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. 2024;42(6):769-792.
doi: 10.1080/07347332.2024.2326146. Epub 2024 Mar 25.

Increases in stress and adverse childhood experiences are associated with the co-occurrence of anxiety and depression in oncology patients

Katie Coupe  1 , Astrid Block  1 , Sueann Mark  1 , Bruce A Cooper  1 , Steven M Paul  1 , Laura B Dunn  2 , Marilyn J Hammer  3 , Yvette P Conley  4 , Jon D Levine  5 , Christine Miaskowski  1   5
Affiliations

Increases in stress and adverse childhood experiences are associated with the co-occurrence of anxiety and depression in oncology patients

Katie Coupe et al. J Psychosoc Oncol. 2024.

Abstract

Purpose: Identify subgroups of patients with distinct joint anxiety AND depression profiles and evaluate for differences in demographic and clinical characteristics, as well as stress, resilience, and coping.

Design: Longitudinal study.

Participants: Patients (n = 1328) receiving chemotherapy.

Methods: Measures of state anxiety and depression were done six times over two cycles of chemotherapy. All of the other measures were completed prior to second or third cycle of chemotherapy. Latent profile analysis was used to identify the distinct joint anxiety and depression profiles.

Findings: Three classes were identified (i.e. Low Anxiety and Low Depression (57.5%); Moderate Anxiety and Moderate Depression (33.7%), High Anxiety and High Depression (8.8%)). For all of the stress measures, a dose response effect was seen among the profiles. Two worst profiles reported higher occurrence rates for a number of adverse childhood experiences.

Implications for providers: Patients need referrals for stress reduction techniques and mental health and social services.

Keywords: adverse childhood experiences; anxiety; cancer; coping; depression; post-traumatic stress disorder; psychological distress, resilience; stress.

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Conflict of interest statement

Disclosure statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
C changes in State Anxiety ((Anx), left y-axis) and Depression ((Dep), right y-axis) scores over two cycles of chemotherapy for subgroups of patients with Low Anxiety and Low Depression (panel A), Moderate Anxiety and Moderate Depression (panel B), and High Anxiety and High Depression (panel C).
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