The Anxiety Depression Pathway Among Men Following a Prostate Cancer Diagnosis: Cross-Sectional Interactions Between Anger Responses and Loneliness

Abstract

Anger has been a largely neglected emotion in prostate cancer research and intervention. This paper highlights the role of anger in the anxiety depression pathway among men with prostate cancer, and whether its impact is dependent on loneliness. Data are presented from a sample of men with prostate cancer ( N = 105, M = 69.12 years, prostatectomy = 63.8%) and analysed using conditional process analysis. Dimensions of anger were evaluated as parallel mediators in bi-directional anxiety and depression pathways. Loneliness was evaluated as a conditional moderator of identified significant mediation relationships. Moderate severity depression (16.5%) was endorsed more frequently than moderate severity anxiety (8.6%, p = .008), with 19.1% of the sample reporting past two-week suicide ideation. Consistent with hypotheses, anger-related social interference (but not other dimensions of anger) significantly mediated the anxiety-depression pathway, but not the reverse depression-anxiety pathway. This indirect effect was conditional on men experiencing loneliness. Sensitivity analyses indicated the observed moderated mediation effect occurred for affective, but not somatic symptoms of depression. Findings support anger-related social interference (as opposed to anger frequency, intensity, duration or antagonism) as key to explaining the previously established anxiety-depression pathway. Results underscore the need for enhanced psychosocial supports for men with prostate cancer, with a particular focus on relational aspects. Supporting men with prostate cancer to adaptively process and manage their anger in ways that ameliorate negative social consequences will likely enhance their perceived social support quality, which may in turn better facilitate post-diagnosis recovery and emotional adjustment.

Loneliness, spiritual well-being, and death perception, as well as their risk factors in urological cancer patients

“…The present study found that loneliness was higher and spiritual well-being was lower in urological cancer patients than in healthy controls, which was partly in line with previous studies that indicated that loneliness and reduced spiritual well-being were prevalent in cancer patients ( 12 , 14 , 20 ). Urological cancer patients have low self-esteem and might also feel a loss of self-worth, which results in less social interaction with others and ultimately contributes to increased loneliness ( 21 , 22 ); it should be mentioned that a previous study reported that loneliness was indirectly responsible for the occurrence of depression in prostate cancer patients ( 23 ). Considering that loneliness is elevated in urological cancer patients, more attention should be given to these patients, and the improvement of psychological management is warranted.…”

Talking about sex: erectile dysfunction in the oncology patient

“…Although the definition of depression remains heterogeneous, any patient living with cancer has to deal with a higher rate of depression compared to the general population (Massie 2004). Alongside depressive symptoms, emotional distress embraces a large spectrum of nuances among the anxiety depressive disorder, ranging from loneliness to anger (Rice et al 2021). Thus, it should be more appropriate to refer to 'psychosocial distress' in oncological patients (1999), which could be detected already at early stages of the diagnosis, due to the climate of uncertainty and fear for the future (Tan et al 2021).…”

Identification of distinct symptom profiles in prostate cancer patients with cancer-related cognitive impairment undergoing androgen deprivation therapy: A latent class analysis

“… 12 , 13 Additionally, chronic loneliness may indirectly contribute to the progression of depression in PC patients. 16 Thus, identifying the latent class of symptom clusters with cognitive impairment as the primary symptom may provide us with a better comprehension of the symptom profile in PC patients treated with ADT. Furthermore, expanding cognitive impairment research beyond prior ADT exposure and focusing on modifiable factors has the potential to provide a new perspective for managing symptom clusters in PC patients.…”