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. 2025 Jul 1;13(1):2525184.
doi: 10.1080/21642850.2025.2525184. eCollection 2025.

Somatosensory amplification and psychological distress in cancer survivors: the mediating role of fear of cancer recurrence

Shahaf Bitan  1 , Shimrit Daches  1 , Ilanit Hasson-Ohayon  1
Affiliations

Somatosensory amplification and psychological distress in cancer survivors: the mediating role of fear of cancer recurrence

Shahaf Bitan et al. Health Psychol Behav Med. .

Abstract

Introduction: Somatosensory amplification (SSA) refers to the tendency to experience body sensations as intense, noxious, and disturbing, and is associated with higher levels of anxiety and depression among cancer survivors. Body sensations among survivors are highly attributed to the possibility of cancer recurrence, thus triggering fear of cancer recurrence (FCR). Given that FCR itself is correlated with higher psychological distress, in this study we examined the mediating role of FCR in the relationship between SSA and symptoms of anxiety and depression among cancer survivors.

Materials and methods: One hundred and seventeen cancer survivors up to 10 years post-diagnosis took part in this cross-sectional study. Measures consisted of a demographic and medical questionnaire; the anxiety and depression domains of the Patient Reported Outcomes Measurement Information System (PROMIS); the Somatosensory Amplification Scale; and the Fear of Cancer Recurrence Inventory-Short Form. Mediation analyses were conducted to determine whether FCR mediated the relationships between SSA and both anxiety and depression.

Results: SSA was found to be positively correlated with anxiety, depression, and FCR, and FCR was found to be positively correlated with anxiety and depression. FCR was found to fully mediate the relationships between SSA and both anxiety and depression.

Conclusion: The findings suggest that FCR may serve as a mechanism linking SSA to psychological distress, highlighting the need to consider targeting FCR in interventions for cancer survivors.

Keywords: Anxiety; cancer survivors; depression; fear of cancer recurrence; somatosensory amplification.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

A mediation model illustrating the relationship between somatosensory amplification (SSA) and anxiety, mediated by fear of cancer recurrence (FCR). Standardized regression coefficients are displayed along each pathway, with statistical significance indicated by asterisks. The direct effect of SSA on anxiety is not significant, indicating full mediation by FCR.
Figure 1.
Standardized regression coefficients and squared correlation effect sizes for the relationship between somatosensory amplification (SSA) and anxiety, as mediated by fear of cancer recurrence (FCR). * p < .05, ** p < .01, *** p < .001.
A mediation model illustrating the relationship between somatosensory amplification (SSA) and depression, mediated by fear of cancer recurrence (FCR). Standardized regression coefficients are displayed along each pathway, with statistical significance indicated by asterisks. The direct effect of SSA on depression is not significant, indicating full mediation by FCR.
Figure 2.
Standardized regression coefficients and squared correlation effect sizes for the relationship between somatosensory amplification (SSA) and depression, as mediated by fear of cancer recurrence (FCR). * p < .05, ** p < .01, *** p < .001.
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