Psychological flexibility and its correlations with and predictive utility for emotional wellbeing, fatigue, insomnia, and post-traumatic growth in cancer patients undergoing treatment

Objective The use of acceptance and commitment therapy has shown favorable results in cancer patients. However, the role of psychological flexibility has yet to be determined. Methods Patients with breast, colorectal, lung and gynaecological cancers in active treatment in stages I-III were invited to complete questionnaires assessing psychological flexibility (AAQ-II), anxiety and depression (HADS), fatigue (BFI), insomnia (ISI) and post-traumatic growth (PTGI-SF). Correlation and regression analyses were performed controlling for possible confounding variables. Results One-hundred and fifty patients completed the questionnaires. The majority were married women with stage III breast cancer, primary-level education and a mean age of 53. On average, 18 months had passed since diagnosis, and surgery, chemotherapy and radiotherapy were the most frequent treatments. Results showed psychological flexibility correlated with and had predictive ability for fatigue, anxiety, depression and insomnia, but not for post-traumatic growth. Anxiety was significantly related to depression, fatigue and insomnia, and depression to fatigue, insomnia and post-traumatic growth. Fatigue was related to insomnia. Conclusion Psychological flexibility appears to be a relevant variable to be taken into account in the treatment of cancer patients.