Emotion dynamics as indicators of maladaptive emotions in patients with cancer

PURPOSE: Patients with cancer frequently experience a wide range of emotions in response to their diagnosis and treatment. Emotions are essentially adaptive, helping patients to cope with the disease. In a minority of patients, however, emotions may become maladaptive and warrant professional mental healthcare. In the field of psycho-oncology, the intensity of emotions is used to distinguish between adaptive and maladaptive emotions. Emotion dynamics (that is changes in emotions over time) may provide additional information on the adaptiveness of the emotions. The aim of this study was to investigate whether emotion dynamics (specifically inertia, variability, and instability) as well as emotion intensity are indicators of maladaptive emotions. METHOD: Patients with a solid malignancy (metastatic and non-metastatic disease; n = 132) were categorized as having adaptive or maladaptive emotions based on one of two reference standards: the psychiatric diagnostic assessment or the subjective need for professional mental healthcare. Patients reported on eight negative emotional symptoms for 14 days using Ecological Momentary Assessment on their mobile phone. Autocorrelation (inertia), standard deviation (variability), root mean square successive differences (instability), and emotional intensity were compared between patients with adaptive or maladaptive emotions using t-tests. RESULTS: Variability and instability as well as intensity were higher in patients with maladaptive emotions, compared to patients with adaptive emotions. Little evidence was found that patients with maladaptive emotions experienced more emotional inertia. CONCLUSION: This is the first study to report that in patients with cancer, emotional instability and variability are indicators of maladaptive emotions, in addition to the intensity of emotions.