The DOI matches its Crossref record; 43 of the 43 references it cites were found in a registry or an index; 1 of the 20 sources its claims cite were checked for support.
Acceptance and commitment therapy for breast cancer survivors with fear of cancer recurrence: A 3-arm pilot randomized controlled trial.
Open accessAbstract
Background: Fear of cancer recurrence (FCR) has a profound negative impact on quality of life (QOL) for many cancer survivors. Breast cancer survivors (BCS) are particularly vulnerable, with up to 70% reporting clinically significant FCR. To the authors' knowledge, evidence-based interventions for managing FCR are limited. Acceptance and commitment therapy (ACT) promotes psychological flexibility in managing life's stressors. The current study examined the feasibility and preliminary efficacy of group-based ACT for FCR in BCS.Methods: Post-treatment BCS (91 patients with stage I-III disease) with clinical FCR randomly were assigned to ACT (6 weekly 2-hour group sessions), survivorship education (SE; 6 weekly 2-hour group sessions), or enhanced usual care (EUC; one 30-minute group coaching session with survivorship readings). FCR severity (primary outcome) and avoidant coping, anxiety, post-traumatic stress, depression, QOL, and other FCR-related variables (secondary outcomes) were assessed at baseline (T1), after the intervention (T2), 1 month after the intervention (T3), and 6 months after the intervention (T4) using intent-to-treat analysis.Results: Satisfactory recruitment (43.8%) and retention (94.5%) rates demonstrated feasibility. Although each arm demonstrated within-group reductions in FCR severity over time, only ACT produced significant reductions at each time point compared with baseline, with between-group differences at T4 substantially favoring ACT over SE (Cohen d for effect sizes, 0.80; P < .001) and EUC (Cohen d, 0.61; P < .01). For 10 of 12 secondary outcomes, only ACT produced significant within-group reductions across all time points. By T4, significant moderate to large between-group comparisons favored ACT over SE and EUC with regard to avoidant coping, anxiety, depression, QOL, and FCR-related psychological distress.Conclusions: Group-based ACT is a feasible and promising treatment for FCR and associated outcomes in BCS that warrants testing in larger, fully powered trials.
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23 Own result · 15 Own method · 10 Own interpretation · 6 No full text of the sources · 3 No basis given · 1 Partly supported · 1 Sources not found · 1 Not checked yet · accuracy not yet measured
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“This interpretation is supported by ACT participants’ reported physical and mental QoL improvement, which likely resulted from a combination of reduced anxiety and increased psychological flexibility.23–26”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > DISCUSSION
What the sources say
- Not matchedcites [23]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites [24] source
- Not checked — no full text of the sourcecites [25] source
- Partly supportedcites [26] sourceExperimental — accuracy not yet measured
The Quality of life (QoL) section (page unavailable) reports that most reviewed studies found QoL improvements after ACT, while the Psychological flexibility section reports post-ACT gains in flexibility. The Distress section also describes improvements in distress, including post-stroke anxiety. The review does not establish that reduced anxiety and increased flexibility jointly caused physical and mental QoL gains, and it cautions that other factors may explain post-intervention QoL improvements. (LLM, conf=0.86)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Although each arm showed within-group FCR severity reductions over time”
- Also stated in: § Primary Outcome · plain
“Each group showed within-group reductions in FCR severity by T4”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > Abstract > Results:
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Primary Outcome · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“compared to SE, ACT showed significantly larger FCR severity reductions with a moderate effect at T2 (d=0.68, p<0.05)”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > RESULTS > Primary Outcome
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“As more time passed, ACT became more efficacious.”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > DISCUSSION
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“No differences between SE and EUC on FCR severity were observed.”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > RESULTS > Primary Outcome
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“This may explain why ACT’s impact was greatest at T4.”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > DISCUSSION
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“No differences between SE and EUC were observed on secondary outcomes.”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > RESULTS > Secondary Outcomes
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Conversely, SE and EUC participants reported significant within-group improvements on only a fraction of secondary outcomes.”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > RESULTS > Secondary Outcomes
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“At each time point, ACT participants reported significant within-group improvements on all secondary outcomes except FCRI-Reassurance Seeking and FCRI-Coping Strategies (Table 2).”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > RESULTS > Secondary Outcomes
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“only ACT produced significant reductions at each time point relative to baseline”
- Also stated in: § Primary Outcome · plain
“only ACT produced significant improvement at each time point”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > Abstract > Results:
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Primary Outcome · plain
- It may state two separate claims as one. 24
- The quote only partly states this claim. 1
- Probably not a substantial claim. 12
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and superior to EUC on 7 of 12 outcomes with moderate to large effect sizes”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > RESULTS > Secondary Outcomes
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Between-group differences at each time point favored ACT, most obviously at T4”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > DISCUSSION
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“by T4 ACT was superior to SE on 10 of 12 secondary outcomes”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > RESULTS > Secondary Outcomes
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one. The quote only partly states this claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“ACT showed strong evidence of feasibility with high accrual (43.8% of BCS screened; 60.7% of eligible BCS), attendance (81.7%), and retention (94.5%) rates.”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > DISCUSSION
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: The observed recruitment (43.8%) and retention (94.5%) rates are satisfactory for demonstrating feasibility.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“By T4, significant moderate-to-large between-group comparisons favored ACT over SE and EUC on avoidant coping, anxiety, depression, QoL, and FCR-related psychological distress.”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > Abstract > Results:
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Relative to baseline, ACT showed significant within-group improvement on FCR severity and nearly all secondary outcomes at all follow-ups, whereas SE and EUC showed minimal change across outcomes.”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > DISCUSSION
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Satisfactory recruitment (43.8%) and retention (94.5%) demonstrated feasibility.”
