title: Assessing anxiety in men with prostate cancer: further data on the reliability and validity of the Memorial Anxiety Scale for Prostate Cancer (MAX-PC).
abstract: Identifying which men with prostate cancer might benefit from mental health treatment has proven to be a challenging task. The authors developed the Memorial Anxiety Scale for Prostate Cancer (MAX-PC) in order to facilitate the identification of prostate cancer-related anxiety. A revised version of this scale was tested in a more clinically varied population. Ambulatory men with prostate cancer (N=367) completed a baseline assessment packet that included the MAX-PC and other psychosocial questionnaires. The MAX-PC showed high internal consistency and concurrent and discriminant validity. Factor analysis identified three distinct factors for the MAX-PC that corresponded to the intended subscales (General Prostate Cancer Anxiety, PSA (prostate-specific antigen) Anxiety, and Fear of Recurrence). PSA levels were not correlated with anxiety overall; however, anxiety was significantly higher among patients whose PSA levels were changing (i.e., rising, falling, and unstable), versus those with stable PSA levels. Also, in a multivariate analysis, the change in PSA levels was a significant predictor of MAX-PC scores, but not Hospital Anxiety and Depression Scale (HADS) scores. These results indicate that the MAX-PC is a valid and reliable measure of anxiety that assesses aspects of anxiety unique to men with prostate cancer, and it may provide a more sensitive measure of anxiety than the HADS for this population.
authors.affiliation: Dept. of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., New York, NY 10021, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Roth
authors.forename: Christian J
authors.initials: CJ
authors.lastname: Nelson
authors.forename: Barry
authors.initials: B
authors.lastname: Rosenfeld
authors.forename: Adam
authors.initials: A
authors.lastname: Warshowski
authors.forename: Noelle
authors.initials: N
authors.lastname: O'Shea
authors.forename: Howard
authors.initials: H
authors.lastname: Scher
authors.forename: Jimmie C
authors.initials: JC
authors.lastname: Holland
authors.forename: Susan
authors.initials: S
authors.lastname: Slovin
authors.forename: Tracy
authors.initials: T
authors.lastname: Curley-Smart
authors.forename: Thomas
authors.initials: T
authors.lastname: Reynolds
authors.forename: William
authors.initials: W
authors.lastname: Breitbart
mesh_terms: D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D003710:Demography; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000523:psychology*; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires