title: The "ick" Factor Matters: Disgust Prospectively Predicts Avoidance in Chemotherapy Patients.
abstract: Chemotherapy can be physically and psychologically demanding. Avoidance and withdrawal are common among patients coping with these demands.
  
  
  
  This report compares established emotional predictors of avoidance during chemotherapy (embarrassment; distress) with an emotion (disgust) that has been unstudied in this context.
  
  
  
  This report outlines secondary analyses of an RCT where 68 cancer patients undergoing chemotherapy were randomized to mindfulness or relaxation interventions. Self-reported baseline disgust (DS-R), embarrassment (SES-SF), and distress (Distress Thermometer) were used to prospectively predict multiple classes of avoidance post-intervention and at 3 months follow-up. Measures assessed social avoidance, cognitive and emotional avoidance (IES Avoidance), as well as information seeking and treatment adherence (General Adherence Scale).
  
  
  
  Repeated-measures ANOVAs evaluated possible longitudinal changes in disgust and forward entry regression models contrasted the ability of the affective variables to predict avoidance. Although disgust did not change over time or vary between groups, greater disgust predicted greater social, cognitive, and emotional avoidance, as well as greater information seeking. Social avoidance was predicted by trait embarrassment and distress predicted non-adherence.
  
  
  
  This report represents the first investigation of disgust's ability to prospectively predict avoidance in people undergoing chemotherapy. Compared to embarrassment and distress, disgust was a more consistent predictor across avoidance domains and its predictive ability was evident across a longer period of time. Findings highlight disgust's role as an indicator of likely avoidance in this health context. Early identification of cancer patients at risk of deleterious avoidance may enable timely interventions and has important clinical implications (ACTRN12613000238774).
authors.affiliation: Department of Psychological Medicine, The University of Auckland, Private bag 92019, Victoria Street West, Auckland, 1142, New Zealand. l.reynolds@auckland.ac.nz.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Reynolds
authors.affiliation: Department of Surgery, The University of Auckland, Private bag 92019, Victoria Street West, Auckland, 1142, New Zealand.
authors.forename: Ian P
authors.initials: IP
authors.lastname: Bissett
authors.affiliation: Auckland Regional Cancer and Blood Service, Auckland, New Zealand.
authors.forename: David
authors.initials: D
authors.lastname: Porter
authors.affiliation: Department of Psychological Medicine, The University of Auckland, Private bag 92019, Victoria Street West, Auckland, 1142, New Zealand.
authors.forename: Nathan S
authors.initials: NS
authors.lastname: Consedine
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D004644:Emotions / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D064866:Mindfulness; D009369:Neoplasms / Q000188:drug therapy* / Q000523:psychology; D012064:Relaxation Therapy; D012919:Social Behavior
keywords: Avoidance; Cancer; Chemotherapy; Disgust; Emotion; Health