Objectives and Purpose
There is an established link between managing uncertainty and cancer-related distress. In the presence of uncertainty, the transdiagnostic mechanism of repetitive negative thinking (RNT) may drive this distress, however, few studies to date have investigated this. The present study therefore cross-sectionally and longitudinally explored how RNT varies among, and impacts the psychosocial outcomes of, people living with and beyond cancer.
Sample and Setting
Participants (baseline N = 82, follow-up N = 65) were adults diagnosed with any stage or type of cancer, recruited through a Flinders University sponsored social media campaign.
Procedures
Participants completed measures of fear of cancer recurrence/progression (FCRP), cancer-specific distress, general distress and quality of life (QoL) at baseline, and at 6 month follow-up.
Results
Cross-sectionally, statistically significant relationships emerged between RNT and psychosocial outcomes (FCRP R2 = .51; cancer-related distress R2 = .59; general distress R2 = .62; QoL R2 = .40, all p <.001). Longitudinally, a significant proportion of change in distress outcomes (FCRP R2 = .13; cancer-related distress R2 = .10; and general distress R2 = .23) were accounted for by changes in RNT (p = .004, .013, and <.001 respectively). Four clinical RNT trajectories were identified: unaffected (N = 37, 57%), persistent (N = 15, 23%), recovered (N = 11, 17%), and deteriorated (N = 2, 3%). Having clinical levels of RNT at baseline was associated with significant group main effects on all psychosocial outcomes (all p <.001), however no group by time interactions were present.
Conclusion and Clinical Implications
Changes in RNT are associated with changes in distress but not QoL outcomes, with the clinical presence of RNT acting as the biggest predictor of distress outcomes. Results demonstrate that while RNT may be a stable construct, trajectories show it is amenable to change through psychological intervention.