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The Intervening Roles of Psychological Inflexibility and Functional Impairment in the Relation between Cancer-related Pain and Psychological Distress

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Abstract

Background

Psychological distress is a significant problem among patients with a diagnosis of cancer and is associated with elevated risk for mortality; however, not all patients with a diagnosis of cancer experience significant psychological distress. Cancer-related pain has been associated with greater psychological distress among patients with a cancer diagnosis (current or previous). The current study aimed to examine potential theoretical mechanisms (i.e., cognitive fusion, experiential avoidance, and functional impairment) as proposed by the psychological flexibility model, for the association between cancer-related pain and psychological distress. We hypothesized that cancer-related pain would be indirectly positively associated with psychological distress among patients with a cancer diagnosis (current or previous) through psychological inflexibility (i.e., cognitive fusion and experiential avoidance) related to pain and functional impairment, in serial.

Method

Sixty-one adult outpatients diagnosed with cancer completed self-report assessments of cancer-related pain, psychological inflexibility related to pain, pain-related functional impairment, and psychological distress.

Results

Cancer-related pain was positively associated with psychological distress indirectly through greater pain-related psychological inflexibility (i.e., cognitive fusion and experiential avoidance) and functional impairment, in serial. Alternative models were explored but unsupported.

Conclusion

Consistent with the psychological flexibility model, psychological inflexibility and functional impairment may be potential mechanisms underlying the association between cancer-related pain and psychological distress among patients with a cancer diagnosis (current or previous).

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Authors and Affiliations

  1. Department of Psychological Sciences, Texas Tech University, Mail Stop 2051, Lubbock, TX, 79409-2051, USA

    Sarah L. Brown & Jared F. Roush

  2. Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden Blvd., Box Psych, Rochester, NY, 14642, USA

    Sarah L. Brown

  3. Department of Family and Protective Services, Austin, TX, 78751, USA

    Andrew J. Marshall

  4. Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, 79430, USA

    Catherine Jones & Charlene Key

Authors
  1. Sarah L. Brown
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  2. Jared F. Roush
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  4. Catherine Jones
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Correspondence to Sarah L. Brown.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Brown, S.L., Roush, J.F., Marshall, A.J. et al. The Intervening Roles of Psychological Inflexibility and Functional Impairment in the Relation between Cancer-related Pain and Psychological Distress. Int.J. Behav. Med. 27, 100–107 (2020). https://doi.org/10.1007/s12529-019-09838-8

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