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Psychotherapeut

, Volume 63, Issue 3, pp 194–203 | Cite as

Angst und Emotionsregulation bei Krebspatienten

  • Sonja Bussmann
  • Lusine Vaganian
  • Michael Kusch
  • Hildegard Labouvie
  • Alexander L. Gerlach
  • Jan Christopher Cwik
Schwerpunkt: Angst – Übersichten
  • 267 Downloads

Zusammenfassung

Eine Krebsdiagnose ist für Betroffene und ihre Angehörigen häufig mit damit einhergehenden psychischen Belastungen und mit wesentlichen Veränderungen der alltäglichen Lebensführung verbunden. Die psychoonkologische Versorgung hat das Ziel, der Belastung der Betroffenen und ihrer Angehörigen mit psychosozialen und psychotherapeutischen Mitteln entgegenzuwirken. Häufig äußert sich die Belastung in Form von Ängsten, die je nach Situation und Krankheitsverlauf inter- und intraindividuell teilweise stark variieren und zudem über die Remission einer Krebserkrankung hinweg fortbestehen können. Für die psychoonkologische Beratung und Therapie ist es daher wichtig, pathologische von nichtpathologischen Ängsten differenzieren zu können sowie Informationen über verschiedene Facetten von Angst im onkologischen Kontext und im Krankheitsverlauf zu kennen. Verschiedene Emotionsregulationsstrategien sind als probates Mittel etabliert, um Ängsten von Patienten zu begegnen. Die Theorie der Emotionsregulation liefert ein hilfreiches Gerüst zur Ableitung indizierter Beratungstechniken und therapeutischer Interventionen. Auch für die psychoonkologische Versorgung – mit ihrem hohen Anspruch an Individualität und Flexibilität – bietet die Wahl der jeweils besten Emotionsregulationsstrategien die Chance, optimal auf Ängste und Angstsymptome von Krebspatienten als auch deren Angehörigen reagieren zu können.

Schlüsselwörter

Psychoonkologie Psychologische Adaptation Coping-Verhalten Lebensqualität Psychotherapie 

Anxiety and emotion regulation in cancer patients

Abstract

A diagnosis of cancer is often associated with substantial changes in everyday life and with psychological distress for afflicted individuals and their relatives. Psycho-oncological patient care aims to reduce the distress of afflicted individuals and their relatives by using psychosocial and psychotherapeutic techniques. Cancer-related distress often results in anxieties, which vary interindividually and intraindividually depending on the patient’s situation and course of the disease and can even continue after remission from cancer. Thus, it is essential for psycho-oncological consultation and therapy to be able to differentiate between pathological and non-pathological anxieties and to be aware of different facets of anxiety in the oncological context and during the course of the disease. Various emotion regulation strategies have been established as useful tools to address patient anxiety. The theory of emotion regulation provides a useful framework for the selection of counseling techniques and therapeutic interventions. Accordingly, in psycho-oncological consultation, with its high requirement of individuality and flexibility, the individual selection of emotion regulation strategies offers the opportunity to optimally react to anxieties and anxiety symptoms of cancer patients and their relatives.

Keywords

Psycho-oncology Psychological adaptation Coping behavior Quality of life Psychotherapy 

Notes

Förderung

Die Erstellung des Beitrags wurde teilweise vom Innovationsfond des Gemeinsamen Bundesausschusses in Form des Projekts „isPO – Integrierte, sektorenübergreifende Psychoonkologie“ gefördert (Förderkennzeichen 01NVF17022-IsPo).

Einhaltung ethischer Richtlinien

Interessenkonflikt

S. Bussmann, L. Vaganian, M. Kusch, H. Labouvie, A.L. Gerlach und J.C. Cwik geben an, dass kein Interessenkonflikt besteht.

Für diese Übersichtsarbeit wurden keine Studien an Menschen oder Tieren durchgeführt.

