Trajectories of Anxiety as a Proxy for Psychological Adjustment in Breast Cancer

Abstract

Background: Psychological distress is reported to be highly prevalent in women with early breast cancer. Consistent with the conceptualization of anxiety as a future oriented mood-state reflecting uncertainty and anticipation of negative outcomes, we approach a gradual decrease in anxiety as a proxy of overall psychological adjustment to breast cancer. The aim of the present study is to identify patterns of trajectories of anxiety to assess the course of adjustment from acute to extended survival in breast cancer. Methods: Data on Hospital Anxiety and Depression Scale acquired from a longitudinal prospective cohort study of women with breast cancer (n =750) were subjected to Mixture Growth Modeling. Results: 94% of the group divided into 3 classes displayed varying initial levels, but significant decrease in anxiety within a year, followed by a non-significant slope from a year to 2 years. A 4th class (6%), however, displayed the highest intercept and non-significant slopes throughout the time frame of the study. Discussion: The results suggest that the main adjustment occurs within the first year following the surgery for most of the women. However, a small subgroup displays abiding levels of anxiety indicating a lack of psychological adjustment 2 years after the surgery. The need for intervention for this group may be extended beyond the first year following the initial treatment.