(PS9-24) Association of Self-reported Purpose in Life with Psychological Distress in Cancer Survivors

Background: Purpose in life has been investigated as a correlate and predictor for psychological adjustment to cancer (e.g., Fleer et al., 2006; Vehling et al., 2011). This led to a proliferation of interventions that aim to clarify and increase purpose in life (Park et al., 2019). However, the association between life purpose and psychological distress in cancer survivors has not been investigated on a national scale alongside a wide variety of other germane health factors. The current study aims to cover these gaps by leveraging data from the Health Information National Trends Survey (HINTS) - a large (n = 6,252) nationally representative and cross-sectional survey focused on health behaviors and engagement (Nelson et al., 2004). The most recent iteration of HINTS (collected March – November 2022) is the first time it included a psychometrically-sound measure focused on an individual’s purpose in life: NIH’s PROMIS Meaning & Purpose scale (Salsman et al., 2020). We hypothesize that purpose in life will be inversely associated with self-rated psychological distress (measured by PHQ-4’s anxiety and depressive symptom items) when controlling for other health-related factors including social isolation, patient-centered communication experience with providers, experience seeking cancer-related information, self-rated health status and demographic variables (age, race, education, gender).

Method: Data from HINTS 6 were analyzed using multiple linear regression to assess associations between purpose in life and mental health outcomes for cancer survivors. The current study set an analytical frame around all adults who self-reported cancer history and were not missing data (n=862). HINTS is a publicly available, de-identified dataset; therefore, IRB approval was not required for this study.

Results: When controlling for the aforementioned variables, greater purpose in life was associated with lower psychological distress (β =-.257, p < 0.001). Additionally, social isolation (β =.344, p < 0.001) and self-report of poor to fair (less than good) health (β =.183, p < 0.001) were both associated with psychological distress.

Conclusion: Our study adds to the existing literature by replicating the association between purpose in life and psychological distress for cancer survivors in a large national sample, while controlling for other health-related variables. Brief purpose in life and social isolation screenings in oncology settings should be explored. Additionally, CBT and ACT practitioners working with oncology patients should consider exploring meaning and increasing social connection. CBT has been associated with increased meaning in life among chronic illness populations (e.g., MS; Hajibabaei et al., 2020). ACT’s focus on values and committed action may be particularly useful in this endeavor, as prior research on an ACT intervention found increased psychological flexibility later predicted increased purpose in life among cancer survivors (Arch & Mitchell, 2016). Two limitations of this study are 1) the data are cross-sectional, and causality cannot be interpreted and 2) the definition of cancer survivorship may include current patients as cancer treatment engagement was not explicitly collected in the HINTS.