Goal disturbance and emotional symptoms in patients with cancer
10 affiliations
- 1Department of Psychiatry, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- 2Amsterdam Public Health, Mental Health Program, Amsterdam, The Netherlands
- 3Cancer Centre Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, The Netherlands
- 4Department of Medical Oncology, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- 5Department of Medical Psychology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- 6Department of Medical Oncology, Rijnstate Hospital, Arnhem, The Netherlands
- 7Department of Medical Oncology, Radboud Medical Center, Nijmegen, The Netherlands
- 8Department of Anesthesiology, Radboud Medical Center, Pain and Palliative Care, Nijmegen, The Netherlands
- 9Department of Medical Oncology, Slingeland Ziekenhuis, Doetinchem, The Netherlands
- 10Department of Medical Oncology, Erasmus Medical Center, Rotterdam, The Netherlands
Abstract
Background: Cancer is a major stressor leading to a wide range of emotions. Emotions, also negative emotions, are essentially adaptive, in the sense that they help patients cope with cancer. Emotions can also be maladaptive, if they are disproportionately severe or persistent, or interfere with functioning. Our overall goal was to explore whether disturbance of life goals provides a fruitful framework for developing indicators that can distinguish between adaptive and maladaptive emotions.
Objective: To test the hypotheses that (1) goal disturbance and emotional symptoms are reciprocally and positively associated to each other; and (2) the association between goal disturbance and emotional symptoms is stronger in patients with maladaptive emotions as compared to patients with adaptive emotions.
Methods: Patients with (non)metastasized disease who recently started systemic treatment (n = 132) filled out Ecological Momentary Assessments 5 times per day for 14 consecutive days in which emotional symptoms and activities related to life goals were documented. The importance of life goals in six domains was assessed with an interview (work/study, disease-related health, lifestyle health, social activities, religious, spiritual and intellectual activities, and leisure). Patients were grouped as having adaptive or maladaptive emotions based on a reference standard (a psychiatric diagnostic assessment, or the subjective need for professional mental healthcare). Linear mixed models were built in R, with either goal disturbance or negative emotional symptoms as dependent variable.
Results: Goal disturbance for social activities and leisure activities was significantly associated with more emotional symptoms. Goal disturbance for disease-related health activities was significantly associated with less emotional symptoms. No significant association was found for other activities (with one exception). With negative emotions as outcome variable, goal disturbance was more strongly associated with more emotional symptoms in patients with maladaptive emotions than patients with adaptive emotions for social, leisure and lifestyle health activities.
Conclusion: Further research is warranted to develop an indicator of maladaptive emotions in patients with cancer based on the extent of goal disturbance of social, leisure and lifestyle health activities.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s10865-026-00683-1.
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BibTeX
@article{doppenbergsmit2026goal,
title = {{Goal disturbance and emotional symptoms in patients with cancer}},
author = {G. Elise Doppenberg-Smit and Myra E. van Linde and Femke Lamers and Annemarie M. J. Braamse and Rutger Koornstra and Evelien J. M. Kuip and Mariette Labots and Rune A. W. van de Wetering and Henk M. W. Verheul and Joost Dekker and Adriaan W. Hoogendoorn and Aartjan T. F. Beekman},
journal = {Journal of Behavioral Medicine},
year = {2026},
month = jul,
doi = {10.1007/s10865-026-00683-1},
url = {https://doi.org/10.1007/s10865-026-00683-1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Goal disturbance and emotional symptoms in patients with cancer
AU - G. Elise Doppenberg-Smit
AU - Myra E. van Linde
AU - Femke Lamers
AU - Annemarie M. J. Braamse
AU - Rutger Koornstra
AU - Evelien J. M. Kuip
AU - Mariette Labots
AU - Rune A. W. van de Wetering
AU - Henk M. W. Verheul
AU - Joost Dekker
AU - Adriaan W. Hoogendoorn
AU - Aartjan T. F. Beekman
PY - 2026
DA - 2026/07/08
JO - Journal of Behavioral Medicine
DO - 10.1007/s10865-026-00683-1
UR - https://doi.org/10.1007/s10865-026-00683-1
AB - Background: Cancer is a major stressor leading to a wide range of emotions. Emotions, also negative emotions, are essentially adaptive, in the sense that they help patients cope with cancer. Emotions can also be maladaptive, if they are disproportionately severe or persistent, or interfere with functioning. Our overall goal was to explore whether disturbance of life goals provides a fruitful framework for developing indicators that can distinguish between adaptive and maladaptive emotions. Objective: To test the hypotheses that (1) goal disturbance and emotional symptoms are reciprocally and positively associated to each other; and (2) the association between goal disturbance and emotional symptoms is stronger in patients with maladaptive emotions as compared to patients with adaptive emotions. Methods: Patients with (non)metastasized disease who recently started systemic treatment (n = 132) filled out Ecological Momentary Assessments 5 times per day for 14 consecutive days in which emotional symptoms and activities related to life goals were documented. The importance of life goals in six domains was assessed with an interview (work/study, disease-related health, lifestyle health, social activities, religious, spiritual and intellectual activities, and leisure). Patients were grouped as having adaptive or maladaptive emotions based on a reference standard (a psychiatric diagnostic assessment, or the subjective need for professional mental healthcare). Linear mixed models were built in R, with either goal disturbance or negative emotional symptoms as dependent variable. Results: Goal disturbance for social activities and leisure activities was significantly associated with more emotional symptoms. Goal disturbance for disease-related health activities was significantly associated with less emotional symptoms. No significant association was found for other activities (with one exception). With negative emotions as outcome variable, goal disturbance was more strongly associated with more emotional symptoms in patients with maladaptive emotions than patients with adaptive emotions for social, leisure and lifestyle health activities. Conclusion: Further research is warranted to develop an indicator of maladaptive emotions in patients with cancer based on the extent of goal disturbance of social, leisure and lifestyle health activities. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s10865-026-00683-1.
SN - 0160-7715
SN - 1573-3521
ER -