Group Psychotherapy of Dysfunctional Fear of Progression in Patients with Chronic Arthritis or Cancer

Abstract

Background: This study investigated the effectiveness of brief psychotherapeutic group interventions in reducing dysfunctional fear of disease progression (FoP). The interventions comprised either cognitive-behavioral group therapy or supportive-experiential group therapy. We tested whether these generic interventions would prove effective in different illness types. Methods: Chronic arthritis in- patients (n = 174) and cancer in-patients (n = 174), respectively, were randomized to receive one of the two interventions. The patients provided data before intervention, at discharge, and at 3 and 12 months of follow-up. FoP was the primary outcome, secondary outcomes were anxiety, depression and quality of life. A treatment-as-usual control group provided data on the primary outcome. Results: Patients with chronic arthritis indicated higher levels of FoP than cancer patients. The results revealed that, compared with no specialized intervention, both group therapies were effective in reducing dysfunctional FoP, but only among cancer patients. The effect sizes were 0.54 (cognitive-behavioral therapy) and 0.50 (supportive experiential therapy). The interventions were not differently effective in reducing the secondary outcomes. Conclusions: Dysfunctional FoP can be effectively targeted with brief group interventions. Psychotherapeutic interventions for reducing FoP should focus on specific illness characteristics.

Anxiety, Posttraumatic Stress, and Fear of Cancer Progression in Patients with Melanoma in Cancer Aftercare

“…The anxiety scores were strikingly low in all 3 of the applied questionnaires. The fear of cancer progression (FoP-Q) was lower, as has also been demonstrated in other cancer patient groups [12,13]. Only 17% of the patients had clinically elevated scores of PTSS-10, whereas in the study of Einsle et al [14] 30.9% of the cancer patients were within this range.…”

“…We measured anxiety using a psychometric tool for the physically ill, and also assessed the fear of cancer progression and posttraumatic stress. Fear of progression has been studied in cancer and other chronically ill patients [11,12]. Using the Fear of Progression Questionnaire (FoP-Q), patients with rheumatoid arthritis were found to present significantly higher values compared to cancer patients, while in stroke patients the fear of progression was significantly lower [13].…”

Fear of recurrence and its impact on quality of life in patients with hematological cancers in the course of allogeneic hematopoietic SCT

“…Pre-treatment evaluation of subclinical depressive symptoms may help to detect patients at risk who might benefit from interventions tailored to specific problems such as FCR. 7,38 Fear of cancer recurrence (FCR) in patients with hematological cancers S Sarkar et al…”

“…FCR is defined as the fear or worry that cancer will return, progress or metastasize. [3][4][5][6][7] FCR is often conceptualized as a multidimensional phenomenon, including emotional components of anxiety and fear, and a cognitive dimension, including worry, preoccupation and intrusive thoughts. 3,8,9 Prevalence estimates of FCR range between 22 and 99% among cancer survivors and FCR is considered to be one of the most distressing psychological consequences of cancer.…”

Shared decision-making in rheumatology : what matters to patients?

“…Previous studies showed that arthritis patients worry about the future, especially about the long term medication use and their prognosis, due to the unpredictable course and the varying disease activity (151)(152)(153)(154). To our knowledge no previous studies have reported patients' concerns about the availability and potential risks of future treatments.…”