Literatur

  1. Ávila M, Brandão T, Teixeira J et al (2015) Attachment, emotion regulation, and adaptation to breast cancer: assessment of a mediational hypothesis. Psychooncology 24:1514–1520CrossRefPubMedGoogle Scholar
  2. Badr H, Krebs P (2013) A systematic review and meta-analysis of psychosocial interventions for couples coping with cancer. Psychooncology 22:1688–1704CrossRefPubMedGoogle Scholar
  3. Bandelow B, Wiltink J, Alpers GW et al (2014) Deutsche S3-Leitlinie Behandlung von Angststörungen. Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, DüsseldorfGoogle Scholar
  4. Bender CM, Gentry AL, Casillo FE et al (2014) Influence of patient and treatment factors on adherence to adjuvant endocrine therapy in breast cancer. Oncol Nurs Forum 41:274–285CrossRefPubMedPubMedCentralGoogle Scholar
  5. Brandão T, Tavares R, Schulz MS et al (2015) Measuring emotion regulation and emotional expression in breast cancer patients: a systematic review. Clin Psychol Rev 43:114–127CrossRefPubMedGoogle Scholar
  6. Brown AJ, Shen MJ, Ramondetta LM et al (2014) Does death anxiety affect end-of-life care discussions? Int J Gynecol Cancer 24:1521–1526CrossRefPubMedPubMedCentralGoogle Scholar
  7. Bundesministerium Für Gesundheit (2017) Nationaler Krebsplan: Handlungsfelder, Ziele, Umsetzungsempfehlungen und Ergebnisse. Bundesministerium für Gesundheit, BonnGoogle Scholar
  8. Butow P, Kelly S, Thewes B et al (2015) Attentional bias and metacognitions in cancer survivors with high fear of cancer recurrence. Psychooncology 24:416–423CrossRefPubMedGoogle Scholar
  9. Butow P, Sharpe L, Thewes B et al (2018) Fear of cancer recurrence: a practical guide for clinicians. Oncol J 32:32–38Google Scholar
  10. Butow PN, Turner J, Gilchrist J et al (2017) Randomized trial of ConquerFear: a novel, theoretically based psychosocial intervention for fear of cancer recurrence. J Clin Oncol 35:4066–4077CrossRefPubMedGoogle Scholar
  11. Cameron LD, Booth RJ, Schlatter M et al (2007) Changes in emotion regulation and psychological adjustment following use of a group psychosocial support program for women recently diagnosed with breast cancer. Psychooncology 16:171–180CrossRefPubMedGoogle Scholar
  12. Conley CC, Bishop BT, Andersen BL (2016) Emotions and emotion regulation in breast cancer survivorship. Healthcare (Basel) 4(3):E56.  https://doi.org/10.3390/healthcare4030056 CrossRefGoogle Scholar
  13. Consedine NS, Magai C, Krivoshekova YS et al (2004) Fear, anxiety, worry, and breast cancer screening behavior: a critical review. Cancer Epidemiol Biomarkers Prev 13:501–510PubMedGoogle Scholar
  14. Crist JV, Grunfeld EA (2013) Factors reported to influence fear of recurrence in cancer patients: a systematic review. Psychooncology 22:978–986CrossRefPubMedGoogle Scholar
  15. Cupit-Link M, Syrjala KL, Hashmi SK (2018) Damocles’ syndrome revisited: Update on the fear of cancer recurrence in the complex world of today’s treatments and survivorship. Hematol Oncol Stem Cell Ther.  https://doi.org/10.1016/j.hemonc.2018.01.005 PubMedGoogle Scholar
  16. Curran L, Sharpe L, Butow P (2017) Anxiety in the context of cancer: a systematic review and development of an integrated model. Clin Psychol Rev 56:40–54CrossRefPubMedGoogle Scholar
  17. Dekker J, Braamse A, Schuurhuizen C et al (2017) Distress in patients with cancer—on the need to distinguish between adaptive and maladaptive emotional responses. Acta Oncol 56:1026–1029CrossRefPubMedGoogle Scholar
  18. Deutsche Krebsgesellschaft, Deutsche Krebshilfe, Awmf (2014) S3-Leitlinie: Psychoonkologische Diagnostik, Beratung und Behandlung von erwachsenen KrebspatientenGoogle Scholar
