Department of Psychological Medicine, National University of Singapore, Singapore; Institute of Mental Health, Singapore.
Department of Psychological Medicine, National University of Singapore, Singapore; Department of Psychology, National University of Singapore, Singapore.
J Psychosom Res. 2018 Aug;111:120-126. doi: 10.1016/j.jpsychores.2018.06.004. Epub 2018 Jun 9.
The Fear of Cancer Recurrence (FCR) is reported to be a normal response to cancer, but little is known about the interaction between FCR and maladaptive cognitive processes, which may increase the risk for depression and anxiety disorders among cancer survivors. Previous studies have shown the influence of rumination on depression and anxiety in other populations. Thus, the present study aimed to examine how FCR and rumination may relate to depression and anxiety symptoms among cancer survivors.
The present study included cancer survivors (N = 388) who had completed their active treatment at the National University Cancer Institute Singapore, and achieved complete remission from cancer. All participants completed self-report measures of FCR (Fear of Cancer Recurrence Inventory), rumination (Rumination Response Scale), depression, and anxiety symptoms (Hospital Anxiety and Depression Scale).
The present study observed that (1) FCR and rumination were associated with more severe depression and anxiety symptoms, and (2) the interaction between FCR and rumination was associated with more severe depressive symptoms (p = .01). Specifically, rumination was significantly associated with higher depressive symptoms in individuals with high FCR (p < .001), while rumination was not associated with depressive symptoms in individuals with low FCR (p > .05).
Habitual rumination may be a maladaptive cognitive style to cope with high FCR. Therefore, the present study's findings elucidate the moderating effect of rumination on FCR, and such findings may better inform psychological interventions to reduce the risk of depression and anxiety among cancer survivors who experience high FCR.
据报道，对癌症的恐惧（FCR）是一种正常的反应，但对于 FCR 与适应不良的认知过程之间的相互作用知之甚少，而这些认知过程可能会增加癌症幸存者患抑郁和焦虑障碍的风险。先前的研究表明，反刍思维对其他人群的抑郁和焦虑有影响。因此，本研究旨在探讨 FCR 和反刍思维如何与癌症幸存者的抑郁和焦虑症状相关。
本研究包括在新加坡国立大学癌症研究所完成积极治疗并已从癌症中完全缓解的癌症幸存者（N=388）。所有参与者均完成了对 FCR（癌症复发恐惧量表）、反刍思维（反刍反应量表）、抑郁和焦虑症状（医院焦虑和抑郁量表）的自我报告测量。
本研究观察到：（1）FCR 和反刍思维与更严重的抑郁和焦虑症状有关，（2）FCR 和反刍思维的相互作用与更严重的抑郁症状有关（p=0.01）。具体来说，反刍思维与 FCR 高的个体的更高抑郁症状显著相关（p<0.001），而在 FCR 低的个体中，反刍思维与抑郁症状无关（p>0.05）。
习惯性反刍思维可能是一种适应不良的认知方式，用于应对高 FCR。因此，本研究的结果阐明了反刍思维对 FCR 的调节作用，这些发现可能更好地为心理干预提供信息，以降低经历高 FCR 的癌症幸存者患抑郁和焦虑的风险。
