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Understanding the Implications of Health Anxiety Following Breast Cancer Diagnosis

Understanding the Implications of Health Anxiety Following Breast Cancer Diagnosis. Kirsten Gullickson, Heather Hadjistavropoulos, & Shannon Jones Department of Psychology University of Regina. Introduction. Breast cancer Effects of diagnosis Health anxiety and other related constructs

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Understanding the Implications of Health Anxiety Following Breast Cancer Diagnosis

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  1. Understanding the Implications of Health Anxiety Following Breast Cancer Diagnosis Kirsten Gullickson, Heather Hadjistavropoulos, & Shannon Jones Department of Psychology University of Regina

  2. Introduction • Breast cancer • Effects of diagnosis • Health anxiety and other related constructs • Goal is to improve well-being of women with breast cancer

  3. Health Anxiety “Health anxiety is a persistent fear of illness or disease” Mild Health Anxiety Moderate Health Anxiety Severe Health Anxiety Ferguson (2009); Warwick & Slakovskis (1990)

  4. Health Anxiety Perceptual Dimension Critical incident Cycle of Health Anxiety Health-related cognitions Knowledge and past experience with illness Cognitive Dimension Affective Dimension Behavioral Dimension Figure adapted from Abramowitz, Deacon, & Valentiner (2007)

  5. Study Design Depression Generalized Anxiety Cancer-Specific Anxiety Body Vigilance Reassurability Health Anxiety Anxiety Sensitivity Quality of Life Intolerance of Uncertainty

  6. Hypotheses (1) Health anxiety will be associated with increased body vigilance, decreased reassurability, and decreased quality of life among women with breast cancer (2) Health anxiety will predict increased body vigilance, decreased reassurability, and poorer quality of life even when controlling for depression, anxiety, cancer-specific anxiety, intolerance of uncertainty, anxiety sensitivity, and other demographic variables

  7. Participants • Women • 18 years or older • Canadian residents • Diagnosed with breast cancer within the past ten years • Access to a computer and the internet

  8. Recruitment • Breast Cancer Organizations • Breast Cancer Support Groups • Dragon Boat Racing Teams • Poster Advertisements • Media Advertisements • Snowball Sampling

  9. Participants • 198 female participants • 27 to 80 years old (M = 50.71 years, SD = 10.70 years) • Canadian residents (1/4 of sample from Saskatchewan) • Primarily caucasian (96.6%) • Diagnosed within the past ten years • Varying stages of breast cancer • Stage 0 = 5% • Stage 1 = 28% • Stage II= 42% • Stage III = 19% • Stage IV = 9%

  10. Measures • Demographics & Breast Cancer History • Short Health Anxiety Inventory (SHAI) - 14 items • Multidimentional Inventory of Hypochondriacal Traits (MIHT) - 31 items • Body Vigilance Scale (BVS) - 4 item • Reassurance Questionnaire (RQ) - 8 item • World Health Organization Quality of Life - BREF (WHOQOL-BREF) - 26 items • Hospital Anxiety and Depression Scale (HADS) - 14 items • Breast Cancer Anxiety Scale (BCAS) - 21 items • Intolerance of Uncertainty Scale - Short Form (IUS-12) - 12 items • Anxiety Sensitivity Index-3 (ASI-3) - 18 items Salkovskis, Rimes, Warwick, & Clark (2002); Longley et al. (2005); Schmidt, Lerew, & Trakowski (1997); Speckens et al. (2000); World Health Organization Quality of Life Group (1998); Zigmond & Snaith (1983); Kash (2001) Carleton, Norton, & Asmundson (2007); Taylor et al. (2007)

  11. Procedure • Online survey • Informed consent • Incentive for participation • Statistical analyses: • Hierarchal multiple regressions

  12. Procedure Dependent Variables: body vigilance, reassurability, physical quality of life • Step 2 • generalized anxiety • depression • cancer-specific anxiety • intolerance of uncertainty • anxiety sensitivity • Step 3 • health anxiety • behavioral health anxiety • cognitive health anxiety • perceptual health anxiety • affective health anxiety • Step 1 • age • marital status • family history • time since diagnosis • stage of breast cancer • other health conditions

  13. Results & Discussion • Health anxiety is a significant predictor of body vigilance • Especially the behavioral and perceptual dimensions • Findings support the cognitive-behavioral model of health anxiety

  14. Results & Discussion • Health anxiety is a significant predictor of reassurability • Especially the affective dimension • Findings support the cognitive-behavioral model of health anxiety

  15. Results & Discussion • Health anxiety is a significant predictor of quality of life

  16. Anxiety-Related Variables • Anxiety sensitivity was a significant predictor of body vigilance and reassurability • Especially the cognitive and behavioral dimensions • Depression was a highly significant predictor of physical quality of life • Intolerance of uncertainty was also related to physical quality of life

  17. Background Variables • Background variables were not significantly related to body vigilance or reassurability • Marital status, time since diagnosis, and the presence of another health condition were all significant predictors of physical quality of life

  18. Other Observations • Dimensions of health anxiety were significant, not just overall health anxiety • Generalized anxiety and cancer-specific anxiety were not important to body vigilance, reassurability, or quality of life • Some background variables were not significant for any of the regressions • Example: Stage of breast cancer

  19. Study Design Depression Depression Generalized Anxiety Body Vigilance Cancer-Specific Anxiety Reassurability Health Anxiety Anxiety Sensitivity Quality of Life Intolerance of Uncertainty Intolerance of Uncertainty

  20. Study Design Depression Generalized Anxiety Body Vigilance Cancer-Specific Anxiety Reassurability Health Anxiety Anxiety Sensitivity Quality of Life Intolerance of Uncertainty

  21. Study Design Depression Generalized Anxiety Body Vigilance Cancer-Specific Anxiety Reassurability Health Anxiety Anxiety Sensitivity Quality of Life Intolerance of Uncertainty

  22. Limitations 1. Cross-sectional design 2. Internet based 3. Self-report measures 4. Generalizing results

  23. Future Research • Longitudinal • How does health anxiety change from time of diagnosis forward? • Male vs. female breast cancer • Is the experience different for men? • Ethnicity/Socio-economic status • Study a more diverse sample

  24. Discussion • Support for the cognitive-behavioral model of health anxiety • Understand the implications of health anxiety and other constructs • Aid clinicians who work with women with breast cancer • Direction for future research

  25. Questions? website: http://www.surveymonkey.com/s/MT8GJYN

  26. STUDY DESIGN Depression Depression Generalized Anxiety Body Vigilance Cancer-Specific Anxiety Reassurability Health Anxiety Anxiety Sensitivity Quality of Life Intolerance of Uncertainty Intolerance of Uncertainty

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