Purpose: Psychological and physical suffering is inherent in the experience of grief in patients with advanced cancer. Grief due to cancer-related losses has not been examined in young adults with cancer. The purpose of this study is to examine the relationship between grief due to cancer-related losses and life disruption due to cancer symptoms in young adults with advanced cancer. Patients and Methods: Fifty-three young adults (20–40 years old) with advanced cancer completed structured clinical interviews that included measures of grief due to cancer-related losses and life disruption due to cancer symptoms. Regression analyses examined the relationship between grief and life disruption. Results: Higher levels of grief were associated with greater life disruption after controlling for an interviewer rating of physical performance status. Conclusions: These results suggest that grief may constitute a unique burden in the cancer experience for young adults with advanced disease, over and above physical performance status. Longitudinal designs with larger data sets are needed to confirm this finding. Nevertheless, this study suggests that grief is problematic for young adults with advanced cancer. Young adults may benefit from clinical assessment of and interventions for grief.
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References
1.
PrigersonHG, MaciejewskiPK. Grief and acceptance as opposite sides of the same coin: setting a research agenda to study peaceful acceptance of loss. Br J Psychiatry., 2008; 193:435–437.
2.
PrigersonHG, HorowitzMJ, JacobsSCet al.Prolonged grief disorder: psychometric validation of criteria proposed for DSM-V and ICD-11. PLoS Med., 2009; 6:e1000121.
3.
BoelenPA, PrigersonHG. The influence of symptoms of prolonged grief disorder, depression, and anxiety on quality of life among bereaved adults: a prospective study. Eur Arch Psychiatry Clin Neurosci., 2007; 257:444–452.
4.
OgrodniczukJS, JoyceAS, PiperWE. Changes in perceived social support after group therapy for complicated grief. J Nerv Ment Dis., 2003; 191:524–530.
5.
PrigersonHG, MaciejewskiPK, ReynoldsCFIIIet al.Inventory of Complicated Grief: a scale to measure maladaptive symptoms of loss. Psychiatry Res., 1995; 59:65–79.
6.
RosnerR, LumbeckG, GeissnerE. Effectiveness of an inpatient group therapy for comorbid complicated grief disorder. Psychother Res., 2011; 21:210–218.
7.
BoelenPA, van den BoutJ, de KeijserJ, HoijtinkH. Reliability and validity of the Dutch version of the Inventory of Traumatic Grief (ITG)Death Stud., 2003; 27:227–247.
8.
PrigersonHG, BierhalsAJ, KaslSVet al.Traumatic grief as a risk factor for mental and physical morbidity. Am J Psychiatry., 1997; 154:616–623.
9.
LathamAE, PrigersonHG. Suicidality and bereavement: complicated grief as psychiatric disorder presenting greatest risk for suicidality. Suicide Life Threat Behav., 2004; 34:350–362.
10.
JacobsenJC, ZhangB, BlockSDet al.Distinguishing symptoms of grief and depression in a cohort of advanced cancer patients. Death Stud., 2010; 34:257–273.
11.
LannenPK, WolfeJ, PrigersonHGet al.Unresolved grief in a national sample of bereaved parents: impaired mental and physical health 4 to 9 years later. J Clin Oncol., 2008; 26:5870–5876.
12.
PrigersonHG, FrankE, KaslSVet al.Complicated grief and bereavement-related depression as distinct disorders: preliminary empirical validation in elderly bereaved spouses. Am J Psychiatry., 1995; 152:22–30.
13.
BoelenPA, van den BoutJ. Complicated grief and uncomplicated grief are distinguishable constructs. Psychiatry Res., 2008; 157:311–314.
14.
ArnettJJ. Emerging Adulthood: The Winding Road from the Late Teens through the Twenties. New York: Oxford University Press, 2004.
15.
AbramsAN, HazenEP, PensonRT. Psychosocial issues in adolescents with cancer. Cancer Treat Rev., 2007; 33:622–630.
16.
EiserC, PennA, KatzE, BarrR. Psychosocial issues and quality of life. Semin Oncol., 2009; 36:275–280.
17.
DaiterS, LarsonRA, WeddingtonWW, UltmannJE. Psychosocial symptomatology, personal growth, and development among young adult patients following the diagnosis of leukemia or lymphoma. J Clin Oncol., 1988; 6:613–617.
18.
SheehanDV. The Anxiety Disease. New York: Scribner, 1983.
19.
MorV, LaliberteL, MorrisJN, WiemannM. The Karnofsky Performance Status Scale. An examination of its reliability and validity in a research setting. Cancer., 1984; 53:2002–2007.
20.
SchagCC, HeinrichRL, GanzPA. Karnofsky performance status revisited: reliability, validity, and guidelines. J Clin Oncol., 1984; 2:187–193.
21.
YatesJW, ChalmerB, McKegneyFP. Evaluation of patients with advanced cancer using the Karnofsky performance status. Cancer., 1980; 45:2220–2224.
22.
KroenkeK, ZhongX, TheobaldDet al.Somatic symptoms in patients with cancer experiencing pain or depression: prevalence, disability, and health care use. Arch Intern Med., 2010; 170:1686–1694.
23.
WangHL, KroenkeK, WuJet al.Cancer-related pain and disability: a longitudinal study. J Pain Symptom Manage., 2011; 42:813–821.
24.
NilssonME, MaciejewskiPK, ZhangBet al.Mental health, treatment preferences, advance care planning, location, and quality of death in advanced cancer patients with dependent children. Cancer., 2009; 115:399–409.
25.
MorganS, DaviesS, PalmerS, PlasterM. Sex, drugs, and rock ’n’ roll: caring for adolescents and young adults with Cancer. J Clin Oncol., 2010; 28:4825–4830.
26.
CurrierJM, NeimeyerRA, BermanJS. The effectiveness of psychotherapeutic interventions for bereaved persons: a comprehensive quantitative review. Psychol Bull., 2008; 134:648–661.
27.
ShearK, FrankE, HouckPR, ReynoldsCFIII. Treatment of complicated grief: a randomized controlled trial. JAMA., 2005; 293:2601–2608.
28.
WagnerB, KnaevelsrudC, MaerckerA. Internet-based cognitive-behavioral therapy for complicated grief: a randomized controlled trial. Death Stud., 2006; 30:429–453.
29.
WagnerB, MaerckerA. An internet-based cognitive-behavioral preventive intervention for complicated grief: a pilot study. G Ital Med Lav Ergon., 2008; 30:B47–B53.
30.
ZebrackB. Information and service needs for young adult cancer patients. Support Care Cancer., 2008; 16:1353–1360.
31.
ZebrackB. Information and service needs for young adult cancer survivors. Support Care Cancer., 2009; 17:349–357.
32.
ZebrackB, HamiltonR, SmithAW. Psychosocial outcomes and service use among young adults with cancer. Semin Oncol., 2009; 36:468–477.
33.
PitceathlyC, MaguireP, FletcherIet al.Can a brief psychological intervention prevent anxiety or depressive disorders in cancer patients? A randomised controlled trial. Ann Oncol., 2009; 20:928–934.
34.
RobertsCS, PiperL, DennyJ, CuddebackG. A support group intervention to facilitate young adults' adjustment to cancer. Health Soc Work., 1997; 22:133–141.
35.
LichtenthalWG, NilssonM, KissaneDWet al. Underutilization of mental health services among bereaved caregivers with prolonged grief disorder. Psychiatr Serv., 2011; 62:1225–1229.
36.
TrevinoKM, MaciejewskiPK, FascianoKet al.Coping and psychological distress in young adults with advanced cancer. J Support Oncol., 2012Epub ahead of print.
