Intolerance of uncertainty, experiential avoidance, and trust in physician: A moderated mediation analysis of emotional distress in advanced cancer Journal Article


Authors: Panjwani, A. A.; Applebaum, A. J.; Revenson, T. A.; Erblich, J.; Rosenfeld, B.
Article Title: Intolerance of uncertainty, experiential avoidance, and trust in physician: A moderated mediation analysis of emotional distress in advanced cancer
Abstract: We tested whether patients' trust in physician moderated the hypothesized indirect association between intolerance of uncertainty (IU; inability to tolerate the unknown) and emotional distress through the mediator, experiential avoidance (EA; efforts to avoid negative emotions, thoughts, or memories), in patients with advanced cancer. The sample included 108 adults with Stage III or IV cancer (53% female; Mage = 63 years) recruited from a metropolitan cancer center. All constructs were measured by standardized self-report instruments. The PROCESS macro for SPSS tested the moderated mediation model. IU evidenced significant direct and indirect relationships with anxiety and depressive symptoms. Trust in physician moderated the indirect relationship between IU and anxiety (not depressive symptoms), albeit in an unexpected direction. Specifically, the indirect relationship between IU and anxiety symptoms through EA was significant for those with moderate to high physician trust but not low trust. Controlling for gender or income did not change the pattern of findings. IU and EA may be key intervention targets, particularly in acceptance-or meaning-based interventions for patients with advanced cancer. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
Keywords: advanced cancer; depression; anxiety; experiential avoidance; intolerance of uncertainty; trust in physician
Journal Title: Journal of Behavioral Medicine
Volume: 47
ISSN: 0160-7715
Publisher: Springer  
Date Published: 2024-02-01
Start Page: 71
End Page: 81
ACCESSION: 2023-81107-001
DOI: 10.1007/s10865-023-00419-5
PROVIDER: Ovid Technologies
PROVIDER: psycinfo
PUBMED: 37285106
PMCID: PMC10942744
DOI/URL:
Notes: The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PubMed record and PDF -- Source: APA PsycInfo
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  1. Allison Joyce Applebaum
    191 Applebaum