Psychological flexibility, distress, and coping in ovarian cancer survivors

Ovarian cancer survivors report elevated levels of psychological distress due to the high rates of recurrence and mortality, but little is currently known about the coping skills and strengths that survivors draw upon during their cancer survivorship. One such possible strength is psychological flexibility, defined as the ability to stay in the present moment regardless of unpleasant experiences and make behavioral choices based on values.

The study aimed to explore psychological flexibility and coping among ovarian cancer survivors prior to their participation in a web-based psychosocial intervention and to examine potential mediators of distress.

Ovarian cancer survivors were recruited to participate in an 11-week group-based, web-delivered psychosocial intervention. Participants completed assessments of mood, psychological flexibility and coping before the intervention. 165 ovarian cancer survivors provided survey data on psychosocial and clinical characteristics prior to randomization. Multiple mediation models were used to examine potential mediators in the relation of psychological flexibility with depression and anxiety.

Survivors reported mild levels of depression and anxiety. Multiple mediation models revealed significant indirect effects of psychological flexibility on both anxiety and depression. The negative association between psychological flexibility and anxiety was partially mediated by avoidant coping (p = .030). Moreover, the association between psychological flexibility and depression was mediated by cancer-related worry (p = .004).

Psychological flexibility is associated with less distress in ovarian cancer survivors who present for psychological intervention, and this pathway is partially mediated by avoidant coping and cancer-related worry. Mindfulness techniques and coping skills training may ameliorate these effects and improve psychological functioning.