- Also stated in: § Feasibility · plain
“Of 208 BCS assessed for eligibility, 91 (43.8%) enrolled and 117 were excluded (Figure 1). Retention was excellent (94.5%) and 89.0% of participants completed all four assessments.”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > Abstract > Results:
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: The observed recruitment (43.8%) and retention (94.5%) rates are satisfactory for demonstrating feasibility.
- Also stated in: § Feasibility · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Most participants were White (84%) college graduates (65%) earning ≥$50,000 annually (73%).”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > RESULTS > Participant Characteristics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Of 208 BCS assessed for eligibility, 91 (43.8%) enrolled and 117 were excluded (Figure 1).”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > RESULTS > Feasibility
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Attendance rates were similar across ACT (81.7%) and SE (86.7%; p=0.47) with 100% of EUC participants attending the single coaching session.”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > RESULTS > Feasibility
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Retention was excellent (94.5%) and 89.0% of participants completed all four assessments.”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > RESULTS > Feasibility
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“While avoidant coping allows survivors to escape anxiety-provoking thoughts about cancer in the short-term, rebound-effects produce sustained, elevated levels of FCR over time.42”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > DISCUSSION
What the sources say
- Not checked — no full text of the sourcecites [42] source
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“six months after intervention, ACT participants reported greater reductions in FCR severity relative to both SE and EUC with differences large enough to be considered clinically significant.40”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > DISCUSSION
What the sources say
- Not checked — no full text of the sourcecites [40] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Breast cancer survivors (BCS) are particularly vulnerable with up to 70% reporting clinically-significant FCR.”
- Also stated in: § INTRODUCTION · plain
“up to 70% of survivors report clinically-significant FCR,8,9 making it the most frequently-reported unmet need of BCS.1,10”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > Abstract > Background:
What the sources say
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Also stated in: § INTRODUCTION · plain
None of the sources cited for this claim have been checked yet.
In the paper
“First, ACT can be delivered efficaciously to a group, potentially reducing costs and increasing the number of those served over individually-delivered interventions.27,29”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > DISCUSSION
What the sources say
- Not matchedcites [27]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites [29] source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Although the Cancer-AAQ captured avoidant coping, the FCRI-Coping Strategies subscale is essentially a count measure of adaptive and maladaptive coping strategies and provided little insight into specific coping styles”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Second, this pilot was not a fully-powered efficacy trial, necessitating a larger randomized trial to confirm results.”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A limitation of this study was the largely White, affluent, college-educated sample, limiting generalizability to other groups.”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > DISCUSSION
plainconditional- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Participants and research assistants were blinded to allocation sequence, and participants were blinded to study hypotheses.”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > METHODS > Procedures
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Between-group differences on change scores of the outcomes were tested using a General Linear Model (GLM) while adjusting for theoretically-important covariates (i.e., age, stage of cancer, education)39 and cancer treatments received, which differed significantly between arms at baseline.”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > METHODS > Statistical Analysis
What the sources say
- Not checked — no full text of the sourcecites [39] source
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“This study is registered with ClinicalTrials.gov ().”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > METHODS > Procedures
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“While intended to assess long-term effects of treatment, the pilot’s 6-month follow-up is only modestly rigorous compared to a 12- or 24-month follow-up assessment”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: fails — The paper’s conclusions may not depend on it.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Using an intent-to-treat design, all available data were analyzed regardless of participants’ attendance or adherence.”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > METHODS > Statistical Analysis
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The allocation sequence was generated by the biostatistician in randomly-varied block sizes of three or six and concealed in opaque sequentially-numbered envelopes.”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > METHODS > Procedures
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Assumptions of normality and homogeneity of variances were satisfied and assessed with histograms and scatterplots.”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > METHODS > Statistical Analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Average fidelity ratings were 95.6% for ACT and 93.8% for SE.”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > METHODS > Interventions
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Unlike SE or EUC, ACT may reduce maladaptive avoidant coping, thereby contributing to long-term management of FCR and associated distress.”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > DISCUSSION
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The Indiana University Institutional Review Board (#1507511085) approved study procedures.”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > METHODS > Procedures
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Both offered resources to indirectly manage FCR but did not directly promote adaptive coping with fearful thoughts and emotions, which may be key in addressing comorbid distress and FCR.”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > DISCUSSION
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Post-hoc Tukey-Kramer tests assessed pairwise differences between arms while controlling the family-wise alpha at 0.05 for each outcome.”
