Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Apr 10;7(5):498-506.
doi: 10.1093/nop/npaa015. eCollection 2020 Oct.

Death-related distress in adult primary brain tumor patients

Ashlee R Loughan  1   2   3 , Farah J Aslanzadeh  4 , Julia Brechbiel  4 , Gary Rodin  5   6 , Mariya Husain  3 , Sarah E Braun  4   7 , Kelcie D Willis  4 , Autumn Lanoye  8
Affiliations

Death-related distress in adult primary brain tumor patients

Ashlee R Loughan et al. Neurooncol Pract. .

Abstract

Background: A diagnosis of cancer may increase mortality salience and provoke death-related distress. Primary brain tumor (PBT) patients may be at particular risk for such distress given the certainty of tumor progression, lack of curative treatments, and poor survival rates. This study is the first to examine the prevalence of death-related distress and its correlates in PBT patients.

Methods: Adult PBT patients (N = 105) enrolled in this cross-sectional study and completed the Death Distress Scale (subscales: Death Depression, Death Anxiety, Death Obsession), Generalized Anxiety Disorder-7, and Patient Health Questionnaire-9. Prevalence and predictors of death-related distress, and the relationships of demographic variables to clusters of distress, were explored.

Results: The majority of PBT patients endorsed clinically significant death-related distress in at least one domain. Death anxiety was endorsed by 81%, death depression by 12.5%, and death obsession by 10.5%. Generalized anxiety was the only factor associated with global death-related distress. Cluster analysis yielded 4 profiles: global distress, emotional distress, resilience, and existential distress. Participants in the resilience cluster were significantly further out from diagnosis than those in the existential distress cluster. There were no differences in cluster membership based on age, sex, or tumor grade.

Conclusions: PBT patients appear to have a high prevalence of death-related distress, particularly death anxiety. Further, 4 distinct profiles of distress were identified, supporting the need for tailored approaches to addressing death-related distress. A shift in clusters of distress based on time since diagnosis also suggest the need for future longitudinal assessment.

Keywords: death anxiety; death-related distress; neuro-oncology; primary brain tumor; quality of life.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Flowchart of Participant Recruitment.
Fig. 2
Fig. 2
Prevalence of Moderate to Severe Existential Distress in a Primary Brain Tumor Sample. Distress endorsement followed suggested guidelines of greater than 18 raw score.
Fig. 3
Fig. 3
Final Clusters for 4-Cluster Solution. GAD-7 indicates Generalized Anxiety Disorder scale–7 Item; PHQ-9, Patient Health Questionnaire–9 Item.
See this image and copyright information in PMC

References

    1. May R, Yalom I.. Existential psychotherapy. In: Corsini RJ, Wedding D, eds. Current Psychotherapies 7th ed. Belmont, CA: Thomson Brooks/Cole Publishing Co; 2005:269–298.
    1. Colosimo K, Nissim R, Pos AE, Hales S, Zimmermann C, Rodin G.. “Double awareness” in psychotherapy for patients living with advanced cancer. J Psychother Integr. 2018;28(2):125–140.
    1. Adelbratt S, Strang P. Death anxiety in brain tumour patients and their spouses. Palliat Med. 2000;14(6):499–507. - PubMed
    1. Lowe J, Harris LM. A comparison of death anxiety, intolerance of uncertainty and self-esteem as predictors of social anxiety symptoms. Behav Chang. 2019;36(3):165–179.
    1. MacLeod R, Crandall J, Wilson D, Austin P.. Death anxiety among New Zealanders: the predictive role of gender and marital status. Ment Heal Relig Cult. 2016;19(4):339–349.