Background: Due to their young age upon entering ‘survivorship’, addressing adaptation to life after cancer is critical for adolescents and young adults (AYAs). Unfortunately, AYAs may experience more long-lasting distress than other age-groups. Little research has examined cognitive factors that account for individual differences in AYAs’ resilience after cancer. Research suggests that the ability to integrate the cancer experience into personal memory, and into an ongoing sense-of-self in the future, promotes good adaptation. Particularly important is the ability to recall specific instances of adaptive coping in the past, in order to be able to clearly envisage such adaptive coping in the future. One factor that may impede these processes is rumination – a maladaptive thinking style associated with depression. This study examined the role of rumination on autobiographical memory and illness-related future thinking.
Methods: A non-clinical sample of N=60 high and low health-anxious undergraduate students was used as an analogue model for post-cancer illness concerns (e.g., fear of recurrence). The effects of maladaptive thinking were mimicked experimentally using a rumination induction. Participants also completed two illness-focused autobiographical memory and future imaginings tasks.
Results: Engaging in ruminative thinking led to more vivid illness-related memories, particularly amongst high health anxious participants (p=0.015). However, rumination also predicted more general, avoidant health-related future thinking (p=0.000). Greater preoccupation with illness-related memories was associated with more negative, illness-related future thinking (p=0.000). Participants with more illness-related future thinking were more likely to expect a serious illness (e.g., cancer) diagnosis, in the next five years (p=0.002).
Conclusions: The way young people remember illness-related events significantly alters how they picture their future. Engaging in ruminative thinking led to health-related future thinking that was more general and avoidant in nature. These findings implicate rumination as a viable process to target in the treatment of post-cancer illness concerns in AYAs.