§ Acceptance and Commitment Therapy for Breast Cancer Survivors with Fear of Cancer Recurrence: A 3-Arm Pilot Randomized Controlled Trial > METHODS > Statistical Analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper relies on this without support.
The observed recruitment (43.8%) and retention (94.5%) rates are satisfactory for demonstrating feasibility.
“Satisfactory recruitment (43.8%) and retention (94.5%) demonstrated feasibility.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source doesn’t support the claim as written.
In the citing paper
“The average fidelity rating across all sessions rated was 98.6% (SD = 0.03), suggesting the interventionist delivered TACTICs in a manner that was highly adherent to the intervention manual.”
From Feasibility and acceptability of an acceptance and commitment therapy intervention for caregivers of adults with Alzheimer’s disease and related dementias (2021) · cites this paper as [36]
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Strong evidence of feasibility and acceptability was reported, with high accrual and retention or enrollment rates [44, 45], high ratings for essentialness and effectiveness of the intervention [47], moderate to high ratings for usefulness or expected benefits from the intervention [48, 52, 54], and high degree of satisfaction with the sessions [45, 46, 48, 51] (see Table 4 for details).”
From Acceptance and commitment therapy in adult cancer survivors: a systematic review and conceptual model (2021) · cites this paper as [44]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“in a 3-arm pilot RCT addressing fear of cancer recurrence among breast cancer survivors, ACT demonstrated greater acceptability and improvements in mental and physical quality of life, cognitive flexibility, and a reduction in avoidant coping skills, relative to survivorship education and enhanced usual care [43].”
From A digital, coach-assisted intervention to address the psychosocial needs of young adult cancer survivors: Randomized controlled trial protocol and intervention adaptation process (2024) · cites this paper as [43]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The 13 articles selected for review were published between 2015 and 2019 from studies conducted in USA [44–46], Australia [47–52], Spain [53, 54], and Iran [55].”
From Acceptance and commitment therapy in adult cancer survivors: a systematic review and conceptual model (2021) · cites this paper as [44]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Eight studies reported time since cancer diagnosis for the participants; the average time post-diagnosis was 36.45 months, with a range of 27 months [47] to 64.08 months [44].”
From Acceptance and commitment therapy in adult cancer survivors: a systematic review and conceptual model (2021) · cites this paper as [44]
Experimental — accuracy not yet measured
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The intervention was administered in groups in about 55% of the studies, with each group consisting of 4–15 participants [44–46, 53, 55] (unpublished thesis).”
From Acceptance and commitment therapy in adult cancer survivors: a systematic review and conceptual model (2021) · cites this paper as [44]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The ACT protocols almost always involved exercises, metaphors, and experiential strategies; acceptance or mindfulness based or experiential exercises were used in about 82% of the included studies [44–48, 51–54].”
From Acceptance and commitment therapy in adult cancer survivors: a systematic review and conceptual model (2021) · cites this paper as [44]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Additionally, all TACTICs sessions were audio-recorded and assessed for fidelity and ACT skill level using a standardized fidelity checklist adopted from our previous ACT pilots (Fowler et al., 2021; Johns et al., 2020).”
From Feasibility and acceptability of a telephone-based ACT intervention for caregivers (TACTICs) of adults with Alzheimer's disease and related dementias (ADRD): a randomized pilot during the COVID-19 pandemic. (2025) · cites this paper as Johns et al., 2020
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The sample size was calculated based on a study in 2020 22 to achieve 2.31 two groups' mean difference with a 3.650 standard deviation with the formula of mean comparison between two groups.”
From A randomized clinical trial: Efficacy of group-based acceptance and commitment therapy program for breast cancer patients with high fear of progression (2024) · cites this paper as [22]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“addressing FOP while increasing cognitive defusion may provide more opportunity for cancer patients to put their energy and time on their values and have outcome improvements at T 3 .22”
From A randomized clinical trial: Efficacy of group-based acceptance and commitment therapy program for breast cancer patients with high fear of progression (2024) · cites this paper as [22]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“There are some studies confirmed the efficacy of ACT on anxiety and FCR reduction in cancer patients.22,29,38”
From A randomized clinical trial: Efficacy of group-based acceptance and commitment therapy program for breast cancer patients with high fear of progression (2024) · cites this paper as [22]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“in the long term, patients with high experiential avoidance find themselves far away from their values, which can decrease their QOL.22,[34][35][36]”
From A randomized clinical trial: Efficacy of group-based acceptance and commitment therapy program for breast cancer patients with high fear of progression (2024) · cites this paper as [22]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“ACT is also effective in managing fear of cancer recurrence and associated significant improvements in avoidant coping, anxiety, depression, and QoL [25].”