  19. Die Trill M (2013) Anxiety and sleep disorders in cancer patients. EJC Suppl 11:216–224CrossRefPubMedPubMedCentralGoogle Scholar
  20. Dimatteo MR, Lepper HS, Croghan TW (2000) Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med 160:2101–2107CrossRefPubMedGoogle Scholar
  21. Dinkel A, Kremsreiter K, Marten-Mittag B et al (2014) Comorbidity of fear of progression and anxiety disorders in cancer patients. Gen Hosp Psychiatry 36:613–619CrossRefPubMedGoogle Scholar
  22. Faller H, Schuler M, Richard M et al (2013) Effects of psycho-oncologic interventions on emotional distress and quality of life in adult patients with cancer: systematic review and meta-analysis. J Clin Oncol 31:782–793CrossRefPubMedGoogle Scholar
  23. Ferrer RA, Green PA, Barrett LF (2015) Affective science perspectives on cancer control: strategically crafting a mutually beneficial research agenda. Perspect Psychol Sci 10:328–345CrossRefPubMedPubMedCentralGoogle Scholar
  24. Greer JA, Pirl WF, Park ER et al (2008) Behavioral and psychological predictors of chemotherapy adherence in patients with advanced non-small cell lung cancer. J Psychosom Res 65:549–552CrossRefPubMedPubMedCentralGoogle Scholar
  25. Greer JA, Macdonald J, Traeger L (2015) Anxiety disorders. In: Holland JC, Breitbart WS, Butow PN, Jacobsen PB, Loscalzo MJ, McCorkle R (Hrsg) Psycho-oncology. Oxford University Press, Oxford, S 296–303Google Scholar
  26. Gross JJ (1989) Emotional expression in cancer onset and progression. Soc Sci Med 28:1239–1248CrossRefPubMedGoogle Scholar
  27. Gross JJ, Jazaieri H (2014) Emotion, emotion regulation, and psychopathology: an affective science perspective. Clin Psychol Sci 2:387–401CrossRefGoogle Scholar
  28. Gross JJ, Thompson RA (2007) Emotion regulation: conceptual foundations. In: Gross JJ (Hrsg) Handbook of emotion regulation. Guilford, New York, London, S 3–24Google Scholar
  29. Heinrichs N, Zimmermann T, Huber B et al (2012) Cancer distress reduction with a couple-based skills training: a randomized controlled trial. Ann Behav Med 49:239–252CrossRefGoogle Scholar
  30. Herrmann-Lingen C, Buss U, Snaith RP (2011) Hospital Anxiety and Depression Scale (HADS) – Deutsche Version: Deutsche Adaptation der Hospital Anxiety and Depression Scale (HADS) von R. P. Snaith und A. S. Zigmond. Hogrefe, GöttingenGoogle Scholar
  31. Hodges LJ, Walker J, Kleiboer AM et al (2011) What is a psychological intervention? A metareview and practical proposal. Psychooncology 20:470–478CrossRefPubMedGoogle Scholar
  32. Hornemann B, Schuler U (2017) Krebs – zum Fürchten!? Wann wird Angst pathologisch. Nervenheilkunde 36:955–962CrossRefGoogle Scholar
  33. Hoyt MA, Nelson CJ, Darabos K et al (2017) Mechanisms of navigating goals after testicular cancer: meaning and emotion regulation. Psychooncology 26:747–754CrossRefPubMedGoogle Scholar
  34. Iverach L, Menzies RG, Menzies RE (2014) Death anxiety and its role in psychopathology: reviewing the status of a transdiagnostic construct. Clin Psychol Rev 34:580–593CrossRefPubMedGoogle Scholar
  35. Jacobsen PB, Donovan KA, Trask PC et al (2005) Screening for psychologic distress in ambulatory cancer patients: a multicenter evaluation of the distress thermometer. Cancer 103:1494–1502CrossRefPubMedGoogle Scholar
  36. Kangas M, Gross JJ (2017) The affect regulation in cancer framework: understanding affective responding across the cancer trajectory. J Health Psychol.  https://doi.org/10.1177/1359105317748468 PubMedGoogle Scholar
  37. Koch L, Jansen L, Brenner H et al (2013) Fear of recurrence and disease progression in long-term (≥ 5 years) cancer survivors—a systematic review of quantitative studies. Psychooncology 22:1–11CrossRefPubMedGoogle Scholar
