Sensitivity to change of the distress thermometer in a sample of pediatric cancer survivors

Abstract

BACKGROUND: The Quebec Cancer Board recommends screening for distress at all major phases of the cancer trajectory in patients and their family. Tools used to screen for distress have been extensively studied in regards to their criterion validity but very little is known on their reliability and sensitivity to change. The objective of this study is to ascertain the degree of sensitivity of the tool and explore moderators of sensitivity. METHODS: Eighty adolescents and young adults (Age 21.6 yrs) who have been treated for a pediatric acute lymphoblastic leukemia have participated to this study. They responded to questions on two occasions. Test-retest measures involved the Distress Thermometer and the Positive and Negative Affect Scale. At retest, participants also took tests of emotion regulation including the Emotion Regulation Questionnaire, in order to evaluate emotional avoidance. FINDINGS: Results from regression analyses indicate that sensitivity of the DT was fair with changes over 11 months correlating with the underlying concept of negative affectivity (r > .49), but not positive affectivity (r < .10). When considered according to pre-validated cut-point, the DT showed higher sensitivity to change in negative affect over the period. Hierarchical regression moderation models showed that emotional avoidance may hinder sensitivity perhaps because it is a barrier to emotional disclosure on the DT. DISCUSSION: Sensitivity of the DT was fair on an ecological period of time. Sensitivity may depend on other important factors such as emotional approach. Measures of the DT in people who are more guarded should be considered cautiously.