Saving Resources: The Relationship between Psychological Flexibility, Fatigue and Cognitive Impairment in Cancer Survivors

Introduction:

Cancer and its treatment can have a detrimental and long-lasting impact on different domains of quality of life, including fatigue and cognitive impairment. Psychological flexibility (PF) as the basis of acceptance and commitment therapy (ACT) has been shown to have a beneficial effect on depression and anxiety. Nevertheless, its relationship to fatigue and cognitive impairment has not been investigated before.

Materials & Methods:

A cross-sectional postal survey was undertaken. Cancer survivors were recruited through two regional cancer registries in Germany. Psychological flexibility (AAQ-II), fatigue (BFI) and cognitive impairment (AFI) were assessed. Applying (moderated) hierarchical regression models, we calculated the predictive effect of psychological flexibility on fatigue and cognitive impairment as well as the impairment by fatigue in relation to high vs. low levels of psychological flexibility.

Results:

Out of 2180 eligible patients, 46% participated (N = 922). Higher levels of psychological flexibility significantly predicted lower levels of fatigue and cognitive impairment (R²= 0.34 and R²= 0.24, respectively). The associations remained significant when control variables were entered into the model. Furthermore, psychologically flexible individuals were less impaired in their daily activities from fatigue than survivors with low psychological flexibility.

Discussion:

Psychological flexibility seems to predict long-term effects like fatigue and cognitive impairment.

Conclusion:

Given that a large bulk of studies has shown that psychological flexibility can be increased by ACT-based interventions, ACT may be beneficially applied in cancer survivors to reduce symptoms of fatigue and cognitive impairment.