From Effectiveness of Acceptance and Commitment Therapy (ACT) on disease acceptance for breast cancer patients: Study protocol of a randomized controlled trial (2024) · cites this paper as [25]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“An 8-week ACT therapy course decreased stress and other psychological health indices in people with IBD in a randomized controlled experiment.”
From The Effect of Acceptance and Commitment Therapy on Psychological Nursing of Acute Cerebral Infarction with Insomnia, Anxiety, and Depression (2022) · cites this paper as [8]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“When facing life challenges, psychological flexibility can provide a significant potential for pattern change in the face of cancer-related problems and discomfort for patients with cancer and survivors.”
From Acceptance and commitment therapy for demoralization syndrome and cancer-related trauma: A randomized clinical trial study (2021) · cites this paper as [11]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Studies reported significant improvement in QoL following the ACT-based interventions, post-intervention [44, 45, 48], and at follow-up periods of 1 and 6 months [44].”
From Acceptance and commitment therapy in adult cancer survivors: a systematic review and conceptual model (2021) · cites this paper as [44]
The cited source says what the claim attributes to it.
In the citing paper
“ACT processes were used exclusively in about 64% of the studies [44, 46, 52–55] (unpublished thesis). The other studies used ACT as a hybrid therapy, where the intervention involved both ACT and other therapies, such as CBT and relaxation [51], metacognitive therapy [47, 48, 51], cognitive-behavioral stress management and mindfulness-based stress reduction [45], and processes of the Common-Sense Model of illness and the Self-Regulatory Executive Function model [47, 48].”
From Acceptance and commitment therapy in adult cancer survivors: a systematic review and conceptual model (2021) · cites this paper as [44]
The cited source says what the claim attributes to it.
In the citing paper
“Both studies demonstrated moderate to large effects of ACT on psychological outcomes [11, 12].”
From Symptom experiences in post-treatment cancer survivors: associations with acceptance and commitment therapy constructs. (2021) · cites this paper as [12]
The cited source says what the claim attributes to it.
In the citing paper
“Another pilot RCT found that compared to survivorship education and enhanced usual care, group-based ACT was effective in reducing breast cancer survivors’ fear of cancer recurrence, general anxiety, and depressive symptoms at 6-month follow-up [12].”
From Symptom experiences in post-treatment cancer survivors: associations with acceptance and commitment therapy constructs. (2021) · cites this paper as [12]
The cited source says what the claim attributes to it.
In the citing paper
“Of the 13 articles, 5 reported results from published randomized controlled trials [44, 48–50, 53].”
From Acceptance and commitment therapy in adult cancer survivors: a systematic review and conceptual model (2021) · cites this paper as [44]
The cited source says what the claim attributes to it.
In the citing paper
“The mean age of participants across the 11 studies was 50.6 years, ranging from 37.6 years [51] to 58.7 years [44].”
From Acceptance and commitment therapy in adult cancer survivors: a systematic review and conceptual model (2021) · cites this paper as [44]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Seven studies included only participants with a single type of cancer (breast cancer [44, 54, 55] (Gardner), ovarian cancer [45], brain tumor [52], or testicular cancer [51]), while the other four studies included participants with different types of cancer [46–48, 53].”
From Acceptance and commitment therapy in adult cancer survivors: a systematic review and conceptual model (2021) · cites this paper as [44]
The cited source says what the claim attributes to it.
In the citing paper
“ACT processes were used exclusively in about 64% of the studies [44, 46, 52–55] (unpublished thesis).”
From Acceptance and commitment therapy in adult cancer survivors: a systematic review and conceptual model (2021) · cites this paper as [44]
The cited source says what the claim attributes to it.
In the citing paper
“Sample size justification or power description was reported for only two (18%) of the 11 studies [44, 48].”
From Acceptance and commitment therapy in adult cancer survivors: a systematic review and conceptual model (2021) · cites this paper as [44]
The cited source says what the claim attributes to it.
In the citing paper
“An active comparator was used in about 36% of the studies [44, 48, 53] (unpublished thesis).”
From Acceptance and commitment therapy in adult cancer survivors: a systematic review and conceptual model (2021) · cites this paper as [44]
The cited source says what the claim attributes to it.
In the citing paper
“Some studies also did not employ adequate statistical approaches; only two studies reported use of intent-to-treat analyses [44, 48], and only one study [46] assessed the outcome measure multiple times before the intervention.”
From Acceptance and commitment therapy in adult cancer survivors: a systematic review and conceptual model (2021) · cites this paper as [44]
The cited source says what the claim attributes to it.
