Effects Of Anxiety And Depression On Social Avoidance And Distress In Young Adults With Cancer:the Mediating Role Of Social Support

ObjectiveThe study aims to investigate the effects of distinct types of anxiety and depression mood on social avoidance and distress in young adult patients with cancer and the mediating role of social support in these relationships.The results of this study will provide a novel perceptive for clinical staffs to identify high-risk patients and develop scientific and targeted interventions.MethodsA total of 330 young adults with cancer had been recruited as the participants in two threegrade hospitals in Jinan,from September 2020 to March 2021.The General Information Questionnaire,the Hospital Anxiety and Depression Scales,the Perceived Social Support Scales,and the Social Avoidance and Distress Scales were used to measure patients’sociodemographic and disease-related information,types of anxiety and depression mood,social support,and social avoidance and distress,respectively.SPSS 24.0 version was used for data analyses.Means,standard deviations,frequencies,and percentages were used to describe the general information of patients.Independent samples t-test and one-way analysis of variance(ANOVA)were used to evaluate the significant difference of social avoidance and distress between groups in the relevant sociodemographic and disease-related characteristics.Multiple linear regression with dummy variable approach was used to assess the influence of sociodemographic and disease-related characteristics and distinct types of anxiety and depression mood on social avoidance and distress.Mediation analysis with a multi-categorical independent variable was used to assess the mediating role of social support in the relationships between diverse types of anxiety and depression mood and social avoidance and distress.Results1 The total score of SAD Scale was 11.04±7.25.The score of social avoidance was 5.83±3.80,the score of social distress was 5.21±3.93 separately,all higher than the norm.2 The results of the univariate analyses and multiple linear regression analysis showed that:① Factors associated with social avoidance and distress regarding sociodemographic characteristics were gender,monthly income,and work status.②Compared with the none anxiety-depression group,depression-only,anxiety-only,and comorbid anxiety-depression were all significant positively predicted patients’ social avoidance and distress,with regression coefficients of 0.197,0.211 and 0.418 respectively(P<0.001).According to the standardized regression coefficients,the magnitude of risk for social avoidance and distress in term of distinct types of anxiety-depression mood in was comorbid anxiety-depression,anxiety-only,and depression-only.3 The results of mediation analysis with a multi-categorical independent variable showed that,with none anxiety-depression as the reference group,depression-only,anxiety-only,and comorbid anxiety-depression all increased patients’ social avoidance and distress by decreasing different social support levels.The relative mediation effects of social support accounted for 17.80%,14.91%and 15.74%respectively.Among them,the relative mediating effect of social support in the depression-only group accounted for a greater proportion.Conclusions1 Social avoidance and distress are higher in young adults with cancer compared to the normal population.This indicates that young adult patients with cancer deserve special attention.2 Factors influencing social avoidance and distress include gender,work status,and monthly income.Knowledge of characteristics associated with social avoidance and distress can be used by nurses to identify higher risk patients and initiate targeted interventions to reduce social avoidance and distress in these patients.3 Compared to none anxiety-depression group,the distinct types of anxiety-depression mood(depression-only,anxiety-only,and comorbid anxiety-depression)all positively predicted social avoidance and distress.This suggests that early screening of anxiety and depression should be conducted to help healthcare providers identify high-risk patients,and the give targeted interventions.4 Social support mediated the association between distinct types of anxiety-depression mood and social avoidance and distress,and the relative mediating effect was higher in patients with depression mood(with or without comorbid anxiety),suggesting that healthcare providers should adopt interventions including both reducing patients’ levels of anxiety and depression and enhancing patients’ levels of social support.Such intervention would reduce patients’ social avoidance and distress and provide them more opportunities for social reintegration.