cancer patients was used. This study is longitudinal, ex post facto prospective, with convenience sampling. METHODS: Participants completed the Medical Outcomes Study 36-Item Short Form (SF-36), the Hospital Anxiety and Depression Scale (HADS) and the Berlin Social Support Scale (BSSS) and a sociodemographic questionnaire. Data were collected between March 2017 and November 2018. RESULTS: Spearman's correlation analysis showed that anxiety, depression and perceived emotional support were related to quality of life. The mediation analysis showed that the relationship between depression after diagnosis and quality of life six months later was mediated by perceived emotional support.

Emotional stability is related to 2D:4D and social desirability in women: Possible implications on subjective well-being and psychopathology.

Emotional stability-Neuroticism is a complex construct influenced by genetics and environmental factors. Women tend to exhibit higher neuroticism scores than men, which may be associated with an increased risk of suffering from some common mental conditions. Some authors have pointed out the influence of sex hormones, since they induce sexual differentiation of the brain that can lead to sex-specific behaviors. 2D:4D digit ratio is commonly used as a marker of prenatal sex hormones. In this study we analyzed whether there was an association between 2D:4D and personality measured through the BFQ in a homogeneous sample of 101 young women college students. We found a positive association between 2D:4D and emotional stability, as well as with its subdimensions emotion control and impulse control. This association could be quadratic and nonlinear. However, no association was found with the other four dimensions. We also measured anxiety, depression and global life satisfaction, variables related to neuroticism. We observed that emotional stability is positively associated to social desirability and global life satisfaction, and negatively related to anxiety and depression. On the other hand, we did not find any association between 2D:4D and anxiety, depression, and global life satisfaction. These results can be linked to other aspects such as subjective well-being and psychopathological symptoms. This study may help to better understand how these constructs are related and could lead to future projects to elucidated how these variables influence personality.

Psychological, educational, and alternative interventions for reducing fear of childbirth in pregnant women: A systematic review.

OBJECTIVE: This review aims to identify non-medical interventions that may reduce the fear of childbirth, directly or indirectly (through its factors). METHODS: This review followed the PRISMA guidance and a rigorous protocol that was registered in PROSPERO. Searches were done in ProQuest, the International Clinical Trials Registry Platform, and Google Scholar. All RCTs published in the last 5 years, in English or Spanish, regarding women with a low-risk pregnancy and without mental disorders were included. RESULTS: From 5147 articles found, only 69 were full-text assessed. Finally, 18 studies were included suggesting that prenatal education, psychoeducation, and counseling might be effective, whereas cognitive-behavioral therapy and some alternative therapies require more research. The results of relaxation techniques were contradictory. Results also suggest that social support and exposure (through education) might have an important role in the efficacy of interventions. CONCLUSIONS: More appropriately randomized and blinded trials are necessary that use a prespecified definition of fear of childbirth and comprehensive measurement tools specific for pregnant women.

Emotional Burden and Perceived Social Support in Male Partners of Women with Cancer.

BACKGROUND: The aim of this study was to describe the correlations between the psychosocial burden on male caregivers and their perception of social support, as well as distress, anxiety, and depression among their partners in the first six months after a cancer diagnosis. METHODS: A cross-sectional, longitudinal and observational study was conducted on a group of 61 couples, with the use of Zarit Burden Interview (ZBI), Caregiver Burden Scale (CBS), Berlín Social Support Scales (BSSS), Hospital Anxiety and Depression Scale (HADS) and Distress Thermometer (DT). Statistical analysis was performed using Statistica v.13. RESULTS: A strong positive correlation between the ZBI and CBS, as well as between support-seeking and the emotional involvement of male partners, was documented. The negative correlation between the lack of instrumental support and a much greater burden on caregivers, in emotional, social, and family life was documented. The level of distress, anxiety, and depression, as well as family problems reported by female patients, were positively correlated with the male caregiver's burden. A demographic analysis showed significant relationships between the number of offspring and the negative health indicators of patients and their partners. IMPLICATIONS: The obtained results encourage deeper reflection on the need to improve the availability of instrumental support for male caregivers and support for families with an oncological ill parent in caring for minor children, and to maintain the social activity of the caregiver.

Caregiver Burden Domains and Their Relationship with Anxiety and Depression in the First Six Months of Cancer Diagnosis.

Cancer caregiving is associated with burden and a poor psychological state. However, there is no previous information about the predictive utility of specific burden domains on anxiety and depression in the first six months after a partner's cancer diagnosis. In a longitudinal study, 67 caregivers completed the Zarit Burden Interview (ZBI) and Hospital Anxiety and Depression Scale (HADS) at T1 (45-60 days after diagnosis) and T2 (180-200 days after diagnosis). Most of the caregivers were female (65.7%, mean age = 51.63, SD = 13.25), while patients were mostly male (56.7%). The TRIPOD checklist was applied. ZBI scores were moderate and HADS anxiety reached significant values. There were no differences in ZBI and HADS between T1 and T2. The relationship between burden, anxiety, and depression were more consistent at T2, while emotional burden at T1 were related and predicted anxiety and depression at T2. Some burden domains were related and predicted anxiety in caregivers in the first six months after partner cancer diagnosis. This information could be useful to prevent the onset of these symptoms in the first six months after diagnosis.

