Eisenberg Stacy A, Kurita Keiko, Taylor-Ford Megan, Agus David B, Gross Mitchell E, Meyerowitz Beth E
Department of Psychology, University of Southern California, Los Angeles, CA, USA.
Psychooncology. 2015 Feb;24(2):228-35. doi: 10.1002/pon.3590. Epub 2014 Jun 2.
Prostate cancer survivors have reported cognitive complaints following treatment, and these difficulties may be associated with survivors' ongoing cancer-related distress. Intolerance of uncertainty may exacerbate this hypothesized relationship by predisposing individuals to approach uncertain situations such as cancer survivorship in an inflexible and negative manner. We investigated whether greater cognitive complaints and higher intolerance of uncertainty would interact in their relation to more cancer-related distress symptoms.
This cross-sectional, questionnaire-based study included 67 prostate cancer survivors who were 3 to 5 years post treatment. Hierarchical multiple regression analyses tested the extent to which intolerance of uncertainty, cognitive complaints, and their interaction were associated with cancer-related distress (measured with the Impact of Event Scale-Revised; IES-R) after adjusting for age, education, physical symptoms, and fear of cancer recurrence.
Intolerance of uncertainty was positively associated with the IES-R avoidance and hyperarousal subscales. More cognitive complaints were associated with higher scores on the IES-R hyperarousal subscale. The interaction of intolerance of uncertainty and cognitive complaints was significantly associated with IES-R intrusion, such that greater cognitive complaints were associated with greater intrusive thoughts in survivors high in intolerance of uncertainty but not those low in it.
Prostate cancer survivors who report cognitive difficulties or who find uncertainty uncomfortable and unacceptable may be at greater risk for cancer-related distress, even 3 to 5 years after completing treatment. It may be beneficial to address both cognitive complaints and intolerance of uncertainty in psychosocial interventions.
前列腺癌幸存者报告称在治疗后出现认知方面的问题，而这些困难可能与幸存者持续存在的癌症相关困扰有关。对不确定性的不耐受可能会使个体倾向于以僵化和消极的方式应对诸如癌症幸存者状态等不确定情况，从而加剧这种假设的关系。我们调查了更多的认知问题和更高的不确定性不耐受是否会在与更多癌症相关困扰症状的关系中相互作用。
这项基于问卷调查的横断面研究纳入了67名治疗后3至5年的前列腺癌幸存者。分层多元回归分析检验了在调整年龄、教育程度、身体症状和对癌症复发的恐惧后，不确定性不耐受、认知问题及其相互作用与癌症相关困扰（用事件影响量表修订版；IES-R测量）之间的关联程度。
不确定性不耐受与IES-R回避和过度唤醒子量表呈正相关。更多的认知问题与IES-R过度唤醒子量表上的更高得分相关。不确定性不耐受和认知问题的相互作用与IES-R侵入显著相关，即对于不确定性不耐受程度高的幸存者，更多的认知问题与更多的侵入性思维相关，而对于不确定性不耐受程度低的幸存者则不然。
报告有认知困难或觉得不确定性令人不适和不可接受的前列腺癌幸存者，即使在完成治疗3至5年后，患癌症相关困扰的风险可能更高。在心理社会干预中同时解决认知问题和对不确定性的不耐受可能是有益的。
