(PS5-25) Elucidating Anxiety in the AYA Cancer Survivorship Experience (EASE): Approach and Methodology

The survival rate among adolescents and young adults (AYA) with cancer is currently 85% and continues to increase, bringing forth larger cohorts of the nearly 86,000 AYAs diagnosed annually who are living with the long-term physical and psychological impacts of cancer. An estimated 1 in 3 AYA cancer survivors experience anxiety, which far surpasses the rates of similar-aged, non-cancer peers. Given that adolescence and young adulthood represent the typical onset periods for anxiety disorders, these survivors are already at a heightened susceptibility for developing anxiety, which is then compounded by the stress of cancer treatment.

Existing research predominantly relies on self-report measures, failing to capture the nuanced experiences of AYA cancer survivors. Our study diverges from this norm, employing both a diagnostic clinical interview and in-depth qualitative interview informed by a cognitive-behavioral framework to comprehensively evaluate anxiety among AYA cancer survivors. This dual-faceted approach allows us to systematically assess diagnostic severity and degree of alignment with traditional diagnostic conceptualizations as well as more flexibly inquire about the origins, temporal evolution, triggers, automatic thoughts, and behaviors associated with their anxiety.

The Anxiety and Related Disorders Interview Schedule (ADIS-5), a validated and reliable structured diagnostic assessment, will be administered by a doctoral level student clinician at the initial visit. A second visit will be scheduled within 7 days of the first, which will consist of the semi-structured qualitative interview. Crafted in line with the cognitive-behavioral model, the qualitative interview aims to capture the cognitive processes, emotional responses, and maladaptive behavioral patterns that contribute to survivors' anxiety presentations.

The combination of utilizing a well-established clinical assessment and a theoretically informed qualitative interview will facilitate the translation of our findings into immediate clinical practice. Specifically, we anticipate our results will guide providers in applying cognitive-behavioral therapy (CBT) techniques, recognized for their effectiveness in treating anxiety disorders, to support young survivors with anxiety. By centering the voices of this vulnerable population, our aim is to gain deeper insights into their unique experiences with anxiety, allowing us to tailor interventions that resonate with their distinct psychological needs. Ultimately, our goal is to improve long-term mental health outcomes for AYA cancer survivors.