Social support as predictor of anxiety and depression in cancer caregivers six months after cancer diagnosis: A longitudinal study.

AIMS AND OBJECTIVES: To establish the predictive utility of specific social support domains for emotional well-being in cancer caregivers, six months after their partner's cancer diagnosis. BACKGROUND: In cancer caregivers, social support has been consistently related to anxiety and depression. There is little information, however, about the predictive utility of specific social support domains for psychological well-being in the first six months after a partner's cancer diagnosis. DESIGN: Longitudinal research study. METHODS: Sixty-seven caregivers of recently diagnosed cancer patients were recruited from the Reina Sofia University Hospital in Cordoba (Spain). Participants completed a set of questionnaires including the Berlin Social Support Scale (BSSS), the Hospital Anxiety and Depression Scale (HADS) and a socio-demographic questionnaire. Data were collected at two time points: T1 (30-45 days after diagnosis) and T2 (180-200 days after). TRIPOD checklist was used. RESULTS: Most of the caregivers were female (65%) and the partner of the patient (58%), with an average age of 51.63 years (SD = 13.25). Statistical differences were observed between the two assessment points for the social support domains of perceived emotional support, satisfaction with support and protective buffering. Logistic regression analysis showed that less physical and sports activity, more support seeking and less informational support received at T1 predicted anxiety at T2, while less perceived available support predicted depression. CONCLUSIONS: Accurate information and support from other members of the community and the promotion of physical and sports routines for cancer caregivers may help to alleviate symptoms of anxiety and depression in the first months after a partner's cancer diagnosis. RELEVANCE TO CLINICAL PRACTICE: Clinicians must pay attention to the social support needs and physical activity of caregivers in the first days after diagnosis, in order to prevent anxiety and depression.

Emotional stability is associated with the MAOA promoter uVNTR polymorphism in women.

BACKGROUND: Neuroticism is associated with low emotional stability, and it is characterized by a tendency to perceive ordinary situations as threatening and difficult to manage. This personality trait has been associated with psychological distress and predicts some mental disorders. Previous studies have shown that women tend to be more neurotic than men and, in general, females have also a higher incidence of anxious and depressive disorders. METHODS: We analyzed in a sample of 99 female university students (from 18 to 26 years old) if emotional stability, measured using the Big Five Questionnaire, was linked to polymorphic variants in candidate genes related to dopaminergic and serotonergic systems, and other personality variables. RESULTS: We found that emotional stability and its subdimensions are genetically associated with MAOA-uVNTR polymorphism. Thus, women carriers of the 3-repeat allele (lower MAO-A expression) showed higher levels of emotional stability. No associations were found with other polymorphisms analyzed, including COMT Val158 Met, 5-HTTLPR, and DAT 3'UTR VNTR. Furthermore, our results showed a negative correlation between emotional stability and depression, state anxiety, and trait anxiety. In fact, MAOA-uVNTR and trait anxiety also explained emotional stability and its subdimensions. We also found that other genetic characteristic, phenylthiocarbamide tasting, explained impulsivity, specifically tasters controlled impulses better than nontasters. CONCLUSION: Our results indicate that neuroticism might be regulated by MAOA and could be a common factor between different phenotypes, such as aggressive behaviors or personality disorders, observed in women with higher activity genotype who had been exposed to negative environments during childhood. This study could lead to a better understanding of the basis of emotional stability and could lead to future projects for this purpose.

The relationship between acceptance, fatigue, and subjective cognitive impairment in hematologic cancer survivors.

Background/Objective: Cancer and its treatment can have a detrimental impact on psychological well-being. Acceptance as the basis of acceptance and commitment therapy (ACT) has shown beneficial effects on depression and anxiety. However, its relationship to fatigue and cognitive impairment has not been investigated. A protective effect of acceptance may open up a new target for psychological intervention. Method: A cross-sectional postal survey was undertaken. 922 hematological cancer survivors (≥ 2.5 years post diagnosis) were recruited through two regional cancer registries in Germany. Acceptance (AAQ-II), fatigue (BFI) and subjective cognitive impairment (AFI) were assessed. Results: Higher levels of acceptance were negatively associated with fatigue and subjective cognitive impairment (R2 = .34 and R2 = .26, respectively). The relationship between fatigue and fatigue-related impairment of daily life was weaker for survivors with high acceptance. Conclusions: Acceptance is strongly associated with fatigue and subjective cognitive impairment. ACT may be useful to reduce symptoms of fatigue and subjective cognitive impairment in cancer survivors.

