Commentary: Psychosocial screening and assessment in oncology and palliative care settings

Citation: Nissen KG (2015) Commentary: Psychosocial screening and assessment in oncology and palliative care settings. Depression and anxiety are common in patients with cancer and psychosocial screening in oncology and palliative care settings is suggested as a means to reduce emotional distress in cancer situations (Grassi et al., 2014). In their study, Grassi and colleagues report the results of a review investigating factors associated with depression and anxiety in cancer patients. As regards psychosocial screening, the findings are reassuring: assessment of distress enables the practitioner to attend to symptomatology, interpersonal dynamics and cultural aspects of distress, which captures distress as a multifaceted phenomenon. In particular, focusing on the interpersonal aspects, for example attachment, is highlighted as a way to detect distress. There is a long-standing tradition of attachment research within developmental and clinical psychology, but in the field of the psychosocial dimensions of cancer, studies of attachment are of only rather recent of origin. Introducing established attachment measures into health psychology seems, prima facie, a promising avenue. However, important theoretical and conceptual knowledge derived from investigating adult attachment in the contexts of clinical and developmental psychology has been omitted in the transition to the setting of health psychology. Ultimately, this has led to an uncertainty of the fundamental nature of attachment, as is also pointed out by Grassi et al. (2014) in their evaluation of attachment research in the fields of oncology and palliative care. They avoid conceptualizing and defining attachment and important questions therefore remain; to which definition of attachment do the authors adhere? How do they conceptualize attachment? What is the convergence between their definition and the conceptualization? Grassi and colleagues state that " the way in which the patient has experienced early relations with caregiving figures in the past relates to her view of herself and to the expectation (.. .). " The description of attachment is relevant to the understanding of the phenomenon, and the quotation above indicates that Grassi et al. consider past experiences to be crucial to the attachment construct. They emphasize past relationships in their description of attachment and they make reference to a self-report instrument for measuring attachment, namely the Experience in Close Relationships questionnaire (ECR). Historically, attachment research has split into two schools using two distinct methodological approaches, i.e., the social psychology tradition and the development of parent-child relations from the child psychology tradition (Bouthillier et al., 2002; Ravitz et al., …