# Psychological flexibility and its correlations with and predictive utility for emotional wellbeing, fatigue, insomnia, and post-traumatic growth in cancer patients undergoing treatment

**Authors:** Francisco García-Torres, Ángel Gómez-Solís, Rosario Castillo-Mayén, Raquel Espejo-Siles, Francisco Jurado-González, Marcin Jablonski, Daniel Galera Bernabé, María José Jaén-Moreno, Enrique Aranda

PMC · DOI: 10.3389/fpsyg.2026.1768998 · Frontiers in Psychology · 2026-03-12

## TL;DR

This study explores how psychological flexibility relates to emotional wellbeing and other factors in cancer patients undergoing treatment.

## Contribution

The study identifies psychological flexibility as a predictor of fatigue, anxiety, and insomnia in cancer patients.

## Key findings

- Psychological flexibility correlates with and predicts fatigue, anxiety, and depression in cancer patients.
- Anxiety is significantly related to depression, fatigue, and insomnia.
- Fatigue is linked to insomnia, but psychological flexibility does not predict post-traumatic growth.

## Abstract

The use of acceptance and commitment therapy has shown favorable results in cancer patients. However, the role of psychological flexibility has yet to be determined.

Patients with breast, colorectal, lung and gynaecological cancers in active treatment in stages I-III were invited to complete questionnaires assessing psychological flexibility (AAQ-II), anxiety and depression (HADS), fatigue (BFI), insomnia (ISI) and post-traumatic growth (PTGI-SF). Correlation and regression analyses were performed controlling for possible confounding variables.

One-hundred and fifty patients completed the questionnaires. The majority were married women with stage III breast cancer, primary-level education and a mean age of 53. On average, 18 months had passed since diagnosis, and surgery, chemotherapy and radiotherapy were the most frequent treatments. Results showed psychological flexibility correlated with and had predictive ability for fatigue, anxiety, depression and insomnia, but not for post-traumatic growth. Anxiety was significantly related to depression, fatigue and insomnia, and depression to fatigue, insomnia and post-traumatic growth. Fatigue was related to insomnia.

Psychological flexibility appears to be a relevant variable to be taken into account in the treatment of cancer patients.

## Linked entities

- **Diseases:** breast cancer (MONDO:0004989), colorectal cancer (MONDO:0005575), lung cancer (MONDO:0005138)

## Full-text entities

- **Diseases:** breast, colorectal, lung and gynaecological cancers (MESH:D001943), Fatigue (MESH:D005221), Anxiety (MESH:D001007), ISI (MESH:D007319), cancer (MESH:D009369), depression (MESH:D003866)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## References

36 references — full list in the complete paper: https://tomesphere.com/paper/PMC13017947/full.md

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Source: https://tomesphere.com/paper/PMC13017947