In the citing paper
“Four studies exclusively included participants with clinically significant anxiety, depression, or FCR [44, 48, 52, 54].”
From Acceptance and commitment therapy in adult cancer survivors: a systematic review and conceptual model (2021) · cites this paper as [44]
The cited source says what the claim attributes to it.
In the citing paper
“However, some aspects of methodological quality were widely ignored; for example, only one article reported blinding of participants [44], while the others gave no information about whether the participants were aware of the study hypotheses.”
From Acceptance and commitment therapy in adult cancer survivors: a systematic review and conceptual model (2021) · cites this paper as [44]
The cited source says what the claim attributes to it.
In the citing paper
“Based on our team’s previous work showing the feasibility and promise of ACT in reducing fear of recurrence and symptoms of anxiety and depression in breast cancer survivors [50]”
From Co-Designing the MOSAIC mHealth App With Breast Cancer Survivors: User-Centered Design Approach (2024) · cites this paper as [50]
The cited source says what the claim attributes to it.
In the citing paper
“Although all have methodological limitations, several ACT trials with cancer populations have noted post-intervention improvements in outcomes, such as psychological distress and quality of life [28, 33–36].”
The check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Female cancer survivors were predominant, with six studies having only female participants [44, 45, 47, 54, 55] (unpublished thesis) and the others with percentage female ranging from 75% [52] to 95% [48].”
From Acceptance and commitment therapy in adult cancer survivors: a systematic review and conceptual model (2021) · cites this paper as [44]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Among the included studies, two had a low risk of bias and received a good quality rating as per the NIH quality assessment tool [44, 48].”
From Acceptance and commitment therapy in adult cancer survivors: a systematic review and conceptual model (2021) · cites this paper as [44]
Experimental — accuracy not yet measuredIn the citing paper
“The results found that the ACT intervention was able to produce a reduction in measures of FCR severity and increase in QoL, pre, post and follow-up.”
From Real-world evaluation of an acceptance and commitment therapy–based group programme for breast cancer survivors with fear of cancer recurrence (2023) · cites this paper as [16]
Citations
Cites
A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.10.1092 · Cited by 31,765
Siegel, R. L., Miller, K. D., & Jemal, A. (2019) · CA: A Cancer Journal for Clinicians · doi:10.3322/caac.21551 · Cited by 20,160
Self-citationThe PHQ-8 as a measure of current depression in the general population
Kroenke, K., Strine, T. W., Spitzer, R. L., Williams, J. B. W., Berry, J. T., & Mokdad, A. H. (2009) · Journal of Affective Disorders · doi:10.1016/j.jad.2008.06.026 · Cited by 5,121
The Impact of Event Scale: Revised
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Ironic processes of mental control.
Wegner, D. M. (1994) · Psychological Review · doi:10.1037//0033-295x.101.1.34 · Cited by 2,609 · cited 1×
“Although avoidant coping allows survivors to escape anxiety-provoking thoughts about cancer in the short term, rebound effects produce sustained, elevated levels of FCR over time.(42) This may explain why the impact of ACT was greatest at T4.”
BackgroundHays, R. D., Bjorner, J. B., Revicki, D. A., Spritzer, K. L., & Cella, D. (2009) · Quality of Life Research · doi:10.1007/s11136-009-9496-9 · Cited by 1,957
Fear of cancer recurrence in adult cancer survivors: a systematic review of quantitative studies
Simard, S., Thewes, B., Humphris, G., Dixon, M., Hayden, C., Mireskandari, S., & Ozakinci, G. (2013) · Journal of Cancer Survivorship · doi:10.1007/s11764-013-0272-z · Cited by 1,217 · cited 6×
“5 million American BCS are expected to survive ≥5 years after treament,(7) up to 70% of survivors report clinically significant FCR,(8,9) making it the most frequently reported unmet need of BCS.(1,10) Left untreated, debilitating fears may linger throughout survivorship,(1,2) thereby reducing quality of life (QOL).”
BackgroundInfluentialHayes, S. C., Levin, M. E., Plumb-Vilardaga, J., Villatte, J. L., & Pistorello, J. (2013) · Behavior Therapy · doi:10.1016/j.beth.2009.08.002 · Cited by 1,120 · cited 1×
“Over 6 weekly 2-hour sessions, ACT sought to reduce the impact of FCR by promoting adaptive strategies for responding to fear.(31) Led by a doctoral-level provider trained in mindfulness and acceptance-based therapies, each session included mindfulness exercises to deepen present-moment awareness.”
