Brittany Mutsaers1, Phyllis Butow2, Andreas Dinkel3, Gerald Humphris4, Christine Maheu5, Gozde Ozakinci4, Judith Prins6, Louise Sharpe2, Allan Ben Smith7, Belinda Thewes2, Sophie Lebel1. 1. University of Ottawa, Ottawa, ON, Canada. 2. School of Psychology, The University of Sydney, Sydney, Australia. 3. Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany. 4. School of Medicine, University of St Andrews, St Andrews, United Kingdom. 5. McGill University, Montreal, Canada. 6. Radboud University, Nijmegen, Netherlands. 7. Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, Sydney, Australia.
Abstract
OBJECTIVE: Without an agreed-upon set of characteristics that differentiate clinical from nonclinical levels of fear of cancer recurrence (FCR), it is difficult to ensure that FCR severity is appropriately measured, and that those in need of intervention are identified. The objective of this study was to establish expert consensus on the defining features of clinical FCR. METHOD: A three-round Delphi was used to reach consensus on the defining features of clinical FCR. Sixty-five experts in FCR (researchers, psychologists, physicians, nurses, and allied health professionals) were recruited to suggest and rate potential features of clinical FCR. Participants who indicated they could communicate diagnoses within their clinical role were also asked to consider the application of established DSM-5 and proposed ICD-11 diagnostic criteria (Health Anxiety, Illness Anxiety Disorder, Somatic Symptom Disorder) to clinical FCR. RESULTS: Participants' ratings suggested that the following four features are key characteristics of clinical FCR: (a) high levels of preoccupation; (b) high levels of worry; (c) that are persistent; and (d) hypervigilance to bodily symptoms. Of participants whose professional role allowed them to diagnose mental disorders, 84% indicated it would be helpful to diagnose clinical FCR, but the use of established diagnostic criteria related to health anxiety or somatic-related disorders to clinical FCR was not supported. This suggests that participants consider clinical FCR as a presentation that is specific to cancer survivors. CONCLUSION: Clinical FCR was conceptualized as a multidimensional construct. Further research is needed to empirically validate the proposed defining features.
OBJECTIVE: Without an agreed-upon set of characteristics that differentiate clinical from nonclinical levels of fear of cancer recurrence (FCR), it is difficult to ensure that FCR severity is appropriately measured, and that those in need of intervention are identified. The objective of this study was to establish expert consensus on the defining features of clinical FCR. METHOD: A three-round Delphi was used to reach consensus on the defining features of clinical FCR. Sixty-five experts in FCR (researchers, psychologists, physicians, nurses, and allied health professionals) were recruited to suggest and rate potential features of clinical FCR. Participants who indicated they could communicate diagnoses within their clinical role were also asked to consider the application of established DSM-5 and proposed ICD-11 diagnostic criteria (Health Anxiety, Illness Anxiety Disorder, Somatic Symptom Disorder) to clinical FCR. RESULTS:Participants' ratings suggested that the following four features are key characteristics of clinical FCR: (a) high levels of preoccupation; (b) high levels of worry; (c) that are persistent; and (d) hypervigilance to bodily symptoms. Of participants whose professional role allowed them to diagnose mental disorders, 84% indicated it would be helpful to diagnose clinical FCR, but the use of established diagnostic criteria related to health anxiety or somatic-related disorders to clinical FCR was not supported. This suggests that participants consider clinical FCR as a presentation that is specific to cancer survivors. CONCLUSION: Clinical FCR was conceptualized as a multidimensional construct. Further research is needed to empirically validate the proposed defining features.
Authors: José A E Custers; Lucy Davis; Christina Messiou; Judith B Prins; Winette T A van der Graaf Journal: Cancer Med Date: 2021-04-09 Impact factor: 4.452
Authors: Paula Heidkamp; Clara Breidenbach; Kati Hiltrop; Christoph Kowalski; Anna Enders; Holger Pfaff; Birgitta Weltermann; Franziska Geiser; Nicole Ernstmann Journal: Support Care Cancer Date: 2021-06-17 Impact factor: 3.603