Associations between empirically proportionate and disproportionate fears of cancer recurrence and anxiety and depression in uveal melanoma survivors: Five-year prospective study.

Brown, Stephen L, Hope-Stone, Laura, van der Voort, Nicola, Hussain, Rumana ORCID: 0000-0001-8208-5009, Heimann, Heinrich, Coventry, William L and Cherry, Mary Gemma (2024) Associations between empirically proportionate and disproportionate fears of cancer recurrence and anxiety and depression in uveal melanoma survivors: Five-year prospective study. British journal of health psychology.

XML Word Processing Document (DOCX) REsubmission BrownDisproportionateFCR (002).docx - Author Accepted Manuscript Download (89kB)

Abstract

<h4>Objective</h4>Fear of cancer recurrence (FCR) may develop into elevated anxiety or depression symptoms, but few risk factors for this development are known. Objective recurrence risk estimation is possible in some cancers. Using theories of risk communication and phobias, we examined whether the proportionality of FCR to known objective recurrence risk influences the development of anxiety and depression symptoms.<h4>Method</h4>Uveal melanoma (UM) patients can opt for reliable prognostic testing. Patients experience either a 'good' or 'poor' prognostic outcome, whereby 10-year mortality due to metastatic disease is, respectively, low or high. In a five-year prospective study of a consecutive sample of 589 UM survivors, we used random intercept cross lagged panel analyses to examine whether proportionality differentially influences whether FCR progresses to anxiety and depression.<h4>Results</h4>Positive cross paths predicting anxiety from FCR were stronger in the poor prognosis group than the good prognosis and not tested groups. Prognostic group differences were not evident for depression.<h4>Conclusions</h4>FCR was more likely to progress to elevated anxiety symptoms when proportionate to the known objective recurrence risk. Objective evidence may play a prominent role in the development and structure of fear because it assumes a high epistemic weight that activates a wide range of emotional and cognitive responses. Interventions that assist survivors to tolerate FCR in the presence of higher recurrence risks may be important in reducing anxiety symptoms.

Item Type:	Article
Uncontrolled Keywords:	anxiety, cancer, depression, fear of cancer recurrence, proportionality, prospective design
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Population Health
Depositing User:	Symplectic Admin
Date Deposited:	13 Mar 2024 10:34
Last Modified:	17 Mar 2024 23:32
DOI:	10.1111/bjhp.12719
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3179374