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Cancer-Related Intrusive Thoughts as an Indicator of Poor Psychological Adjustment at 3 or More Years After Breast Surgery: A Preliminary Study

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Abstract

Intrusive thoughts are one of the re-experiencing symptoms in posttraumatic stress disorder, and have been suggested as a predictor for the continuous presence of psychological distress in cancer survivors. The aim of this preliminary study was to examine the possibility of using cancer-related intrusive thoughts (CITs) as an indicator of psychological distress and adjustment after breast surgery. A consecutive series of ambulatory breast cancer survivors at 3 or more years after surgery were given the Structured Clinical Interview for DSM-IV (SCID) and self-report questionnaires, including Profile Of Mood States (POMS), Impact of Event Scale (IES) and Mental Adjustment to Cancer (MAC) scale, to measure psychological distress and/or adjustment. The SCID identified a history of CITs in 34 (46%) of the 74 participants. No significant differences were found in the POMS and IES psychological distress scores between subjects with and without a history of CITs. Subjects with a history of CITs showed significantly higher levels of anxious preoccupation, one of the MAC subscale scores. The association continued to be significant after controlling for potential confounders such as social support, depression, avoidance, arousal, and neuroticism. The results indicated that CITs might be useful for indicating poor psychological adjustment, but not distress, in patients at 3 or more years after breast surgery.

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References

  1. Smith MY, Redd WH, Peyser C, Vogl D: Post-traumatic stress disorder in cancer: a review. Psychooncology 8: 521–537, 1999

    Google Scholar 

  2. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. 4th edn, American Psychiatric Press, Washington, DC, 1994

    Google Scholar 

  3. Alter CL, Pelcovitz D, Axelrod A, Goldenberg B, Harris H, Meyers B, Grobois B, Mandel F, Septimus A, Kaplan S: Iden-tification of PTSD in cancer survivors. Psychosomatics 37: 137–143, 1996

    Google Scholar 

  4. Green BL, Rowland JH, Krupnick JL, Epstein SA, Stockton P, Stern NM, Spertus IL, Steakley C: Prevalence of posttraumatic stress disorder in women with breast cancer. Psychosomatics 39: 102–111, 1998

    Google Scholar 

  5. Tjemsland L, Soreide JA, Malt UF: Posttraumatic distress symptoms in operable breast cancer III: status one year after surgery. Breast Cancer Res Treat 47: 141–151, 1998

    Google Scholar 

  6. McBride CM, Clipp E, Peterson BL, Lipkus IM, Demark-Wahnefried W: Psychological impact of diagnosis and risk re-duction among cancer survivors. Psychooncology 9: 418–427, 2000

    Google Scholar 

  7. Green BL, Krupnick JL, Rowland JH, Epstein SA, Stockton P, Spertus I, Stern N: Trauma history as a predictor of psycholog-ic symptoms in women with breast cancer. J Clin Oncol 18: 1084–1093, 2000

    Google Scholar 

  8. Bleiker EM, Pouwer F, van der Ploeg HM, Leer JW, Ader HJ: Psychological distress two years after diagnosis of breast cancer: frequency and prediction. Patient Educ Couns 40: 209–217, 2000

    Google Scholar 

  9. Marshall RD, Olfson M, Hellman F, Blanco C, Guardino M, Struening EL: Comorbidity, impairment, and suicidality in subthreshold PTSD. Am J Psychiat 158: 1467–1473, 2001

    Google Scholar 

  10. Epping-Jordan JE, Compas BE, Osowiecki DM, Oppedisano G, Gerhardt C, Primo K, Krag DN: Psychological adjust-ment in breast cancer: processes of emotional distress. Health Psychol 18: 315–326, 1999

    Google Scholar 

  11. Nordin K, Glimelius B: Predicting delayed anxiety and de-pression in patients with gastrointestinal cancer. Br J Cancer 79: 525–529, 1999

    Google Scholar 

  12. Bloom JR: Surviving and thriving? Psychooncology 11: 89–92, 2002.

    Google Scholar 

  13. First MB, Spitzer RL, Gibbon M, Williams JBW: Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) – Clinician Version. American Psychiatric Press, Washington, DC, 1997

    Google Scholar 

  14. NcNair DM, Lorr M, Droppleman LF: Manual for the Profile Of Mood States (POMS). Educational and Industrial Testing Service, San Diego, 1971

    Google Scholar 

  15. Yokoyama K, Araki S, Kawakami N, Takeshita T: Production of the Japanese edition of Profile Of Mood States (POMS): as-sessment of reliability and validity. Nippon Koshu Eisei Zasshi 37: 913–918, 1990 (in Japanese)

    Google Scholar 

  16. Horowitz M, Wilner N, Alvarez W: Impact of event scale: a measure of subjective stress. Psychosom Med 41: 209–218, 1979

    Google Scholar 

  17. Kelly B, Raphael B, Smithers M, Swanson C, Reid C, McLeod R, Thomson D, Walpole E: Psychological responses to malig-nant melanoma. An investigation of traumatic stress reactions to life-threatening illness. Gen Hosp Psychiat 17: 126–134, 1995

    Google Scholar 

  18. Watson M, Greer S, Young J, Inayat Q, Burgess C, Robertson B: Development of a questionnaire measure of adjustment to cancer: the MAC scale. Psychol Med 18: 203–209, 1988

