ABSTRACT
Immunotherapies and targeted therapies have revolutionised treatment of metastatic melanoma and improved survival rates. However, survivors treated with novel therapies are vulnerable to high levels of fear of cancer recurrence or progression (FCR). Existing FCR interventions have rarely been trialled in people with advanced cancer. The current study aimed to evaluate the acceptability and feasibility of Fear-Less: a stepped-care model to treat FCR in people with metastatic melanoma treated with immunotherapy or targeted therapy. Sixty-one outpatients with metastatic melanoma were screened using the Fear of Cancer Recurrence Inventory Short Form (FCRI-SF) and Fear of Progression Questionnaire Short Form (FoP-Q-SF). Survivors with subthreshold FCR were stratified to a self-management intervention while those with clinical levels of FCR were provided with an individual therapy, Conquer Fear. Survivor experience surveys and rescreening were administered post-intervention completion. Results indicated that Fear-Less was an acceptable and feasible FCR intervention. Results provided preliminary support for the potential impact of Fear-Less in reducing FCR. Fear-Less is a promising first step in providing an acceptable and feasible stepped-care model to treat FCR in survivors with metastatic disease.
ABSTRACT
The effects on blood-injury fear and fainting of scripts concerning pain, nausea, and anger and individual differences in trait anxiety and disgust sensitivity were investigated. Eighteen participants were high in disgust sensitivity and trait anxiety, 11 were low in disgust sensitivity but high in trait anxiety, 10 were high in disgust sensitivity but low in trait anxiety, and 16 were low in disgust sensitivity and trait anxiety. Participants were exposed to pain, nausea, and anger scripts during presentation of blood-injury slides. The ability of the scripts to increase symptoms of fear and faintness, on a state version of the Blood-Injection Symptom Scale (BISS; Page, A. C., Bennett, K. S., Carter, O., Smith, J., & Woodmore, K. (1997). Blood-Injection Symptom Scale (BISS): Assessing the structure of phobic symptomatology elicited by blood and injections. Behaviour Research and Therapy, 35, 457-464) were examined. Analyses indicated that individual differences in trait anxiety and disgust sensitivity interact to generate symptoms of faintness when the pain script was read. That is, disgust sensitive and trait anxious participants reported greater faintness relative to other conditions. The implications for theory and treatment of blood-injury-injection phobia are discussed.
