Predicting symptoms of anxiety and depression in patients living with advanced cancer: the differential roles of hope and optimism

Purpose Psychological distress is related to poorer functioning and reduced quality of life in patients with advanced cancer and may have untoward influences on treatment decisions. Current research on factors associated with this distress is limited, making targeted interventions to reduce it suboptimal. We examined the relationships between two goal-related expectancies and two of the most common symptoms of psychological distress in patients living with advanced cancer: anxiety and depressive symptoms. Methods Patients with advanced gastrointestinal cancer, colorectal cancer, lung cancer, or melanoma (N = 84) completed measures of anxiety, depressive symptoms, optimism, hope, and prediction for 12-month survival. Oncologists provided prediction for patient 12-month survival and patient performance status. Results Hope, but not optimism, was associated with less severe depressive symptoms (beta = -0.42). Conversely, optimism, but not hope, was associated with less severe anxiety symptoms (beta = -0.36). Conclusions Hope and optimism appear to be associated with different aspects of psychological distress in patients living with advanced cancer. This may be explained by different appraisals of the uncertainty and distress that are associated with living with advanced-stage cancer. Hope- or optimism-focused interventions can be tailored to help alleviate specific aspects of psychological distress among these patients.