Antecedentes/Objetivo: El cáncer y su tratamiento pueden tener un impacto perjudicial sobre el bienestar psicológico. La aceptación, base de la terapia de aceptación y compromiso (ACT), ha mostrado efectos beneficiosos sobre la depresión y la ansiedad. Sin embargo, su relación con la fatiga y el deterioro cognitivo no ha sido investigada. Un efecto protector de la aceptación puede abrir un nuevo objetivo para la intervención psicológica.Método: Se llevó a cabo un estudio transversal de encuesta por correo. Un total de 922 supervivientes al cáncer hematológico (≥ 2,5 años después del diagnóstico) fueron reclutados a través de dos registros regionales en Alemania. Se evaluaron la aceptación (AAQ-II), la fatiga (BFI) y el deterioro cognitivo subjetivo (AFI).Resultados: Los niveles elevados de aceptación se asociaron negativamente con la fatiga y el deterioro cognitivo subjetivo (R2 = 0,34 y R2 = 0,26, respectivamente). La relación entre fatiga y deterioro ede la vida diaria relacionado con la fatiga fue más débil en supervivientes con una mayor aceptación.Conclusiones: La aceptación se asocia fuertemente con la fatiga y el deterioro cognitivo subjetivo. La ACT puede ser útil para reducir los síntomas de fatiga y el deterioro cognitivo subjetivo en supervivientes al cáncer.

The relationship between acceptance, fatigue, and subjective cognitive impairment in hematologic cancer survivors

Background/Objective: Cancer and its treatment can have a detrimental impact on psychological well-being. Acceptance as the basis of acceptance and commitment therapy (ACT) has shown beneficial effects on depression and anxiety. However, its elationship to fatigue and cognitive impairment has not been investigated. A protective effect of acceptance may open up a new target for psychological intervention. Method: A cross-sectional postal survey was undertaken. 922 hematological cancer survivors (≥ 2.5 years post diagnosis) were recruited through two regional cancer registries in Germany. Acceptance (AAQ-II), fatigue (BFI) and subjective cognitive impairment (AFI) were assessed. Results: Higher levels of acceptance were negatively associated with fatigue and subjective cognitive impairment (R2= .34 and R2= .26, respectively). The relationship between fatigue and fatigue-related impairment of daily life was weaker for survivors with high acceptance. Conclusions: Acceptance is strongly associated with fatigue and subjective cognitive impairment. ACT may be useful to reduce symptoms of fatigue and subjective cognitive impairment in cancer survivors

Antecedentes/Objetivo: El cáncer y su tratamiento pueden tener un impacto perjudicial sobre el bienestar psicológico. La aceptación, base de la terapia de aceptación y compromiso (ACT), ha mostrado efectos beneficiosos sobre la depresión y la ansiedad. Sin embargo, su relación con la fatiga y el deterioro cognitivo no ha sido investigada. Un efecto protector de la aceptación puede abrir un nuevo objetivo para la intervención psicológica. Método: Se llevó a cabo un estudio transversal de encuesta por correo. Un total de 922 supervivientes al cáncer hematológico (≥ 2,5 años después del diagnóstico) fueron reclutados a través de dos registros regionales en Alemania. Se evaluaron la aceptación (AAQ-II), la fatiga (BFI) y el deterioro cognitivo subjetivo (AFI). Resultados: Los niveles elevados de aceptación se asociaron negativamente con la fatiga y el deterioro cognitivo subjetivo (R2= 0,34 y R2= 0,26, respectivamente). La relación entre fatiga y deterioro ede la vida diaria relacionado con la fatiga fue más débil en supervivientes con una mayor aceptación. Conclusiones: La aceptación se asocia fuertemente con la fatiga y el deterioro cognitivo subjetivo. La ACT puede ser útil para reducir los síntomas de fatiga y el deterioro cognitivo subjetivo en supervivientes al cáncer

Differences in Eysenck's Personality Dimensions between a Group of Breast Cancer Survivors and the General Population.

Cancer may influence personality in patients and survivors. However, the possible relations between the treatments that the patients have undergone and the personality in survivors are not clear. This study aimed to establish the differences in personality between a group of breast cancer survivors and a control group, and to test the predictive utility of the treatments on the personality traits in survivors. Thirty breast cancer survivors and thirty participants from the general population completed the Eysenck personality questionnaire-revised (EPQ-R) and a socio-demographic questionnaire. Survivors had lower scores on extraversion and higher scores on neuroticism than the control group, but these differences were not significant. However, differences in psychoticism were significant, with higher scores in the survivor group. Breast-conserving therapy predicted extraversion while breast reconstruction predicted psychoticism. These results suggest that the physical consequences of surgery may lead to social and psychological impairments in this group of patients.