    Google Scholar 

  19. Akechi T, Fukue-Saeki M, Kugaya A, Okamura H, Nishiwaki Y, Yamawaki S, Uchitomi Y: Psychometric properties of the Japanese version of the mental adjustment to cancer (MAC) scale. Psychooncology 9: 395–401, 2000

    Google Scholar 

  20. Breslau N, Davis GC, Andreski P: Risk factors for PTSD-related traumatic events: a prospective analysis. Am J Psychiat 152: 529–535, 1995

    Google Scholar 

  21. Eysenck SBG, Eysenck HJ, Barret P: A revised version of the psychoticism scale. Pers Indiv Differ 6: 21–29, 1985

    Google Scholar 

  22. Hosokawa T, Ohyama M: Reliability and validity of a Japanese version of the short-form Eysenck personality questionnaire-revised. Psychol Rep 72: 823–832, 1993

    Google Scholar 

  23. Brewin CR, Watson M, McCarthy S, Hyman P, Dayson D: Intrusive memories and depression in cancer patients. Behav Res Ther 36: 1131–1142, 1998

    Google Scholar 

  24. Watson M, Greer S, Rowden L, Gorman C, Robertson B, Bliss JM, Tunmore R: Relationships between emotional con-trol, adjustment to cancer and depression and anxiety in breast cancer patients. Psychol Med 21: 51–57, 1991

    Google Scholar 

  25. Ferrero J, Barreto M, Toledo M: Mental adjustment to cancer and quality of life in breast cancer patients: an exploratory study. Psychooncology 3: 223–232, 1994

    Google Scholar 

  26. Lampic C, Wennberg A, Schill JE, Glimelius B, Brodin O, Sjoden PO: Coping, psychosocial well-being and anxiety in cancer patients at follow-up visits. Acta Oncol 33: 887–894, 1994

    Google Scholar 

  27. Nordin K, Glimelius B: Reactions to gastrointestinal cancer – variation in mental adjustment and emotional well-being over time in patients with different prognoses. Psychooncology 7: 413–423, 1998

    Google Scholar 

  28. Morris T, Greer HS, White P: Psychological and social adjust-ment to mastectomy: a two-year follow-up study. Cancer 40: 2381–2387, 1977

    Google Scholar 

  29. Grassi L, Rosti G: Psychosocial morbidity and adjustment to illness among long-term cancer survivors. A six-year follow-up study. Psychosomatics 37: 523–532, 1996

    Google Scholar 

  30. Andrykowski MA, Brady MJ, Henslee-Downey PJ: Psychoso-cial factors predictive of survival after allogeneic bone marrow transplantation for leukemia. Psychosom Med 56: 432–439, 1994

    Google Scholar 

  31. Jenkins PL, May VE, Hughes LE: Psychological morbidity associated with local recurrence of breast cancer. Int J Psychiat Med 21: 149–155, 1991

    Google Scholar 

  32. Akech T, Okuyama T, Imoto S, Yamawaki S, Uchitomi Y: Biomedical and psychosocial determinants of psychi-atric morbidity among postoperative ambulatory breast cancer patients. Breast Cancer Res Treat 65: 195–202, 2001

    Google Scholar 

  33. Butler LD, Koopman C, Classen C, Spiegel D: Traumatic stress, life events, and emotional support in women with meta-static breast cancer: cancer-related traumatic stress symptoms associated with past and current stressors. Health Psychol 18: 555–560, 1999

    Google Scholar 

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Authors and Affiliations

  1. Psycho-Oncology Division, National Cancer Center Research Institute East, Kashiwanoha, Kashiwa, Chiba, Japan

    Yutaka Matsuoka, Tomohito Nakano, Masatoshi Inagaki, Yuriko Sugawara, Tatsuo Akechi & Yosuke Uchitomi

  2. Department of Psychiatry and Neuroscience, Hiroshima University School of Medicine, Kasumi, Hiroshima, Japan

    Yutaka Matsuoka & Shigeto Yamawaki

  3. Psychiatry Division, National Cancer Center Hospital, Tsukiji, Chuo-ku, Tokyo, Japan

    Tomohito Nakano

  4. Psychiatry Division, National Cancer Center Hospital East, Kashiwanoha, Kashiwa, Chiba, Japan

    Tatsuo Akechi & Yosuke Uchitomi

  5. Division of Breast Surgery, National Cancer Center Hospital East, Kashiwanoha, Kashiwa, Chiba, Japan

    Shigeru Imoto

  6. Department of Radiology, National Cancer Center Hospital East, Kashiwanoha, Kashiwa, Chiba, Japan

    Koji Murakami

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  1. Yutaka Matsuoka
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  2. Tomohito Nakano
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  8. Shigeto Yamawaki
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  9. Yosuke Uchitomi
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Matsuoka, Y., Nakano, T., Inagaki, M. et al. Cancer-Related Intrusive Thoughts as an Indicator of Poor Psychological Adjustment at 3 or More Years After Breast Surgery: A Preliminary Study. Breast Cancer Res Treat 76, 117–124 (2002). https://doi.org/10.1023/A:1020572505095

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  • DOI: https://doi.org/10.1023/A:1020572505095

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