  38. Kusch M, Labouvie H, Hein-Nau B (2013) Klinische Psychoonkologie. Springer, Berlin, HeidelbergCrossRefGoogle Scholar
  39. Kusch M, Labouvie H, Gerlach A et al (2016) Kommt die personalisierte Psychoonkologie? TumorDiagn Ther 37:560–564CrossRefGoogle Scholar
  40. Lebel S, Ozakinci G, Humphris G et al (2016) From normal response to clinical problem: definition and clinical features of fear of cancer recurrence. Support Care Cancer 24:3265–3268CrossRefPubMedGoogle Scholar
  41. Lewis F, Merckaert I, Liénard A et al (2014a) Anxiety and its time courses during radiotherapy for non-metastatic breast cancer: a longitudinal study. Radiother Oncol 111:276–280CrossRefPubMedGoogle Scholar
  42. Lewis F, Merckaert I, Liénard A et al (2014b) Anxiety at the first radiotherapy session for non-metastatic breast cancer: key communication and communication-related predictors. Radiother Oncol 114:35–41CrossRefPubMedGoogle Scholar
  43. Lim CC, Devi MK, Ang E (2011) Anxiety in women with breast cancer undergoing treatment: a systematic review. Int J Evid Based Healthc 9:215–235PubMedGoogle Scholar
  44. Linden W, Vodermaier A, Mackenzie R et al (2012) Anxiety and depression after cancer diagnosis: prevalence rates by cancer type, gender, and age. J Affect Disord 141:343–351CrossRefPubMedGoogle Scholar
  45. Matthews H, Grunfeld EA, Turner A (2017) The efficacy of interventions to improve psychosocial outcomes following surgical treatment for breast cancer: a systematic review and meta-analysis. Psychooncology 26:593–607CrossRefPubMedGoogle Scholar
  46. Mehnert A, Lehmann C, Koch U (2006) Prävalenz und Diagnostik psychischer Störungen in der Onkologie. Onkologe 12:18–26CrossRefGoogle Scholar
  47. Mitchell AJ, Meader N, Symonds P (2010) Diagnostic validity of the Hospital Anxiety and Depression Scale (HADS) in cancer and palliative settings: a meta-analysis. J Affect Disord 126:335–348CrossRefPubMedGoogle Scholar
  48. Mitchell AJ, Chan M, Bhatti H et al (2011) Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. Lancet Oncol 12:160–174CrossRefPubMedGoogle Scholar
  49. Molassiotis A, Lee PH, Burke TA et al (2016) Anticipatory nausea, risk factors, and its impact on chemotherapy-induced nausea and vomiting: results from the Pan European Emesis Registry Study. J Pain Symptom Manage 51:987–993CrossRefPubMedGoogle Scholar
  50. Neel C, Lo C, Rydall A et al (2015) Determinants of death anxiety in patients with advanced cancer. BMJ Support Palliat Care 5:373–380CrossRefPubMedGoogle Scholar
  51. Osborn RL, Demoncada AC, Feuerstein M (2006) Psychosocial interventions for depression, anxiety, and quality of life in cancer survivors: meta-analyses. Int J Psychiatry Med 36:13–34CrossRefPubMedGoogle Scholar
  52. O’toole MS, Zachariae R, Renna ME et al (2017) Cognitive behavioral therapies for informal caregivers of patients with cancer and cancer survivors: a systematic review and meta-analysis. Psychooncology 26:428–437CrossRefPubMedGoogle Scholar
  53. Peh CX, Liu J, Bishop GD et al (2017) Emotion regulation and emotional distress: the mediating role of hope on reappraisal and anxiety/depression in newly diagnosed cancer patients. Psychooncology 26:1191–1197CrossRefPubMedGoogle Scholar
  54. Piet J, Würzten H, Zachariae R (2012) The effect of mindfulness-based therapy on symptoms of anxiety and depression in adult cancer patients and survivors: a systematic review and meta-analysis. J Consult Clin Psychol 80:1007–1020CrossRefPubMedGoogle Scholar
  55. Prinz-Zaiss M (2017) Perspektiven der Niedergelassenen Psychotherapeuten in der Psychoonkologie. Nervenheilkunde 36:969–971CrossRefGoogle Scholar
  56. Reed RG, Weihs KL, Sbarra DA et al (2016) Emotional acceptance, inflammation, and sickness symptoms across the first two years following breast cancer diagnosis. Brain Behav Immun 56:165–174CrossRefPubMedPubMedCentralGoogle Scholar
