Worry and metacognition in cancer patients and their caregivers
Raffaela Massa, Annalisa Lacidogna, Libera Reale, Costanza Valentini, Lucia Caligiani, Giovanni Maria Ruggiero
Cancer is a disease characterised by feelings of vulnerability, sadness, fear and anxiety, which if
becoming disabling and pervasive may lead to negative and repetitive thoughts focusing excessive
attention on future threatening events. Cancer-related worry is a cognitive process which worsens
patients’ and family members’ quality of life, and is influenced both by trait anxiety and psychological
distress. The aim of this research is to explore the relationship between worry, trait anxiety and
distress in adult cancer patients during chemotherapy treatment and in their caregivers. 50 patients
and 50 caregivers were recruited to take part in the research. They completed a series of selfreport
questionnaires: personal details; Penn State Worry Questionnaire (PSWQ) and Metacognition
Questionnaire 30 (MCQ30) to investigate the process and metacognitive dimensions of worry; Trait
Anxiety Inventory (STAI Y-2) to investigate trait anxiety; and Distress Thermometer (DT). This study
shows that both positive and negative metacognitive beliefs prevail in cancer patients, whereas
caregivers only experience negative beliefs. Worry is positively related to trait anxiety and distress (p
< 0.001). Trait anxiety has been shown to predict worry (p < 0.001). Worry and trait anxiety represent
significant predictors of distress (p < 0.05). Future research may focus on differentiated metacognitive
therapeutic approaches for patients and caregivers.
Keywords
Worry, Oncology, Metacognitive therapy, Trait anxiety, Distress.
