5 - (OP6) Psychological Predictors of Fear of Disease Progression Across Rheumatic Disease, Cancer and Type 1 Diabetes

Fear of progression (FOP) was originally defined as “fear, worry or concern relating to the possibility that cancer will come back or return”. While initially this construct was studied in those with cancer, emerging research suggests that FOP may be a transdiagnostic construct, which is also relevant to those with chronic and progressive conditions. However, research is yet to examine whether shared mechanisms contributing to FOP are present across illness groups. Importantly, if shared mechanisms were identified this would strengthen the argument that FOP is a transdiagnostic construct and help to inform intervention development. This study investigated the psychological predictors of FOP across adults with rheumatic conditions, cancer and type 1 diabetes. A total of 773 participants completed this study (152 with a rheumatic condition, 208 with cancer and 195 with type 1 diabetes). Participants were administered several online questionnaires which measured their FOP, as well as psychological mechanisms, including health-threat interpretation bias, death anxiety, meta-cognitions, illness-related intrusions, responses to intrusions and body threat monitoring. Hierarchical regression analyses were then conducted in each group to identify predictors of FOP, controlling for demographics and symptom severity. The final regression models explained a large proportion of variance in FOP (ranging from 47-54%). Across all illnesses, symptom severity and the tendency to ruminate in response to intrusions emerged as significant predictors of FOP. In both the rheumatic and cancer groups, intrusions about disease progression were also predictive of FOP. Alternatively, in those with type 1 diabetes, negative beliefs about worry and body threat monitoring also significant predicted greater FOP concerns. Taken together, these findings demonstrate that FOP may be maintained by a combination of both shared and illness-specific psychological mechanisms. As a result, interventions which target maladaptive responses to intrusive thoughts may have transdiagnostic utility. However, these results also highlight the need for intervention to target illness-specific factors such as meta-cognitions and excessive body threat monitoring in type 1 diabetes.