Study of Anxiety and Avoidance of Others in Patients Previously Treated for Head and Neck Cancer

Study Overview
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Brief Summary
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RATIONALE: Patients who undergo treatment for head and neck cancer may become anxious and avoid contact with other people. Learning how cancer treatment may cause anxiety in patients with head and neck cancer may help improve the quality of life in these patients. PURPOSE: This clinical trial is studying anxiety and avoidance of others in patients previously treated for head and neck cancer.

Detailed Description
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OBJECTIVES: Determine the relationship between treatment-provoked social anxiety and avoidance in patients previously treated for head and neck cancer. Determine the relationship between pre-cancer psychiatric diagnosis and post-treatment social anxiety and avoidance in these patients. Determine the effect of social anxiety and/or avoidance on the quality of life of these patients. Investigate the specificity of these relationships in patients with head and neck cancer by comparing patients with head and neck cancer to patients with lung cancer. OUTLINE: This is a cross-sectional study. Patients are stratified according to prior treatment type (significantly impairing [surgery] vs less impairing [chemotherapy/radiotherapy]). Patients undergo a face-to-face interview with a mental health clinician over 2 hours. Patients complete multiple psychiatric/psychological assessments during the interview, including the Structured Clinical Interview for DSM-IV (SCID); the Liebowitz Social Anxiety Scale (SAS); the Performance Status Scale for Head and Neck Cancer Patients (PSS-HN); the Social Phobia and Anxiety Inventory (SPAI); the State-Trait Anxiety Inventory (STAI); Response to Stress Questionnaire, Cancer Version (RSQ-CV); the Functional Assessment of Cancer Therapy (FACT-HNC (head neck cancer) or LC); the Voice Handicap Index (VHI); and the Body Image Scale (BIS). Cancer treatment and medical history information are gathered from patients' medical records.

Official Title
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Social Anxiety and Avoidance in Head and Neck Cancer Patients

Conditions
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Anxiety Disorder, Head and Neck Cancer, Lung Cancer

Intervention / Treatment
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* Other: Medical chart review
* Other: Liebowitz Social Anxiety Scale and the Social Phobia and Anxiety Inventory
* Procedure: management of therapy complications
* Procedure: Structured Clinical Interview for the Diagnostic and Statistical Manual-IV SCID
* Other: Functional Assessment of Cancer Therapy-General (FACT-G)


Participation Criteria
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Eligibility Criteria
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PATIENT CHARACTERISTICS: Diagnosis of 1 of the following: Head and neck cancer Lung cancer (control group) Must have received treatment for head and neck cancer or lung cancer within the past 5 years PATIENT CHARACTERISTICS: Able to speak and read English to answer surveys, interviews, and questionnaires PRIOR CONCURRENT THERAPY: See Disease Characteristics

Ages Eligible for Study
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Minimum Age: 21 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: Medical chart review|medical chart review|
|Other: Liebowitz Social Anxiety Scale and the Social Phobia and Anxiety Inventory|survey administration|
|Procedure: management of therapy complications|management of therapy complications|
|Procedure: Structured Clinical Interview for the Diagnostic and Statistical Manual-IV SCID|psychosocial assessment|
|Other: Functional Assessment of Cancer Therapy-General (FACT-G)|survey administration|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Level of social anxiety and avoidance in HNC patients post-treatment | Measured by the Liebowitz Social Anxiety Scale and the Social Phobia and Anxiety Inventory, containing 24 items with each item separately rated for fear as 0 (none), 1 (mild), 2 (moderate) to 3 (severe)and for avoidance behavior as 0 (never), 1 (occasionally), 2 (often), to 3 (usually). Scores are summed with lower values indicating lower levels of social anxiety and avoidance. | at study entry, day 1 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Relationship between pre-cancer psychiatric diagnosis and post-treatment social anxiety and avoidance | Assessed using the Structured Clinical Interview for the Diagnostic and Statistical Manual-IV SCID lifetime diagnostic status (pre-cancer diagnosis) and related to the outcome for social anxiety measures. The SCID does not involve a specific scoring of responses. Trained interviewers ask questions that may involve yes/no answers or more detailed explanations. They make their diagnoses based on their experience and training. For this outcome, interviews results will be compared to and contrasted with scores on the Liebowitz Social Anxiety Scale and Social Phobia and Anxiety Inventory. | at study entry | 
| Quality of Life | Each patient is scored on the Functional Assessment of Cancer Therapy-General (FACT-G) with 4 related sub-scales (physical, social/family, emotional, functional well-being. To generate sub-scale scores, physical and emotional items are reverse coded and items are then summed, such that higher values indicate better quality of life. Thus, each sub-scale score ranges from 0 (not at all, worse outcome) to 4 (very much, better outcome) with a minimum total score of 0 (worst quality of life) to a maximum of 16 (good quality of life). | at study entry, day 1 | 
| Comparison of social anxiety and avoidance in patients with head and neck cancer to patients with lung cancer | Measured by the Liebowitz Social Anxiety Scale and the Social Phobia and Anxiety Inventory, containing 24 items with each item separately rated for fear as 0 (none), 1 (mild), 2 (moderate) to 3 (severe)and for avoidance behavior as 0 (never), 1 (occasionally), 2 (often), to 3 (usually). Scores are summed with lower values indicating lower levels of social anxiety and avoidance. Scores in study participants will be compared to scores in studies of social anxiety and avoidance in lung cancer patients | at study entry, day 1 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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anxiety disorder, long-term effects secondary to cancer therapy in adults, head and neck cancer, non-small cell lung cancer, small cell lung cancer