MethodSimard, S., & Savard, J. (2009) · Supportive Care in Cancer · doi:10.1007/s00520-008-0444-y · Cited by 608
Lebel, S., Ozakinci, G., Humphris, G., Mutsaers, B., Thewes, B., Prins, J., Dinkel, A., Butow, P., & on behalf of the University of Ottawa Fear of Cancer Recurrence Colloquium attendees (2016) · Supportive Care in Cancer · doi:10.1007/s00520-016-3272-5 · Cited by 586
Koch, L., Jansen, L., Brenner, H., & Arndt, V. (2013) · Psycho-Oncology · doi:10.1002/pon.3022 · Cited by 511 · cited 1×
“Left untreated, debilitating fears may linger throughout survivorship,(1,2) thereby reducing quality of life (QOL).(1,2,8,11,12) Many BCS manage FCR with maladaptive hypervigilant or avoidant coping.”
BackgroundTesting for baseline balance in clinical trials
Senn, S. (1994) · Statistics in Medicine · doi:10.1002/sim.4780131703 · Cited by 503
The truly remarkable universality of half a standard deviation: confirmation through another look
Norman, G. R., Sloan, J. A., & Wyrwich, K. W. (2004) · Expert Review of Pharmacoeconomics & Outcomes Research · doi:10.1586/14737167.4.5.581 · Cited by 490 · cited 1×
“Betweengroup differences at each time point favored ACT, most obviously at T4; 6 months after the intervention, ACT participants reported greater reductions in FCR severity compared with both SE and EUC participants, with differences large enough to be considered clinically significant.(40) Moderate to large improveme…”
ResultGraham, C. D., Gouick, J., Krahé, C., & Gillanders, D. (2016) · Clinical Psychology Review · doi:10.1016/j.cpr.2016.04.009 · Cited by 476
Factors reported to influence fear of recurrence in cancer patients: a systematic review
Crist, J. V., & Grunfeld, E. A. (2013) · Psycho-Oncology · doi:10.1002/pon.3114 · Cited by 431 · cited 1×
“Many BCS manage FCR with maladaptive hypervigilant or avoidant coping.(11,13) Hypervigilant coping may result in excessive monitoring through daily breast self-examinations or requests for unnecessary scans, whereas avoidant coping involves attempts to ignore thoughts of cancer.”
BackgroundFear of cancer progression and cancer‐related intrusive cognitions in breast cancer survivors
Mehnert, A., Berg, P., Henrich, G., & Herschbach, P. (2009) · Psycho-Oncology · doi:10.1002/pon.1481 · Cited by 354 · cited 3×
“Although avoidance provides short-term stress reduction, such efforts often fail over time as thoughts of death become increasingly intrusive.(11,14) Cognitive behavioral therapy (CBT) is a common psychotherapeutic intervention for patients with FCR.”
BackgroundScreening and comorbidity of clinical levels of fear of cancer recurrence
Simard, S., & Savard, J. (2015) · Journal of Cancer Survivorship · doi:10.1007/s11764-015-0424-4 · Cited by 329 · cited 2×
“Left untreated, debilitating fears may linger throughout survivorship,(1,2) thereby reducing quality of life (QOL).(1,2,8,11,12) Many BCS manage FCR with maladaptive hypervigilant or avoidant coping.”
BackgroundFear of cancer recurrence: specific profiles and nature of intrusive thoughts
Simard, S., Savard, J., & Ivers, H. (2010) · Journal of Cancer Survivorship · doi:10.1007/s11764-010-0136-8 · Cited by 229 · cited 1×
“Characterized by maladaptive coping, intrusive thoughts, and excessive distress,(4) clinically significant FCR disproportionally affects breast cancer survivors (BCS) compared with survivors of other common cancers.(5,6) Although approximately 90% of the 3.”
BackgroundButow, P. N., Turner, J., Gilchrist, J., Sharpe, L., Smith, A. B., Fardell, J. E., Tesson, S., O’Connell, R., Girgis, A., Gebski, V. J., et al. (2017) · Journal of Clinical Oncology · doi:10.1200/jco.2017.73.1257 · Cited by 228 · cited 2×
“First, ACT can be delivered efficaciously to a group, thereby potentially reducing costs and increasing the number of those served compared to individually delivered interventions.(27,29) Second, it appears that targeting FCR while reducing maladaptive coping may promote concomitant reductions in distress outcomes.”
BackgroundHulbert-Williams, N. J., Storey, L., & Wilson, K. G. (2015) · European Journal of Cancer Care · doi:10.1111/ecc.12223 · Cited by 228 · cited 1×
“Theoretically, reducing avoidant coping promotes psychological flexibility, allowing individuals to pursue more adaptive strategies to handle cancer-related and other challenges.(43) This interpretation is supported by the improvements in physical and mental QOL reported by ACT participants, which likely resulted from…”
BackgroundFeros, D. L., Lane, L., Ciarrochi, J., & Blackledge, J. T. (2013) · Psycho-Oncology · doi:10.1002/pon.2083 · Cited by 216
the FCR Study Advisory Committee, Thewes, B., Butow, P., Bell, M. L., Beith, J., Stuart-Harris, R., Grossi, M., Capp, A., & Dalley, D. (2012) · Supportive Care in Cancer · doi:10.1007/s00520-011-1371-x · Cited by 213
van de Wal, M., Thewes, B., Gielissen, M., Speckens, A., & Prins, J. (2017) · Journal of Clinical Oncology · doi:10.1200/jco.2016.70.5301 · Cited by 195 · cited 1×
“Only 2 FCRI subscales (ie, Reassurance Seeking and Coping Strategies) failed to demonstrate significant differences, a finding that is consistent with reports from other recent studies.(18,41) Although preliminary, the results of the current study are promising for several reasons.”