  57. Roth AJ, Kornblith AB, Batel-Copel L et al (1998) Rapid screening for psychologic distress in men with prostate carcinoma: a pilot study. Cancer 82:1904–1908CrossRefPubMedGoogle Scholar
  58. Rudolph B, Wünsch A, Herschbach P et al (2018) Ambulante verhaltenstherapeutische Gruppentherapie zur Behandlung von Progredienzangst bei Krebspatienten. Psychother Psychosom Med Psychol 68:38–43CrossRefPubMedGoogle Scholar
  59. Schlatter MC, Cameron LD (2010) Emotional suppression tendencies as predictors of symptoms, mood, and coping appraisals during AC chemotherapy for breast cancer treatment. Ann Behav Med 40:15–29CrossRefPubMedGoogle Scholar
  60. Simonelli LE, Siegel SD, Duffy NM (2017) Fear of cancer recurrence: a theoretical review and its relevance for clinical presentation and management. Psychooncology 26:1444–1454CrossRefPubMedGoogle Scholar
  61. Singer S, Bringmann H, Hauss J et al (2007) Häufigkeit psychischer Begleiterkrankungen und der Wunsch nach psychosozialer Unterstützung bei Tumorpatienten im Akutkrankenhaus. Dtsch Med Wochenschr 132:2071–2076CrossRefPubMedGoogle Scholar
  62. Singer S, Beckerle J, Kleining B et al (2017) „Die Strukturen müssen viel flexibler sein“. Qualitative Befragung niedergelassener Psychotherapeuten zur Versorgung von Krebspatienten. Psychotherapeut 62:440–449CrossRefGoogle Scholar
  63. Tamagawa R, Giese-Davis J, Speca M et al (2013) Trait mindfulness, repression, suppression, and self-reported mood and stress symptoms among women with breast cancer. J Clin Psychol 69:264–277CrossRefPubMedGoogle Scholar
  64. Vehling S, Koch U, Ladehoff N et al (2012) Prävalenz affektiver und Angststörungen bei Krebs: Systematischer Literaturreview und Metaanalyse. Psychother Psychosom Med Psychol 62:249–258CrossRefPubMedGoogle Scholar
  65. Waadt S, Duran G, Berg P et al (2011) Progredienzangst – Manual zur Behandlung von Zukunftsängsten bei chronisch Kranken. Schattauer, StuttgartGoogle Scholar
  66. Yu Y, Peng L, Tang T et al (2014) Effects of emotion regulation and general self-efficacy on posttraumatic growth in Chinese cancer survivors: assessing the mediating effect of positive affect. Psychooncology 23:473–478CrossRefPubMedGoogle Scholar
  67. Zhang M‑F, Wen Y‑S, Liu W‑Y et al (2015) Effectiveness of mindfulness-based therapy for reducing anxiety and depression in patients with cancer: a meta-analysis. Medicine (Baltimore) 94:e897CrossRefGoogle Scholar
  68. Zimmermann T, Heinrichs N, Scott JL (2006) CanCOPE „Schritt für Schritt“. Die Effektivität eines partnerschaftlichen Unterstützungsprogramms bei Frauen mit Brust- oder gynäkologischen Krebserkrankungen. Verhaltenstherapie 16:247–255CrossRefGoogle Scholar
  69. Zimmermann T, Heinrichs N, Baucom DH (2007) “Does one size fit all?” Moderators in psychosocial interventions for breast cancer patients: a meta-analysis. Ann Behav Med 34:225–239CrossRefPubMedGoogle Scholar
  70. Zimmermann T, Alsleben M, Heinrichs N (2012) Progredienzangst gesunder Lebenspartner von chronisch erkrankten Patienten. Psychother Psychosom Med Psychol 62:344–351CrossRefPubMedGoogle Scholar

Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  • Sonja Bussmann
    • 1
  • Lusine Vaganian
    • 1
  • Michael Kusch
    • 2
  • Hildegard Labouvie
    • 2
  • Alexander L. Gerlach
    • 1
  • Jan Christopher Cwik
    • 1
  1. 1.Klinische Psychologie und Psychotherapie, Humanwissenschaftliche FakultätUniversität zu KölnKölnDeutschland
  2. 2.Centrum für Integrierte Onkologie, Klinik I für Innere MedizinUniversitätsklinikum KölnKölnDeutschland

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