Psychological flexibility correlates with patient-reported outcomes independent of clinical or sociodemographic characteristics
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The evidence for the effectiveness of psychological interventions for cancer patients is currently unclear. Acceptance and Commitment Therapy (ACT), which increases individual’s levels of psychological flexibility, may be more effective than other frameworks of psychological intervention, but good quality research is needed to inform adoption and implementation. This study explored the correlation between psychological flexibility and patient-reported outcomes to assess the viability of this intervention for cancer survivors.
Recruitment was coordinated through a regional cancer centre. One hundred twenty-nine respondents completed a cross-sectional postal questionnaire. They were of mixed gender, diagnosis and cancer stage; a mean 61 years old; and a mean 207 days post-diagnosis. Self-report questionnaires assessed psychological flexibility, mood, anxiety, depression, stress, quality of life and benefit finding.
Psychological flexibility was a strong and consistent correlate of outcome; effects were maintained even when potentially confounding clinical and sociodemographic characteristics were controlled.
Psychological flexibility can be modified through ACT-based interventions. Given the strong correlational evidence found in this study, it seems that such interventions might be useful for cancer survivors. High-quality and well-designed controlled trials are now needed to establish effectiveness.
KeywordsCancer Oncology Intervention Quality of life Distress Acceptance
We are grateful to Lynda Appleton and Helen Wong at The Clatterbridge Cancer Centre (UK) for their help in identifying suitable patients for this study. We would also like to thank Lee Hulbert-Williams for statistical and data analysis advice. This study was funded through a Capacity Building Grant from the University of Chester UK.
Compliance with ethical standards
Conflict of interest
The authors declare no conflict of interest in respect to this work, and the publication thereof. The authors have full control of all primary data which can be provided to the journal on request.
Ethical approval was granted via University and NHS Ethics Committees (NRES Committee North West—Liverpool East; REC Reference 11/NW/0381) and research governance approval was granted from the primary Cancer Treatment Centre.
- 2.Macmillan (2006) Worried sick: the emotional impact of cancer. Macmillan Cancer Support, London UKGoogle Scholar
- 3.Maguire P (2000) Psychological aspects. In: Dixon M (ed) ABC of breast diseases. BMJ Books, London, pp 150–153Google Scholar
- 5.Edwards AGK, Hulbert-Williams NJ, Neal RD (2008). Psychological interventions for women with metastatic breast cancer. Cochrane Database of Systematic Reviews Issue 2. Art. No.: CD004253, doi: 10.1002/14651858.CD004253.pub3.
- 7.Hayes SC, Strosahl KD, Wilson KG (2011) Acceptance and Commitment Therapy: the process and practice of mindful change. Guildford Press, New YorkGoogle Scholar
- 14.Skinta MD, Lezama M, Wells G, Dilley JW (2014). Acceptance and compassion-based group therapy to reduce HIV stigma. Cognitive and Behavioural Practice e-publication ahead of print. doi: 10.1016/j.cbpra.2014.05.006.
- 16.Wetherell JL, Afari N, Rutledge T, Sorrell JT, Stoddard JA, Petkus AJ, Solomon BC, Lehman DH, Liu L, Lang AJ, Atkinson JH (2011) A randomized, controlled trial of acceptance and commitment therapy and cognitive-behavioural therapy for chronic pain. Pain 152:2098–2107. doi: 10.1016/j.pain.2011.05.016 CrossRefPubMedGoogle Scholar
- 19.Gillanders DT, Sinclair AK, MacLean M & Jardine K (2015). Illness cognitions, cognitive fusion, avoidance and self-compassion as predictors of distress and quality of life in a heterogenous sample of adults, after cancer. J Contextual Behav Scie, 1–2. DOI: 10.1016/j.jcbs.2015.07.003Google Scholar
- 21.Trompetter HR, Bholmeijer ET, Veehof MM, Schreurs KMG (2014). Internet-based guided self-help intervention for chronic pain based on Acceptance and Commitment Therapy: a randomized controlled trial. Journal of Behavioral Medicine, e-publication ahead of print doi: 10.1007/s10865-014-9579-0.Google Scholar
- 24.Bond FW, Hayes SC, Baer RA, Carpenter KM, Guenole N, Orcutt HK, Waltz T, Zettle RD (2011) Preliminary psychometric properties of the Acceptance and Action Questionnaire-II: a revised measure of psychological inflexibility and experiential avoidance. Behav Ther 42:676–688. doi: 10.1016/j.beth.2011.03.007 CrossRefPubMedGoogle Scholar
- 34.Tabachnick BG, Fidell LS (2006) Using multivariate statistics, 5th edn. Pearson Education Ltd., London UKGoogle Scholar