title: Trajectories of anxiety in oncology patients and family caregivers during and after radiation therapy.
abstract: OBJECTIVE
  Anxiety is common in patients undergoing radiation therapy (RT) and in their family caregivers (FCs). Little is known about individual differences in anxiety trajectories during and after RT. This study aimed to identify distinct latent classes of oncology patients and their FCs based on self-reported anxiety symptoms from the beginning to four months after the completion of RT.
  
  
  METHODS
  Using growth mixture modeling (GMM), longitudinal changes in Spielberger State Anxiety Inventory (STAI-S) scores among 167 oncology outpatients with breast, prostate, lung, or brain cancer and 85 FCs were evaluated to determine distinct anxiety symptom profiles. STAI-S scores were assessed just prior to, throughout the course of, and for four months following RT (total of 7 assessments). Baseline trait anxiety and depressive symptoms (during and after RT) were also assessed.
  
  
  RESULTS
  The GMM analysis identified three latent classes of oncology patients and FCs with distinct trajectories of state anxiety: Low Stable (n = 93, 36.9%), Intermediate Decelerating (n = 82, 32.5%), and High (n = 77, 30.6%) classes. Younger participants, women, ethnic minorities, and those with children at home were more likely to be classified in the High anxiety class. Higher levels of trait anxiety and depressive symptoms, at the initiation of RT, were associated with being in the High anxiety class.
  
  
  CONCLUSIONS
  Subgroups of patients and FCs with high, intermediate, and low mean levels of anxiety during and after RT were identified with GMM. Additional research is needed to better understand the heterogeneity of symptom experiences as well as comorbid symptoms in patients and FCs.
authors.affiliation: School of Medicine, University of California, San Francisco, CA, USA.
authors.forename: Laura B
authors.initials: LB
authors.lastname: Dunn
authors.forename: Bradley E
authors.initials: BE
authors.lastname: Aouizerat
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Cooper
authors.forename: Marylin
authors.initials: M
authors.lastname: Dodd
authors.forename: Kathryn
authors.initials: K
authors.lastname: Lee
authors.forename: Claudia
authors.initials: C
authors.lastname: West
authors.forename: Steven M
authors.initials: SM
authors.lastname: Paul
authors.forename: William
authors.initials: W
authors.lastname: Wara
authors.forename: Patrick
authors.initials: P
authors.lastname: Swift
authors.forename: Christine
authors.initials: C
authors.lastname: Miaskowski
mesh_terms: D001007:Anxiety / Q000175:diagnosis / Q000209:etiology*; D001932:Brain Neoplasms / Q000523:psychology / Q000532:radiotherapy; D001943:Breast Neoplasms / Q000523:psychology / Q000532:radiotherapy; D017028:Caregivers / Q000523:psychology*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000523:psychology / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000532:radiotherapy; D011471:Prostatic Neoplasms / Q000523:psychology / Q000532:radiotherapy; D012959:Socioeconomic Factors