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Emotional adjustment over 1 year post-diagnosis in patients with cancer: understanding and predicting adjustment trajectories

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Abstract

Purpose

The aim of this study was to determine the prevalence of basic trajectories in emotional adjustment in cancer survivors and identify predictors of long-term change.

Methods

We assessed 421 patients with cancer after diagnosis and 6 and 12 months later. Measures comprised anxiety, depression, perceived support, desired support, and illness intrusiveness.

Results

Anxiety decreased over time, whereas depression increased as did need for support. About one third of initial diagnostic classifications (into low distress, symptoms, or clinical level of distress) changed from one assessment to the next. Lower age and higher illness intrusiveness predicted which patient showed worse adjustment over time.

Conclusion

To avoid both over- and undertreatment of distressed individuals, repeated measurements are needed to identify actual adjustment trajectories. Initial assessment of emotional reaction to a diagnosis is not a reliable predictor of long-term adjustment. Patients should be made aware that completion of initial medical treatment even when accompanied by a positive prognosis does not in and of itself forecast how well patients adjust during survivorship.

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Acknowledgments

We are grateful to Colleen Wong, CHIM, from the BC Cancer Agency, Surveillance & Outcomes Unit—Population Oncology, for provision of the survival data. This study was supported by the Canadian Institute for Health Research (CIHR Team for Supportive Cancer Care; #AQC83559, PIs Richard Doll and Arminee Kazanjian).

Conflict of interest

There are no financial interests associated with this work, and none of the authors are in a conflict of interest.

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Authors and Affiliations

  1. Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC, V6T 1Z4, Canada

    W. Linden, C. Marshall & A. Vodermaier

  2. BC Cancer Agency, Vancouver, Canada

    W. Linden & R. MacKenzie

  3. Department of Psychology, Western University, London, Canada

    K. Rnic

Authors
  1. W. Linden
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  2. R. MacKenzie
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  3. K. Rnic
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  4. C. Marshall
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  5. A. Vodermaier
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Corresponding author

Correspondence to W. Linden.

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Linden, W., MacKenzie, R., Rnic, K. et al. Emotional adjustment over 1 year post-diagnosis in patients with cancer: understanding and predicting adjustment trajectories. Support Care Cancer 23, 1391–1399 (2015). https://doi.org/10.1007/s00520-014-2492-9

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  • DOI: https://doi.org/10.1007/s00520-014-2492-9

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