Catherine E Mosher1, Ellen Krueger1, Ekin Secinti1, Shelley A Johns1,2. 1. Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA. 2. Indiana University School of Medicine, Center for Health Services Research, Regenstrief Institute, Indianapolis, IN, USA.
Abstract
OBJECTIVE: This study examined relations between acceptance and commitment therapy (ACT) constructs and symptom-based subgroups of advanced cancer patients. METHODS: Patients with advanced breast, gastrointestinal, lung, and prostate cancer (N = 201) completed questionnaires assessing five common symptoms and ACT variables (i.e., psychological inflexibility, cognitive fusion, values obstruction and progress, peaceful acceptance, mindfulness, and activity engagement) on one occasion. RESULTS: Latent profile analysis showed three patient classes: (1) normal levels of all symptoms (32%); (2) normal levels of all symptoms except for mild sleep problems and moderate fatigue (19%); and (3) normal pain, mild levels of sleep problems, anxiety, and depressive symptoms, and moderate fatigue (48%). Controlling for demographic covariates, lower psychological inflexibility, cognitive fusion, and values obstruction were associated with a higher likelihood of being in classes 1 or 2 than class 3. In addition, greater values progress, peaceful acceptance, mindfulness, and activity engagement were associated with a higher likelihood of being in class 1 than class 3. Of these four factors, only greater mindfulness and activity engagement were associated with a higher likelihood of being in class 2 than class 3. CONCLUSIONS: Advanced cancer patients show heterogeneous symptom profiles, and even mild to moderate symptom levels are related to greater withdrawal from personally meaningful activities and less acceptance of cancer and internal experiences (e.g., symptoms, thoughts, feelings). Findings are consistent with the ACT model and support further testing of ACT to address symptom interference with functioning in advanced cancer patients.
OBJECTIVE: This study examined relations between acceptance and commitment therapy (ACT) constructs and symptom-based subgroups of advanced cancer patients. METHODS: Patients with advanced breast, gastrointestinal, lung, and prostate cancer (N = 201) completed questionnaires assessing five common symptoms and ACT variables (i.e., psychological inflexibility, cognitive fusion, values obstruction and progress, peaceful acceptance, mindfulness, and activity engagement) on one occasion. RESULTS: Latent profile analysis showed three patient classes: (1) normal levels of all symptoms (32%); (2) normal levels of all symptoms except for mild sleep problems and moderate fatigue (19%); and (3) normal pain, mild levels of sleep problems, anxiety, and depressive symptoms, and moderate fatigue (48%). Controlling for demographic covariates, lower psychological inflexibility, cognitive fusion, and values obstruction were associated with a higher likelihood of being in classes 1 or 2 than class 3. In addition, greater values progress, peaceful acceptance, mindfulness, and activity engagement were associated with a higher likelihood of being in class 1 than class 3. Of these four factors, only greater mindfulness and activity engagement were associated with a higher likelihood of being in class 2 than class 3. CONCLUSIONS: Advanced cancer patients show heterogeneous symptom profiles, and even mild to moderate symptom levels are related to greater withdrawal from personally meaningful activities and less acceptance of cancer and internal experiences (e.g., symptoms, thoughts, feelings). Findings are consistent with the ACT model and support further testing of ACT to address symptom interference with functioning in advanced cancer patients.
Authors: Frank W Bond; Steven C Hayes; Ruth A Baer; Kenneth M Carpenter; Nigel Guenole; Holly K Orcutt; Tom Waltz; Robert D Zettle Journal: Behav Ther Date: 2011-05-25
Authors: Jennifer C Plumb Vilardaga; Joseph G Winger; Irene Teo; Lynda Owen; Linda M Sutton; Francis J Keefe; Tamara J Somers Journal: J Pain Symptom Manage Date: 2019-09-17 Impact factor: 3.612
Authors: David T Gillanders; Helen Bolderston; Frank W Bond; Maria Dempster; Paul E Flaxman; Lindsey Campbell; Sian Kerr; Louise Tansey; Penelope Noel; Clive Ferenbach; Samantha Masley; Louise Roach; Joda Lloyd; Lauraine May; Susan Clarke; Bob Remington Journal: Behav Ther Date: 2013-09-18
Authors: David Cella; William Riley; Arthur Stone; Nan Rothrock; Bryce Reeve; Susan Yount; Dagmar Amtmann; Rita Bode; Daniel Buysse; Seung Choi; Karon Cook; Robert Devellis; Darren DeWalt; James F Fries; Richard Gershon; Elizabeth A Hahn; Jin-Shei Lai; Paul Pilkonis; Dennis Revicki; Matthias Rose; Kevin Weinfurt; Ron Hays Journal: J Clin Epidemiol Date: 2010-08-04 Impact factor: 6.437
Authors: Jennifer W Mack; Matthew Nilsson; Tracy Balboni; Robert J Friedlander; Susan D Block; Elizabeth Trice; Holly G Prigerson Journal: Cancer Date: 2008-06 Impact factor: 6.860
Authors: Lauren A Zimmaro; James W Carson; Maren K Olsen; Linda L Sanders; Francis J Keefe; Laura S Porter Journal: Psychooncology Date: 2019-10-17 Impact factor: 3.894
Authors: Anne M Walling; Jane C Weeks; Katherine L Kahn; Diana Tisnado; Nancy L Keating; Sydney M Dy; Neeraj K Arora; Jennifer W Mack; Philip M Pantoja; Jennifer L Malin Journal: J Pain Symptom Manage Date: 2014-06-26 Impact factor: 3.612
Authors: Charles Cleeland; Roger von Moos; Mark S Walker; Yuanyuan Wang; Jianqing Gao; Mariana Chavez-MacGregor; Alexander Liede; Jorge Arellano; Arun Balakumaran; Yi Qian Journal: Support Care Cancer Date: 2016-03-29 Impact factor: 3.603
Authors: Suzanne K Chambers; Elizabeth Foley; Samantha Clutton; Robert McDowall; Stefano Occhipinti; Martin Berry; Martin R Stockler; Stephen J Lepore; Mark Frydenberg; Robert A Gardiner; Ian D Davis; David P Smith Journal: Qual Life Res Date: 2016-06-17 Impact factor: 4.147