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Emotional distress impacts fear of the future among breast cancer survivors not the reverse

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Abstract

Introduction

Fear of the future is one of the most stressful aspects of having cancer. Research to date has conceptualized fear of the future as a precursor of distress or stress-response symptoms. Yet it is equally plausible that distress would predict increased fear of the future or that they would have a reciprocal influence on each other. The purpose of the present study was to examine the bidirectional relations between fear of the future and distress as well as intrusion and avoidance among breast cancer survivors at 3, 7, 11, and 15 months after diagnosis.

Methods

We used a bivariate latent difference score model for dynamic change to examine these bidirectional relationships among 146 early-stage breast cancer survivors. Using Lisrel version 8.80, we examined four models testing different hypothesized relationships between fear of the future and distress and intrusion and avoidance.

Results

Based on model fit evaluation, our data shows that decreases in distress over time lead to a reduction of fear of the future but that changes in fear do not lead to changes in distress. On the other hand, there is no relationship between changes in fear of the future and intrusion and avoidance over time.

Discussion

Ongoing fear of the future does not appear to be a necessary condition for the development of stress-response symptoms. Implications for Cancer Survivors: Future studies need to explore the role of distressing emotions in the development and exacerbation of fear of the future among cancer survivors.

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Notes

  1. We would like to thank the two anonymous reviewers who suggested we clearly define the concepts of fear of the future and fear of cancer recurrence.

  2. For a more detailed description of the relations between fear of the future and sociodemographic factors, please refer to an earlier publication (Lebel et al. 2007).

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Acknowledgments

Thank you to Dwayne Schindler (University of Ottawa) and Emilio Ferrer (University of California, Davis) for their help with the statistical analyses

Author information

Authors and Affiliations

  1. School of Psychology, University of Ottawa, 11 Marie Curie room 515, Ottawa, ON, Canada, K1N 6N5

    Sophie Lebel

  2. Sir Mortimer B. Davis-Jewish General Hospital, Montreal, QC, Canada

    Zeev Rosberger & Linda Edgar

  3. Psychosocial Oncology and Palliative Care, University Health Network, Toronto, ON, Canada

    Gerald M. Devins

  4. Department of Psychiatry, University of Toronto, Toronto, ON, Canada

    Gerald M. Devins

  5. Ontario Cancer Institute, Toronto, Canada

    Gerald M. Devins

Authors
  1. Sophie Lebel
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  2. Zeev Rosberger
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  3. Linda Edgar
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  4. Gerald M. Devins
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Correspondence to Sophie Lebel.

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Lebel, S., Rosberger, Z., Edgar, L. et al. Emotional distress impacts fear of the future among breast cancer survivors not the reverse. J Cancer Surviv 3, 117–127 (2009). https://doi.org/10.1007/s11764-009-0082-5

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  • DOI: https://doi.org/10.1007/s11764-009-0082-5

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