ResultPrimary Health and Supportive Care Needs of Long-Term Cancer Survivors: A Questionnaire Survey
Harrison, S. E., Watson, E. K., Ward, A. M., Khan, N. F., Turner, D., Adams, E., Forman, D., Roche, M. F., & Rose, P. W. (2011) · Journal of Clinical Oncology · doi:10.1200/jco.2010.32.5167 · Cited by 176 · cited 4×
“Despite these limitations, the results of the current study suggest that ACT is a promising treatment for reducing FCR in BCS. Unlike SE or EUC, ACT may reduce maladaptive avoidant coping, thereby contributing to the long-term management of FCR and associated distress.”
BackgroundInfluentialMind‐body interventions for fear of cancer recurrence: A systematic review and meta‐analysis
Hall, D. L., Luberto, C. M., Philpotts, L. L., Song, R., Park, E. R., & Yeh, G. Y. (2018) · Psycho-Oncology · doi:10.1002/pon.4757 · Cited by 159
Evaluation of two group therapies to reduce fear of progression in cancer patients
Herschbach, P., Book, K., Dinkel, A., Berg, P., Waadt, S., Duran, G., Engst-Hastreiter, U., & Henrich, G. (2010) · Supportive Care in Cancer · doi:10.1007/s00520-009-0696-1 · Cited by 145 · cited 1×
“57).(16,19-21) It is interesting to note that CBT produced a moderate effect (≥−0.”
BackgroundTaking CHARGE: a self-management program for women following breast cancer treatment
Cimprich, B., Janz, N. K., Northouse, L., Wren, P. A., Given, B., & Given, C. W. (2005) · Psycho-Oncology · doi:10.1002/pon.891 · Cited by 134 · cited 1×
“SE covered relevant survivorship topics (eg, symptom management, weight management, physical activity, and survivorship care plans).(33,34) Didactic discussions were guided by masters-level oncology social workers.”
BackgroundSavard, J., & Ivers, H. (2013) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2012.12.013 · Cited by 131
Ellegaard, M.-B. B., Grau, C., Zachariae, R., & Bonde Jensen, A. (2017) · Acta Oncologica · doi:10.1080/0284186x.2016.1268714 · Cited by 128
Cancer Distress Reduction with a Couple-Based Skills Training: A Randomized Controlled Trial
Heinrichs, N., Zimmermann, T., Huber, B., Herschbach, P., Russell, D. W., & Baucom, D. H. (2012) · Annals of Behavioral Medicine · doi:10.1007/s12160-011-9314-9 · Cited by 128
Dieng, M., Butow, P. N., Costa, D. S. J., Morton, R. L., Menzies, S. W., Mireskandari, S., Tesson, S., Mann, G. J., Cust, A. E., & Kasparian, N. A. (2016) · Journal of Clinical Oncology · doi:10.1200/jco.2016.68.2278 · Cited by 123
Arch, J. J., & Mitchell, J. L. (2016) · Psycho-Oncology · doi:10.1002/pon.3890 · Cited by 111 · cited 1×
“Cancer-related avoidant coping was measured using the 17-item Cancer Acceptance and Action Questionnaire with items rated on a 7-point scale (with 1 indicating never true and 7 indicating always true).(28) Distress measures included the Generalized Anxiety Disorder 7-item scale(36) and 8-item Patient Health Questionna…”
MethodKoch-Gallenkamp, L., Bertram, H., Eberle, A., Holleczek, B., Schmid-Höpfner, S., Waldmann, A., Zeissig, S. R., Brenner, H., & Arndt, V. (2016) · Health Psychology · doi:10.1037/hea0000374 · Cited by 107 · cited 1×
“Characterized by maladaptive coping, intrusive thoughts, and excessive distress,(4) clinically significant FCR disproportionally affects breast cancer survivors (BCS) compared with survivors of other common cancers.(5,6) Although approximately 90% of the 3.”
