Coutts-Bain Daelin, Sharpe Louise, Techakesari Pirathat, Forrester Madeline Anne, Hunt Caroline
School of Psychology, Faculty of Science, The University of Sydney, Australia.
School of Psychology, Faculty of Science, The University of Sydney, Australia.
Clin Psychol Rev. 2023 Nov;105:102342. doi: 10.1016/j.cpr.2023.102342. Epub 2023 Sep 23.
A fear that one's physical illness will recur or worsen has received substantial research attention over the past decade, most notably as fear of cancer recurrence. Indeed, such fear is known to be associated with poorer quality of life, adjustment, and psychopathology. However, fear of a recurrence or progression (FORP) of mental health conditions has received comparatively little study. The present review aimed to, 1) systematically review quantitative research on FORP in mental health regarding its association with age, gender, quality of life, mental health outcomes, and health behaviours, and 2) meta-synthesize qualitative research related to FORP to construct a transdiagnostic model. A qualitative meta-synthesis of 19 studies identified four subthemes underlying FORP (fear of symptoms, loss of progress, fear of death, and traumatic experiences). The three themes related to FORP were: inability to trust oneself, hypervigilance, and a low-risk low-reward lifestyle which was comprised of three subthemes (limiting relationships, limiting life goals, and fear of changing treatment). A quantitative systematic review of 15 studies found that FORP was strongly associated with worse quality of life, and greater depression, anxiety, psychotic symptoms, and medication adherence, but was not associated with age or gender. Hence, FORP can be understood transdiagnostically, and is generally associated with poorer mental health outcomes but may also predict adaptive health behaviours, such as appropriate medication adherence.
在过去十年中，对身体疾病复发或恶化的恐惧受到了大量研究关注，最显著的是对癌症复发的恐惧。事实上，已知这种恐惧与较差的生活质量、适应能力和精神病理学有关。然而，对心理健康状况复发或进展的恐惧（FORP）受到的研究相对较少。本综述旨在：1）系统回顾关于FORP在心理健康方面与年龄、性别、生活质量、心理健康结果和健康行为之间关联的定量研究；2）对与FORP相关的定性研究进行元综合，以构建一个跨诊断模型。对19项研究的定性元综合确定了FORP背后的四个子主题（对症状的恐惧、进展丧失、对死亡的恐惧和创伤经历）。与FORP相关的三个主题是：无法信任自己、过度警惕以及低风险低回报的生活方式，后者由三个子主题组成（限制人际关系、限制生活目标以及对改变治疗的恐惧）。对15项研究的定量系统回顾发现，FORP与较差的生活质量、更严重的抑郁、焦虑、精神病症状以及药物依从性密切相关，但与年龄或性别无关。因此，FORP可以从跨诊断的角度来理解，并且通常与较差的心理健康结果相关，但也可能预测适应性健康行为，如适当的药物依从性。
