Background: The Common-Sense Model of illness self-regulation underpins illness-specific cognitions (including both illness perceptions and a fear of cancer recurrence; FCR). There is evidence in adults of associations between FCR, illness perceptions, and mental health in adult cancer survivors. However, there is limited empirical research examining these constructs within the developmentally distinct population of adolescent and young adult (AYA) survivors of cancer. The current study aimed to bridge that gap to inform potentially modifiable treatment targets in this population. Method: A cross-sectional, correlational design was used to examine the associations between illness perceptions, FCR, and mental health. A web-based survey was completed by a convenience sample of AYA survivors. Regression and mediation analyses were performed. Results: Overall, more negative illness perceptions were associated with more severe FCR and greater depressive and anxiety symptomatology. Higher FCR was predictive of worse overall mental health. More negative overall illness perceptions predicted the relationship between FCR-depression, mediating 24.1% of the variance. Contrastingly, overall illness perceptions did not predict or mediate the relationship between FCR-anxiety. However, the specific illness perceptions regarding timeline, personal control, and emotional representation, were predictive of the FCR-anxiety relationship. Discussion: Illness perceptions and FCR were predictive of mental health outcomes. Identifying and therapeutically targeting negative illness perceptions in those young adults who have survived adolescent cancer could therefore be a means of reducing anxiety and depressive symptomatology. Limitations and future directions are discussed.

中文翻译：

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青少年和年轻癌症幸存者的疾病认知、对癌症复发的恐惧以及心理健康。

背景：疾病自我调节的常识模型支撑着特定疾病的认知（包括疾病认知和对癌症复发的恐惧；FCR）。有证据表明，成人癌症幸存者的 FCR、疾病认知和心理健康之间存在关联。然而，在发育独特的青少年和年轻成人 (AYA) 癌症幸存者群体中检验这些结构的实证研究有限。目前的研究旨在弥合这一差距，为该人群提供潜在可修改的治疗目标。方法：采用横断面相关设计来​​检验疾病认知、FCR 和心理健康之间的关联。一项基于网络的调查是通过 AYA 幸存者的方便样本完成的。进行了回归和中介分析。结果：总体而言，更消极的疾病认知与更严重的 FCR 以及更严重的抑郁和焦虑症状相关。较高的 FCR 预示着整体心理健康状况较差。更消极的整体疾病认知预测了 FCR 与抑郁之间的关系，调节了 24.1% 的方差。相比之下，总体疾病认知并不能预测或调节 FCR 与焦虑之间的关系。然而，关于时间线、个人控制和情绪表征的具体疾病认知可以预测 FCR-焦虑关系。讨论：疾病认知和 FCR 可预测心理健康结果。因此，识别和治疗那些从青少年癌症中幸存下来的年轻人的负面疾病认知可能是减少焦虑和抑郁症状的一种方法。讨论了局限性和未来的方向。