Cited by 234Childhood Cancer Survivors' Quality of LifeCancer survivorship and careFamily Support in Illness

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Trajectories of Psychological Distress in Adolescent and Young Adult Patients With Cancer: A 1-Year Longitudinal Study

Kwak, Minyoung, Zebrack, Brad J., Meeske, Kathleen A., Embry, Leanne, Aguilar, Christine, Block, Rebecca, Hayes-Lattin, Brandon, Li, Yun, Butler, Melissa, Cole, Steven·2013·Journal of Clinical Oncology

DOI 10.1200/jco.2012.45.9222

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Abstract

Purpose: To examine prevalence and changes in symptoms of psychological distress over 1 year after initial cancer diagnosis in adolescent and young adult (AYA) patients with cancer. Sociodemographic and clinical predictors of changes in distress were examined. Patients and Methods: In this multisite, longitudinal, prospective study of an ethnically diverse sample, 215 patients age 14 to 39 years were assessed for psychological distress within the first 4 months of diagnosis and again 6 and 12 months later. Linear mixed models with random intercept and slope estimated changes in distress, as measured by the Brief Symptom Inventory-18 (BSI-18). Results: Within the first 4 months of diagnosis, 60 respondents (28%) had BSI-18 scores suggesting caseness for distress. On average, distress symptoms exceeded population norms at the time of diagnosis, dipped at the 6-month follow-up, but increased to a level exceeding population norms at the 12-month follow-up. A statistically significant decline in distress over 1 year was observed; however, the gradient of change was not clinically significant. Multivariate analyses revealed that the reduction in distress over time was primarily a function of being off treatment and involved in school or work. Notably, cancer type or severity was not associated with distress. Conclusion: Findings emphasize the importance of early psychosocial intervention for distress in AYAs as well as the need to manage treatment-related symptoms and facilitate AYAs' involvement in work or school to the extent possible. Continued research is needed to understand how distress relates to quality of life, functional outcomes, treatment, and symptom burden throughout the continuum of care.

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Authors: Kwak, M., Zebrack, B. J., Meeske, K. A., Embry, L., Aguilar, C., Block, R., Hayes-Lattin, B., Li, Y., Butler, M., & Cole, S.
Affiliations: University of Southern California (US)
Minyoung Kwak and Brad J. Zebrack, University of Michigan School of Social Work; Yun Li, University of Michigan and University of Michigan Comprehensive Cancer Center, Ann Arbor; Melissa Butler, University of Michigan, Dearborn, MI; Kathleen A. Meeske, University of Southern California, Children's Hospital Los Angeles, Los Angeles; Steven Cole, HopeLab Foundation, Redwood City, CA; Leanne Embry and Christine Aguilar, University of Texas Health Science Center at San Antonio, San Antonio, TX; Rebecca Block...
ORCID: Zebrack, Brad J.
Embry, Leanne
Aguilar, Christine
Block, Rebecca
Li, Yun
Venue: Journal of Clinical Oncology
Publisher: American Society of Clinical Oncology (ASCO)
Published: 2013-06-10
Volume: 31
Issue: 17
Pages: 2160-2166
ISSN: 0732-183X (ISSN-L)
1527-7755
DOI: 10.1200/jco.2012.45.9222
OpenAlex: W2106939934
Cited by: 234
References: 53
Citations by year: 2026: 4 · 2025: 12 · 2024: 21 · 2023: 21 · 2022: 19 · 2021: 21 · 2020: 19 · 2019: 28 · 2018: 24 · 2017: 22 · 2016: 17 · 2015: 11 · 2014: 13 · 2013: 2
FWCI: 13.35
Type: journal article
Language: en
Open access: closed
Locations: Journal of Clinical Oncology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
Health Sciences › Medicine › Oncology › Cancer survivorship and care
Social Sciences › Psychology › Clinical Psychology › Family Support in Illness
Keywords: psychological distress, adolescent and young adult cancer, cancer survivors, Brief Symptom Inventory-18, predictors of distress, treatment discontinuation, psychosocial interventions, quality of life
MeSH terms: Adolescent, Adult, Female, Humans, Longitudinal Studies, Male, Neoplasms, Prospective Studies, Quality of Life, Stress, Psychological, Prevalence, Survivors, Young Adult

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Trajectories of Psychological Distress in Adolescent and Young Adult Patients With Cancer: A 1-Year Longitudinal Study

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