TY - JOUR
T1 - Social isolation, depression, and anxiety among young adult cancer survivors
T2 - The mediating role of social connectedness
AU - Li, Xiaoyin
AU - Hathaway, Cassandra A.
AU - Small, Brent J.
AU - Tometich, Danielle B.
AU - Gudenkauf, Lisa M.
AU - Hoogland, Aasha I.
AU - Fox, Rina S.
AU - Victorson, David E.
AU - Salsman, John M.
AU - Gonzalez, Brian D.
AU - Jim, Heather S.L.
AU - Siegel, Erin M.
AU - Tworoger, Shelley S.
AU - Oswald, Laura B.
N1 - Publisher Copyright:
© 2024 American Cancer Society.
PY - 2024/12/1
Y1 - 2024/12/1
N2 - Background: Social isolation and social connectedness are health determinants and aspects of social well-being with strong associations with psychological distress. This study evaluated relationships among social isolation, social connectedness, and psychological distress (i.e., depression, anxiety) over 1 year in young adult (YA) cancer survivors 18–39 years old. Methods: Participants were YAs in a large cohort study that completed questionnaires every 2 months for 1 year. Social isolation, aspects of social connectedness (i.e., companionship, emotional support, instrumental support, and informational support), depression, and anxiety were assessed with Patient-Reported Outcomes Measurement Information System short form measures. Mixed-effect models were used to evaluate changes over time. Confirmatory factor analysis and multilevel structural equation modeling were used to define social connectedness as a latent construct and determine whether relationships between social isolation and psychological distress were mediated by social connectedness. Results: Participants (N = 304) were mean (M) = 33.5 years old (SD = 4.7) and M = 4.5 years (SD = 3.5) post-initial cancer diagnosis. Most participants were female (67.4%) and non-Hispanic White (68.4%). Average scores for social well-being and psychological distress were within normative ranges and did not change (p values >.05). However, large proportions of participants reported at least mild social isolation (27%–30%), depressive symptoms (36%–37%), and symptoms of anxiety (49%–51%) at each time point. Across participants, more social isolation was related to less social connectedness (p values <.001), more depressive symptoms (p <.001), and more symptoms of anxiety (p <.001). Social connectedness mediated the relationship between social isolation and depression (p =.004), but not anxiety (p >.05). Conclusions: Social isolation and connectedness could be intervention targets for reducing depression among YA cancer survivors.
AB - Background: Social isolation and social connectedness are health determinants and aspects of social well-being with strong associations with psychological distress. This study evaluated relationships among social isolation, social connectedness, and psychological distress (i.e., depression, anxiety) over 1 year in young adult (YA) cancer survivors 18–39 years old. Methods: Participants were YAs in a large cohort study that completed questionnaires every 2 months for 1 year. Social isolation, aspects of social connectedness (i.e., companionship, emotional support, instrumental support, and informational support), depression, and anxiety were assessed with Patient-Reported Outcomes Measurement Information System short form measures. Mixed-effect models were used to evaluate changes over time. Confirmatory factor analysis and multilevel structural equation modeling were used to define social connectedness as a latent construct and determine whether relationships between social isolation and psychological distress were mediated by social connectedness. Results: Participants (N = 304) were mean (M) = 33.5 years old (SD = 4.7) and M = 4.5 years (SD = 3.5) post-initial cancer diagnosis. Most participants were female (67.4%) and non-Hispanic White (68.4%). Average scores for social well-being and psychological distress were within normative ranges and did not change (p values >.05). However, large proportions of participants reported at least mild social isolation (27%–30%), depressive symptoms (36%–37%), and symptoms of anxiety (49%–51%) at each time point. Across participants, more social isolation was related to less social connectedness (p values <.001), more depressive symptoms (p <.001), and more symptoms of anxiety (p <.001). Social connectedness mediated the relationship between social isolation and depression (p =.004), but not anxiety (p >.05). Conclusions: Social isolation and connectedness could be intervention targets for reducing depression among YA cancer survivors.
KW - anxiety
KW - depression
KW - multilevel structural equation modeling
KW - social connectedness
KW - social isolation
KW - young adult cancer survivors
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U2 - 10.1002/cncr.35508
DO - 10.1002/cncr.35508
M3 - Article
C2 - 39097814
AN - SCOPUS:85200105715
SN - 0008-543X
VL - 130
SP - 4127
EP - 4137
JO - Cancer
JF - Cancer
IS - 23
ER -