Cancer during the adolescent and young adult (AYA) years disrupts a developmentally formative life period, and can significantly impede young people’s goals and plans for the future.1 This can result in a sense of ‘biographical disruption’ at a time where young people are at the cusp of entering adulthood; however, how this may impact AYAs subsequent adjustment is unknown. This study explored the impact of a cancer experience on how AYAs think about their ‘life story’, sense of self, and futures.
The two aims were to examine: 1) how the life stories and imagined futures of AYAs with, and without, cancer differ; and 2) the relationship between AYAs’ current psychological distress, life stories and imagined future events.
Twenty-five AYAs with cancer (AYAC) and 60 healthy AYA controls completed structured interviews involving the validated Life Narrative Task and Future Imaginings Task. Interviews were audio-recorded and coded for content by two raters. Participants also completed the Depression, Anxiety, Stress Scales-Short Form and the Centrality of Events Scale to examine associations between memory/future imaginings, appraisals about their cancer experience, and current psychological adjustment.
AYACs showed more illness-focused life narratives and future imaginings compared to healthy AYAs. In addition, AYACs with elevated distress showed less specific future imaginings, and had less redemptive life narratives (less positive appraisals), compared to healthy AYAs.
How young people integrate their cancer experience into their life story may significantly impact how they imagine their future lives. This appears to be related to their distress levels. Assisting AYAs to form adaptive appraisals about their cancer experience, and understand how it fits into their life narrative, may promote adjustment in the transition to cancer survivorship. These findings will be used to tailor existing evidence-based interventions to promote adaptation in the aftermath of cancer.