title: Individual differences in physical symptom burden and psychological responses in individuals with chronic lymphocytic leukemia.
abstract: Chronic lymphocytic leukemia (CLL) is an incurable illness, with some patients requiring no treatment until disease progression. Burden from physical symptoms has been associated with depression, anxiety, and stress in cancer patients. Additionally, patient factors, i.e., individual differences, have been associated with worse psychological outcomes. There are few psychological studies of CLL, with no examination of individual differences. A cross-sectional design studied the covariation of symptom burden with depressive and anxiety symptoms and cancer-specific stress, and tested patients' individual differences as predictors and as moderators. CLL patients (N = 112) receiving active surveillance participated. They were Caucasian (100 %) and predominately male (55 %) with a mean age of 61; most (62.5 %) had stage 0 disease. A composite measure of physical symptom burden (CLL symptoms, fatigue, pain, impaired functional status) was tested as a predictor of psychological responses. Individual differences in psychiatric history and social support were tested as moderators. Using multiple linear regression, greater symptom burden covaried with higher levels of depressive and anxiety symptoms and cancer stress (ps < .05). Those with a psychiatric history, low social support, and low relationship satisfaction with one's partner reported greater symptom burden and more psychological symptoms and stress (ps < .05). Findings suggest that CLL patients in surveillance with a psychiatric history and/or low social support are at risk for greater distress when coping with high symptom burden. These new data clarify the experience of CLL surveillance and identify characteristics of patients with heightened risk for symptom burden, stress, and anxiety or depressive symptoms.
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. morrison.eleshia@mayo.edu.
authors.forename: Eleshia J
authors.initials: EJ
authors.lastname: Morrison
authors.affiliation: Norton Cancer Institute, 234 E Gray St, Louisville, KY, 40202, USA.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Flynn
authors.affiliation: Division of Hematology, The Ohio State University, Starling Loving Hall, 320 W 10th Avenue, Columbus, OH, 43210, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Jones
authors.affiliation: Division of Hematology, The Ohio State University, Starling Loving Hall, 320 W 10th Avenue, Columbus, OH, 43210, USA.
authors.forename: John C
authors.initials: JC
authors.lastname: Byrd
authors.affiliation: Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210, USA.
authors.forename: Barbara L
authors.initials: BL
authors.lastname: Andersen
mesh_terms: D000328:Adult; D000368:Aged; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007206:Individuality; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D013315:Stress, Psychological / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*
keywords: Active surveillance; Chronic lymphocytic leukemia; Individual differences; Physical symptom burden; Psychological responses