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Predicting symptoms of anxiety and depression in patients living with advanced cancer: the differential roles of hope and optimism

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Abstract

Purpose

Psychological distress is related to poorer functioning and reduced quality of life in patients with advanced cancer and may have untoward influences on treatment decisions. Current research on factors associated with this distress is limited, making targeted interventions to reduce it suboptimal. We examined the relationships between two goal-related expectancies and two of the most common symptoms of psychological distress in patients living with advanced cancer: anxiety and depressive symptoms.

Methods

Patients with advanced gastrointestinal cancer, colorectal cancer, lung cancer, or melanoma (N = 84) completed measures of anxiety, depressive symptoms, optimism, hope, and prediction for 12-month survival. Oncologists provided prediction for patient 12-month survival and patient performance status.

Results

Hope, but not optimism, was associated with less severe depressive symptoms (β = − 0.42). Conversely, optimism, but not hope, was associated with less severe anxiety symptoms (β = − 0.36).

Conclusions

Hope and optimism appear to be associated with different aspects of psychological distress in patients living with advanced cancer. This may be explained by different appraisals of the uncertainty and distress that are associated with living with advanced-stage cancer. Hope- or optimism-focused interventions can be tailored to help alleviate specific aspects of psychological distress among these patients.

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Notes

  1. We believe it is important to point out that, while higher hope is correlated with lower depressive symptoms (Snyder et al. 1991), this is not because hope and hopelessness are two conceptualizations of the same depressive symptom (and thus any observed association results from criterion contamination). In fact, despite the lexical similarities between the names of the hope and hopelessness constructs, research has shown them to be structurally and conceptually distinct [40]. Conceptually, hopelessness is more similar to pessimism, whereas hope is a trait belief about one’s ability to achieve important goals.

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Funding

This project was supported by a research scholar grant awarded to Kevin L. Rand (RSGPB-10-014-01-CPPB) by the American Cancer Society.

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Authors and Affiliations

  1. Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA

    Ian C. Fischer & Kevin L. Rand

  2. School of Medicine, Indiana University, Indianapolis, IN, USA

    Larry D. Cripe

  3. Indiana University Simon Cancer Center, Indianapolis, IN, USA

    Larry D. Cripe

Authors
  1. Ian C. Fischer
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Corresponding author

Correspondence to Ian C. Fischer.

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This study was granted approval by the institutional review board (IRB) at Indiana University Purdue University Indianapolis (IUPUI). The authors have full control of all primary data and agree to allow the journal to review the data if requested.

Conflict of interest

The authors declare that they have no conflict of interest.

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Fischer, I.C., Cripe, L.D. & Rand, K.L. Predicting symptoms of anxiety and depression in patients living with advanced cancer: the differential roles of hope and optimism. Support Care Cancer 26, 3471–3477 (2018). https://doi.org/10.1007/s00520-018-4215-0

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