BackgroundThewes, B., Lebel, S., Seguin Leclair, C., & Butow, P. (2016) · Supportive Care in Cancer · doi:10.1007/s00520-015-3025-x · Cited by 104 · cited 2×
“Hypervigilant coping may result in excessive monitoring through daily breast self-examinations or requests for unnecessary scans, whereas avoidant coping involves attempts to ignore thoughts of cancer.(1,14) Although avoidance provides short-term stress reduction, such efforts often fail over time as thoughts of death…”
BackgroundGermino, B. B., Mishel, M. H., Crandell, J., Porter, L., Blyler, D., Jenerette, C., & Gil, K. M. (2013) · Oncology Nursing Forum · doi:10.1188/13.onf.82-92 · Cited by 83 · cited 1×
“Several CBT trials have included FCR as a primary(16-19) or secondary outcome.(20,21) Although CBT has proven superior to usual care in reducing FCR (reported effect sizes of −0.”
The Use of Acceptance and Commitment Therapy in Oncology Settings: A Narrative Review
Fashler, S. R., Weinrib, A. Z., Azam, M. A., & Katz, J. (2018) · Psychological Reports · doi:10.1177/0033294117726061 · Cited by 80
(2015) · Europe PMC (PubMed Central) · Cited by 68
Merckaert, I., Lewis, F., Delevallez, F., Herman, S., Caillier, M., Delvaux, N., Libert, Y., Liénard, A., Nogaret, J., Ogez, D., et al. (2017) · Psycho-Oncology · doi:10.1002/pon.4294 · Cited by 53 · cited 1×
“Several CBT trials have included FCR as a primary(16-19) or secondary outcome.(20,21) Although CBT has proven superior to usual care in reducing FCR (reported effect sizes of −0.”
Psychometric properties of the Fear of Cancer Recurrence Inventory: an item response theory approach
Costa, D. S. J., Dieng, M., Cust, A. E., Butow, P. N., & Kasparian, N. A. (2015) · Psycho-Oncology · doi:10.1002/pon.4018 · Cited by 46 · cited 1×
“Only 2 FCRI subscales (ie, Reassurance Seeking and Coping Strategies) failed to demonstrate significant differences, a finding that is consistent with reports from other recent studies.(18,41) Although preliminary, the results of the current study are promising for several reasons.”
ResultBreast Cancer Survivorship Program
Chung, L. K., Cimprich, B., Janz, N. K., & Mills-Wisneski, S. M. (2009) · Cancer Nursing · doi:10.1097/ncc.0b013e318196c67b · Cited by 35 · cited 1×
“SE covered relevant survivorship topics (eg, symptom management, weight management, physical activity, and survivorship care plans).(33,34) Didactic discussions were guided by masters-level oncology social workers.”
BackgroundWorry about Breast Cancer Recurrence: A Population-based Analysis
Tewari, A., & Chagpar, A. B. (2014) · The American Surgeon™ · doi:10.1177/000313481408000716 · Cited by 31 · cited 1×
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“First, ACT can be delivered efficaciously to a group, thereby potentially reducing costs and increasing the number of those served compared to individually delivered interventions.(27,29) Second, it appears that targeting FCR while reducing maladaptive coping may promote concomitant reductions in distress outcomes.”
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Breast cancer: pathogenesis and treatments
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Metadata
- Authors
- Johns, S. A., Stutz, P. V., Talib, T. L., Cohee, A. A., Beck‐Coon, K. A., Brown, L. F., Wilhelm, L. R., Monahan, P. O., LaPradd, M. L., Champion, V. L., Miller, K. D., & Giesler, R. B.
- Affiliations
- Regenstrief Institute (US)
- Indiana University Indianapolis (US)
- West Virginia University (US)
- Butler University (US)
- Corresponding author
- Johns, Shelley A.
- ORCID
- Venue
- Cancer
- Publisher
- Wiley
- Published
- 2019-09-20
- Volume
- 126
- Issue
- 1
- Pages
- 211-218
- ISSN
- 0008-543X (ISSN-L)
- 1097-0142
- PMC
- PMC6906228
- OpenAlex
- W2974123878
- Cited by
- 141
- References
- 43
- Citations by year
- 2026: 18 · 2025: 20 · 2024: 19 · 2023: 25 · 2022: 29 · 2021: 21 · 2020: 8 · 2019: 1
- FWCI
- 6.15
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Cancer (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- IUScholarWorks (Indiana University) (submittedVersion)
- Funders
- Indiana University Health (0952)
- National Cancer Institute (K05CA175048)
- Walther Cancer Foundation (0175.01)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Keywords
- acceptance and commitment therapy, fear of cancer recurrence, breast cancer survivors, group therapy, survivorship education, psychological flexibility, avoidance coping, anxiety, depression, post-traumatic stress, quality of life, psychological distress, feasibility
- MeSH terms
- Cancer Survivors, Involuntary Commitment, Adult, Aged, Anxiety, Breast, Breast Neoplasms, Depression, Fear, Female, Humans, Middle Aged, Neoplasm Recurrence, Local, Neoplasm Staging, Phobic Disorders, Quality of Life, Stress Disorders, Post-Traumatic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-09-28, under version 3 of the claim definition (prompt extract-v3).
A second model labelled each claim on 2026-09-28 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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