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. 2025 Jun 4;17(11):1884.
doi: 10.3390/cancers17111884.

Effect of Intolerance of Uncertainty on Perceived Cognitive Function Among Breast Cancer Patients Before Chemotherapy

Yesol Yang  1   2 , Alai Tan  1 , Sagar D Sardesai  3 , Nicole O Williams  3 , Margaret Gatti-Mays  3 , Daniel G Stover  3 , Preeti K Sudheendra  3 , Robert Wesolowski  3 , Stephanie M Gorka  4   5 , Leah M Pyter  2   4   5
Affiliations

Effect of Intolerance of Uncertainty on Perceived Cognitive Function Among Breast Cancer Patients Before Chemotherapy

Yesol Yang et al. Cancers (Basel). .

Abstract

Background: Cancer-related cognitive impairment (CRCI) is one of the most frequently reported symptoms by breast cancer patients. However, it remains unclear precisely what contributing factors are present among chemotherapy-naïve breast cancer patients that contribute to CRCI. Thus, it is essential to identify potential factors related to CRCI that may occur before chemotherapy so that interventions can be employed to help prevent the worsening of CRCI. Objective: This study examined the association between intolerance of uncertainty (IU) and cognitive function among breast cancer patients before chemotherapy and explored whether anxiety mediates this association. Methods: A total of 58 females diagnosed with stage I-III breast cancer and scheduled for chemotherapy were included in this study. Data on cognitive function, IU, anxiety, and other relevant information were analyzed. Results: We found that higher IU was associated with higher anxiety and such higher anxiety was subsequently associated with lower cognitive function being reported by breast cancer patients who were scheduled for chemotherapy. The association between IU and cognitive function was largely mediated through anxiety with standardized β = -0.19 (SE = 0.07) for the indirect association via anxiety and β = -0.2 (SE = 0.12) for the total association. Conclusions: IU shows an impact on cognitive function. Therefore, it is necessary to assess IU before chemotherapy, which may help detect patient risk for cognitive impairment early.

Keywords: anxiety; breast cancer; cognitive impairment; intolerance of uncertainty.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Path model results. Unstandardized path coefficients (SE) were presented. ** p < 0.01, *** p < 0.001. The corresponding standardized estimates were 0.47 (0.10) for the IU to anxiety path, −0.40 (0.12) for the path of anxiety to cognitive function, and −0.08 (0.13) for the path of IU to cognitive function.
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