Mindfulness and metacognition in facing with fear of recurrence: A proof‐of‐concept study with breast‐cancer women

Abstract

Objective Fear of recurrence is a crucial issue in cancer care. On the one hand, the increase of cancer‐survival rates and complexity of care is exposing patients to this type of fear. On the other hand, it is a distressing and recurrent psychosocial risk that affects quality of life and adherence to follow‐up. Patients should have access to targeted psychological interventions aimed at reducing or preventing fear of recurrence. This mixed‐methods pilot study reports the preliminary results of a novel mindfulness‐ and metacognition‐based intervention specifically targeting fear of recurrence. Methods The study was composed of an individual (n = 76) and a group (n = 38) intervention, both lasting 8 weeks, that were evaluated through a preassessment and postassessment and a 1‐month follow‐up. We enrolled women recovering from breast cancer (n = 114) in follow‐up care, with significant psychosocial distress. Patients with more severe psychopathology were assigned to the individual treatment, whereas the less severe ones were assigned to the group treatment. We explored the distress and the fear of recurrence through standardized measures and in‐depth qualitative interviews. Results Results showed that depressive, anxious, and post‐traumatic symptoms were reduced significantly in the entire sample. Patients reported a significant reduction of fear of recurrence, which was described in terms of loss of control, increase of uncertainty, and decrease of metacognitive and interpersonal skills. Conclusions Although further studies are needed, these findings provide preliminary proof‐of‐concept results for the potential of integrated mindfulness‐ and metacognition‐based interventions to reduce fear of recurrence in cancer patients.

Qualitative and quantitative analysis of the defensive profile in breast cancer women: A pilot study

“…The early detection of maladaptive defense mechanisms is considered important for preventing adverse progression of the illness (Beresford et al, 2006). Better detection and understanding of the peculiar defensive manifestations of BC patients might support psychological interventions promoting adaptive management of their illness (Cheli et al, 2019; Perry and Bond, 2012; Perry et al, 2009), with the effect of better cancer progression and wellbeing (Koh et al, 2005; Kreitler et al, 1993).…”

When kindness falls apart: The disrupting effect of dependency, perfectionism, and narcissism in adjusting to cancer

“…An intervention for cancer patients should offer a flexible strategy aimed at reducing distress, increasing awareness on maladaptive strategies, and developing adaptive ones . The OP we described urges professionals to explore traits or behaviors that may compromise the course of psychotherapy and cancer treatment, and then to assess the personality through dimensional models such as SCID‐5‐AMPD.…”

“…An intervention for cancer patients should offer a flexible strategy aimed at reducing distress, increasing awareness on maladaptive strategies, and developing adaptive ones. 9 The OP we described urges professionals to explore traits or behaviors that may compromise the course of psychotherapy and cancer treatment, and then to assess the personality through dimensional models such as SCID-5-AMPD. The recurrence of negative affectivity and perfectionism suggests that the therapists should not to force the patients to revolutionize his/her own standards, but instead to shift from achieving an unattainable perfect self to experimenting with here-and-now adaptive strategies.…”

“…Five cancer patients were recruited retrospectively from a wider study whose aim was to test a novel mindfulness‐based intervention: (i) Mary (female; 26 yy) was in follow‐up after a cervical cancer; (ii) Louise (female, 47 yy) was under treatment for a breast cancer; (iii) Susan (female; 62 yy) was in follow‐up care after a colon‐rectal cancer; (iv) Mark (male; 44 yy) was under treatment for a lung cancer; and (v) Karen (female; 38 yy) was under treatment for a breast cancer.…”

Mindfulness-Based Stress Reduction for Breast Cancer Survivors (MBSR (BC)): Evaluating Mediators of Psychological and Physical Outcomes in a Large Randomized Controlled Trial

“…MBSR reduced cancer-related anxiety and intolerance of uncertainty, and increased mindfulness, among prostate cancer patients up to 12-months post diagnosis (Victorson et al, 2012). MBSR(BC) and other mindfulness interventions have also reduced fear of cancer recurrence while concurrently enhancing mindfulness and self-regulation (Butow et al, 2017; Cheli et al, 2019; Compen et al, 2018; Crane-Okada et al, 2012; C.A. Lengacher et al, 2011; C.…”