title: Emotional adjustment over 1 year post-diagnosis in patients with cancer: understanding and predicting adjustment trajectories.
abstract: OBJECTIVE
  The aim of this study was to determine the prevalence of basic trajectories in emotional adjustment in cancer survivors and identify predictors of long-term change.
  
  
  METHODS
  We assessed 421 patients with cancer after diagnosis and 6 and 12 months later. Measures comprised anxiety, depression, perceived support, desired support, and illness intrusiveness.
  
  
  RESULTS
  Anxiety decreased over time, whereas depression increased as did need for support. About one third of initial diagnostic classifications (into low distress, symptoms, or clinical level of distress) changed from one assessment to the next. Lower age and higher illness intrusiveness predicted which patient showed worse adjustment over time.
  
  
  CONCLUSIONS
  To avoid both over- and undertreatment of distressed individuals, repeated measurements are needed to identify actual adjustment trajectories. Initial assessment of emotional reaction to a diagnosis is not a reliable predictor of long-term adjustment. Patients should be made aware that completion of initial medical treatment even when accompanied by a positive prognosis does not in and of itself forecast how well patients adjust during survivorship.
authors.affiliation: Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC, V6T 1Z4, Canada, wlinden@psych.ubc.ca.
authors.forename: W
authors.initials: W
authors.lastname: Linden
authors.forename: R
authors.initials: R
authors.lastname: MacKenzie
authors.forename: K
authors.initials: K
authors.lastname: Rnic
authors.forename: C
authors.initials: C
authors.lastname: Marshall
authors.forename: A
authors.initials: A
authors.lastname: Vodermaier
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology*; D003863:Depression / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000523:psychology*; D011379:Prognosis; D012917:Social Adjustment; D013315:Stress, Psychological / Q000523:psychology*; D017741:Survivors / Q000523:psychology