Investigation of the Relationship Between Intolerance of Uncertainty, Metacognitions, Maladaptive Coping, and Fear of Cancer Recurrence via Moderated Mediation Model.

Abstract

Objective: In recent years, many studies have investigated the triggers, perpetuating factors, and outcomes of Fear of Cancer Recurrence (FCR), highlighting its complexity with multiple dimensions that encompass both antecedents and consequences. In this sense, the cognitive approach to FCR has explored variables such as metacognition, maladaptive coping strategies, and intolerance of uncertainty (IU). On the other hand, the findings of a restricted number of studies investigating the relationship between FCR and stated variables appear to be inconsistent. The objective of this study was thus to examine the relationship that existed among these variables in breast cancer survivors by moderated mediation model.

Methods: In this cross-sectional study, 130 breast cancer survivors completed the Fear of Cancer Recurrence Inventory (FCRI), the Intolerance of Uncertainty Scale Short Form (IUS-12), Metacognitions Questionnaire-30 (MCQ-30), and Brief COPE Scale (BCS) Short Form. The mediated moderation analysis was conducted using Process Macro.

Results: There was a significant positive correlation found between FCR and IU (r = 0.87, p < 0.001), and between FCR and negative metacognitions (r = 0.72, p < 0.001). A weak to moderate positive correlation was identified between IU and maladaptive coping strategies (r = 0.19, p < 0.05), and between negative metacognitions and maladaptive coping strategies (r = 0.31, p < 0.001). The relationship between FCR and maladaptive coping strategies was nonsignificant (r = 0.16, p > 0.05). As a result of hierarchical regression analysis, controlling for demographic and clinical variables, IU, positive metacognitions, and negative metacognitions significantly explained 45%, 2%, and 1% of the variance in FCR, respectively.

Conclusion: The results of the current study contribute to the literature in terms of supporting the views that cognitive models of worrying could be used to understand the FCR mechanism and address the IU been which has limitedly studied in the FCR literature. The current study's findings have also contributed to the clinical field by highlighting the importance of incorporating breast cancer survivors' metacognitions and IU in FCR intervention programs.