title: Persistent symptoms among survivors of Hodgkin's disease: an explanatory model based on classical conditioning.
abstract: Persistent symptoms of nausea, distress, and vomiting triggered by reminders of cancer treatment were examined among 273 Hodgkin's disease survivors, 1 to 20 years posttreatment. Prevalence rates were high for distress and nausea but low for vomiting. Retrospective report of anticipatory symptoms during treatment was the strongest predictor of persistent symptoms, suggesting that treatment-induced symptoms are less likely to persist if conditioning does not occur initially. Time since treatment was also a significant predictor, with patients more recently treated more likely to experience persistent symptoms. Thus, an explanatory model based on classical conditioning theory successfully predicted presence of persistent symptoms. Symptoms also were associated with ongoing psychological distress, suggesting that quality of life is diminished among survivors with persistent symptoms. Recommendations for prevention and treatment of symptoms are discussed.
authors.affiliation: Center for Outcomes Research and Education, Evanston Northwestern Healthcare, Illinois 60201, USA.
authors.forename: C L
authors.initials: CL
authors.lastname: Cameron
authors.forename: D
authors.initials: D
authors.lastname: Cella
authors.forename: J E
authors.initials: JE
authors.lastname: Herndon
authors.forename: A B
authors.initials: AB
authors.lastname: Kornblith
authors.forename: E
authors.initials: E
authors.lastname: Zuckerman
authors.forename: E
authors.initials: E
authors.lastname: Henderson
authors.forename: R B
authors.initials: RB
authors.lastname: Weiss
authors.forename: M R
authors.initials: MR
authors.lastname: Cooper
authors.forename: R T
authors.initials: RT
authors.lastname: Silver
authors.forename: L
authors.initials: L
authors.lastname: Leone
authors.forename: G P
authors.initials: GP
authors.lastname: Canellos
authors.forename: B A
authors.initials: BA
authors.lastname: Peterson
authors.forename: J C
authors.initials: JC
authors.lastname: Holland
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003214:Conditioning, Classical; D005260:Female; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced / Q000523:psychology*; D011788:Quality of Life; D013315:Stress, Psychological; D014840:Vomiting, Anticipatory / Q000209:etiology / Q000523:psychology*
chemical_list: D000970:Antineoplastic Agents