title: Anxiety symptoms prior to a prostate cancer diagnosis: Associations with knowledge and openness to treatment.
abstract: OBJECTIVE
  Research suggests that anxiety may be a common response to a cancer diagnosis, but research is needed to examine anxiety before diagnosis. Anxiety before diagnosis may relate to the comprehension of relevant health information or openness to potential treatments. This study examined anxiety and these outcomes in men who were waiting to learn of a prostate cancer diagnosis.
  
  
  OBJECTIVE
  One goal of this study was to determine whether anxiety would increase as men came closer to learning the results of their prostate cancer biopsy. Another goal was to test whether anxiety was associated with knowledge about prostate cancer or openness to different treatments.
  
  
  METHODS
  Men (N = 265) who were facing a prostate cancer diagnosis were surveyed at two time points. Time 1 occurred at the time of biopsy, and Time 2 occurred immediately before men received their biopsy result. At each time point, men reported their anxiety about prostate cancer and their biopsy result. At Time 2, they completed a knowledge test of information about prostate cancer and reported their openness to different potential treatments.
  
  
  RESULTS
  Anxiety symptoms increased as men came closer to learning their diagnosis. Also, higher anxiety was associated with lower knowledge and greater openness to particular treatments like surgery. Interactions showed that when anxiety increased from Time 1 to Time 2, having high or low knowledge mattered less to treatment openness.
  
  
  CONCLUSIONS
  Waiting for a cancer diagnosis is an important time period in which anxiety may increase and relate to information processing and openness to treatments. Statement of contribution What is already known on this subject? Men undergoing prostate cancer screening have been found to experience high and low levels of anxiety. Research has shown that negative emotions like anxiety are common following a cancer diagnosis, but little research has examined emotions right before diagnosis. Anxiety has been associated with information processing and motivation to engage in preventive behaviours. What does this study add? Applies and tests a theoretical idea related to how anxiety may change as one approaches personally relevant threatening health feedback. Shows relationships between changes in anxiety and knowledge in the context of waiting for actual health feedback. Associates increased anxiety in the prostate cancer context with knowledge and openness to different treatments.
authors.affiliation: Department of Psychology, Grand Valley State University, Allendale, Michigan, USA.
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Dillard
authors.affiliation: Department of Psychological Sciences, University of Missouri, Columbia, Missouri, USA.
authors.forename: Laura D
authors.initials: LD
authors.lastname: Scherer
authors.affiliation: Fuqua School of Business and Sanford School of Public Policy, Duke University, Durham, North Carolina, USA.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Ubel
authors.affiliation: Department of Consumer Science, Purdue University, West Lafayette, Indiana, USA.
authors.forename: Stewart
authors.initials: S
authors.lastname: Alexander
authors.affiliation: Departments of Internal Medicine and Psychology, Ann Arbor VA Center for Clinical Management Research, Michigan, USA.|Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Angela
authors.initials: A
authors.lastname: Fagerlin
mesh_terms: D001007:Anxiety / Q000523:psychology*; D001706:Biopsy / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000523:psychology* / Q000628:therapy
keywords: anxiety symptoms; information processing; intrusive thoughts; prostate cancer diagnosis; treatment preferences