Anxiety in Head and Neck Cancer Patients: The Role of Social Support and Posttraumatic Stress Syndrome Symptoms

Background: Anxiety is common among head and neck cancer (HNC) patients undergoing standard radiotherapy, with varying levels reported throughout treatment. While most studies suggest an overall decrease in anxiety during the treatment trajectory, some report no significant changes over time. Limited evidence exists regarding the role of social support and post-traumatic stress symptoms (PTSS) in predicting anxiety. Aim: This study investigated levels of anxiety throughout radiotherapy, and whether pre-treatment levels of social support as well as PTSS predicted post-radiotherapy anxiety. Hypotheses: It was hypothesized that overall anxiety would decrease during radiotherapy, while also indicating individual differences. Additionally, pre-radiotherapy anxiety was expected to be negatively associated with social support and positively associated with PTSS symptoms. Finally, both pre-radiotherapy social support and PTSS were hypothesized to predict post-radiotherapy anxiety. Method:...Show moreBackground: Anxiety is common among head and neck cancer (HNC) patients undergoing standard radiotherapy, with varying levels reported throughout treatment. While most studies suggest an overall decrease in anxiety during the treatment trajectory, some report no significant changes over time. Limited evidence exists regarding the role of social support and post-traumatic stress symptoms (PTSS) in predicting anxiety. Aim: This study investigated levels of anxiety throughout radiotherapy, and whether pre-treatment levels of social support as well as PTSS predicted post-radiotherapy anxiety. Hypotheses: It was hypothesized that overall anxiety would decrease during radiotherapy, while also indicating individual differences. Additionally, pre-radiotherapy anxiety was expected to be negatively associated with social support and positively associated with PTSS symptoms. Finally, both pre-radiotherapy social support and PTSS were hypothesized to predict post-radiotherapy anxiety. Method: 16 HNC patients undergoing radiotherapy at a university hospital completed self-report questionnaires at pre-treatment, including the Beck Anxiety Inventory (BAI), the Social Support Questionnaire-Interaction (SSL-I), and the Posttraumatic Stress Disorder Checklist (PCL-5). The BAI was also administered multiple times during treatment. Results: Friedman’s test showed no significant changes in anxiety levels before, during, or after radiotherapy. No clinically significant individual differences in anxiety were observed between pre- and post-radiotherapy, but some were detected between pre-radiotherapy and day 10 (control). Spearman’s rank-order correlation revealed no significant associations between pre-radiotherapy anxiety and social support (ρ = -0.352, p = 0.239) or PTSS (ρ = 0.324, p = 0.279). The Generalized Linear Model indicated that neither social support (ß = -0.010, p = 0.943) nor PTSS (ß = -0.028, p = 0.720) predicted post-radiotherapy anxiety. Conclusion: No support was found for an overall decrease in anxiety levels throughout radiotherapy. Although the direction of the associations between anxiety and social support as well as anxiety and PTSS symptoms were supported, there was no support that social support, as well as PTSS symptoms predicted post-radiotherapy anxiety. Future research recommends a larger study sample and a questionnaire measuring situational anxiety multiple times throughout treatment. This could provide a deeper insight into anxiety during radiotherapy.Show less

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Anxiety in Head and Neck Cancer Patients: The Role of Social Support and Posttraumatic Stress Syndrome Symptoms