Intolerance of uncertainty, psychological symptoms, and pain in long-term childhood cancer survivors: a report from the Childhood Cancer Survivor Study
Menée à partir de données portant sur 228 adultes ayant survécu à un cancer pédiatrique (âge moyen : 39,6 ans), cette étude analyse l'association entre l'intolérance à l'incertitude, des symptômes psychiques et la douleur
Purpose: Intolerance of uncertainty is central to many psychological disorders and may contribute to pain. Despite the uncertainty inherent in childhood cancer survivorship, little is known about intolerance of uncertainty in this population. This study aimed to characterize intolerance of uncertainty, its risk factors, and its associations with psychological symptoms and pain in childhood cancer survivors.
Methods: Survivors from the Childhood Cancer Survivor Study completed psychosocial measures via online survey, including the Intolerance of Uncertainty Scale-12 (score range = 12–60). Cancer and treatment variables were abstracted from medical records. Multivariable regression models with 95% confidence intervals (CI) adjusted for age and sex examined the effects of demographic, disease, treatment, pain, and psychological variables on intolerance of uncertainty.
Results: Participants included 228 adult survivors of childhood cancer (mean age = 39.6 years, 50.4% female, n = 93 chronic pain). Mean level of intolerance of uncertainty among survivors was 26.2 (SD = 10.0, 95% CI 24.9 to 27.5). Intolerance of uncertainty was associated with female sex (
β [95% CI]; 2.7 [0.2
–5.3]), unemployment (5.2 [1.9–8.5]), neurologic (4.1 [0.5–7.7]) and cardiovascular (5.0 [2.2–7.8]) chronic health conditions, elevated anxiety (10.9 [8.1–13.7]), and perceived poor health status (4.5 [1.4–7.6]). Higher levels of intolerance of uncertainty were observed in survivors with chronic pain (LS mean = 29.2) compared to survivors without (LS mean = 23.5; p < 0.01).
Conclusions: Mean levels of intolerance of uncertainty in childhood cancer survivors are comparable to the general population and associated with psychological symptoms and chronic pain.
Implications for Cancer Survivors: Intolerance of uncertainty may be a modifiable target for transdiagnostic interventions in survivorship care.
Journal of Cancer Survivorship , résumé, 2025