Journal of Behavioral Medicine

, Volume 38, Issue 2, pp 294–305 | Cite as

A meta-analysis of the relationship between social constraints and distress in cancer patients

  • Rebecca N. Adams
  • Joseph G. Winger
  • Catherine E. Mosher


Social constraints on cancer-related disclosure have been associated with increased distress among cancer patients. The goals of this meta-analysis were: (1) to quantify the average strength of the relationships between social constraints and general and cancer-specific distress in cancer patients; and (2) to examine potential moderators of these relationships. A literature search was conducted using electronic databases, and 30 studies met inclusion criteria. Moderate, significant relationships were found between social constraints and both general distress (r = 0.37, 95 % CI 0.31–0.43) and cancer-specific distress (r = 0.37, 95 % CI 0.31–0.44). The relationship between social constraints and cancer-specific distress was stronger for studies of patients who, on average, had been diagnosed more recently. Relationships between social constraints and both general and cancer-specific distress did not vary by age or gender. Findings suggest that social constraints may be important to target in interventions to reduce distress in cancer patients, especially those who have been recently diagnosed.


Cancer Distress Social constraints Social support Meta-analysis 



The work of the first author was supported by R25 CA117865-06 (V. Champion, PI) from the NCI, and the work of the second author was supported by a fellowship from the Behavioral Cooperative Oncology Group Center for Symptom Management and the Walther Cancer Foundation. The work of the third author was supported by K07CA168883 from the NCI. The authors would like to thank Adam T. Hirsh, Ph.D., Melissa A. Cyders, Ph.D., and Ayca Coskunpinar, M.S. for their assistance with this project.

Conflicts of interest

Rebecca N. Adams, Joseph G. Winger, and Catherine E. Mosher declare that they have no conflicts of interest.

Human and animal rights and Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study.

Supplementary material

10865_2014_9601_MOESM1_ESM.pdf (19 kb)
Supplementary material 1 (PDF 19 kb)


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Rebecca N. Adams
    • 1
  • Joseph G. Winger
    • 1
  • Catherine E. Mosher
    • 1
  1. 1.Department of PsychologyIndiana University-Purdue University IndianapolisIndianapolisUSA

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