Decisional conflict and physiological dysregulation among adolescents and young adults with cancer.

PURPOSE: Adolescents and young adults with cancer (AYA) are faced with making several cancer-related decisions daily (e.g. managing pain/fatigue). Many of these decisions involve uncertainty (e.g. feeling uninformed about alternatives, feeling unsupported about making a choice), even under ideal conditions that have implications for health (e.g. wear and tear on the body). The present study examined relationships between decisional conflict within cancer-related decision-making and physiological responding.

METHODS

Participants included 18 AYAs on active cancer treatment, diagnosed within the past 2 years. Participation included two days of salivary samples (assessing cortisol) followed by a 7-day collection of decisional conflict within cancer-related decision-making. Associations between decisional conflict and the cortisol awakening response (CAR) were examined.

RESULTS

Decisional conflict was significantly associated with a smaller (i.e. blunted) cortisol awakening response, reflecting cortisol dysregulation.

CONCLUSION

Results from this study add to an emerging body of literature focused on the role of decisional conflict and physiological stress responding enhancing our understanding of decisional processes that may impact stress systems among AYAs undergoing cancer treatment.