Posttraumatic growth, positive psychology, perceived spousal support, and psychological complications in head and neck cancer: Evaluating their association in a longitudinal study

Head and neck cancer (HNC) specifically, refers to malignant tumor which develop around the head and neck area, such as the throat, mouth, nose and ear. HNC contributes to a wide range of psychosocial issues, such as depression, anxiety, substance use disorder, suicide, conflict in interpersonal relationship, damage to self-esteem, social isolation, and facial disfigurement. Hence, it is associated with various psychological complications such as depression, anxiety and posttraumatic stress disorder. Notwithstanding to these negative impacts of HNC, positive psychology such as posttraumatic growth (PTG), hope, and optimism have been reported in HNC patients. Higher degree of positive psychology may resulting in better appreciation of life, improved interpersonal relationship, greater spiritual development, more possibilities in life, and enhancement of the personal strength of HNC patients. However, data on how positive psychology is related to psychological complications of HNC across time is lacking. This longitudinal study examined the trends of positive psychology (such as PTG, hope, and optimism), perceived spousal support, and psychological complications (such as depression, anxiety, and posttraumatic stress symptoms); and determined the association between these positive psychology, psychological complications, and PTG across two timelines among a cohort of HNC patients. We found that a total of 175 HNC respondents exhibited increasing trend of positive psychology and perceived spousal support, while reported reducing trend of psychological complications between baseline and follow up assessments. Greater degree of hope and perceived spousal support contributed to higher degree of PTG across time. Conversely, higher severity of anxiety symptoms was associated with lower degree of PTG over time. This study indicates the pivotal role of incorporating psychosocial interventions into the treatment regimen to enhance the degree of hope and perceived spousal support as well as reducing anxiety symptoms severity, which in turn will facilitate the development of PTG and improve the mental well-being of HNC patients.