Joint Trajectories of Death Anxiety and Experiential Avoidance After Cancer Diagnosis: A Longitudinal Study

Background: Despite the observed association between death anxiety and experiential avoidance, their joint short-term trajectories in patients with newly diagnosed cancer remain unclear. This study aimed to identify joint trajectories of death anxiety and experiential avoidance during early cancer care. Methods: This secondary longitudinal analysis included 266 adults with newly diagnosed cancer recruited at Hunan Cancer Hospital, China, between April and September 2022. Death anxiety and experiential avoidance were assessed using the 15-item Templer Death Anxiety Scale (DAS) and the seven-item Acceptance and Action Questionnaire-II (AAQ-II), respectively, at hospital admission, discharge, and one month after discharge. This interval represented the acute adaptation phase after diagnosis and treatment initiation. Outcome-specific trajectory models informed a fully crossed dual-trajectory model. Results: Participants (mean age, 48.33 ± 11.18 years; 53.8% male) followed three jointly re-estimated declining DAS trajectories (low, 37.3%; moderate, 26.5%; high, 36.3%) and two declining AAQ-II trajectories (low, 70.6%; high, 29.4%). In the dual-trajectory model (entropy = 0.849), the probability of high-AAQ-II increased across low, moderate, and high-DAS trajectories (8.5%, 18.7%, and 58.6%), and 72.3% of the high-AAQ-II trajectory followed the high-DAS trajectory. A high-DAS/low-AAQ-II combination accounted for 15.0%, indicating incomplete correspondence. Conclusions: During early care after cancer diagnosis, high-AAQ-II membership was concentrated in higher DAS trajectories, whereas high-DAS could also accompany low-AAQ-II.