ORIGINAL RESEARCH article
Front. Psychol.
Sec. Psycho-Oncology
Psychological flexibility and its correlations with and predictive utility for emotional well-being, fatigue, insomnia, and post-traumatic growth in cancer patients undergoing treatment
Francisco Garcia-Torres 1
Angel Gómez Solís 2
Rosario Castillo-Mayén 3
Raquel Espejo Siles 3
Francisco Jurado González 3
Marcin Jacek Jablonski 4
Daniel Bernabé 5
María José Jaén Moreno 3
Enrique Aranda 2
1. University of Cordoba, Córdoba, Spain
2. Hospital Universitario Reina Sofia, Córdoba, Spain
3. Universidad de Cordoba, Córdoba, Spain
4. Wydawnictwo Uniwersytetu Jana Kochanowskiego w Kielcach, Kielce, Poland
5. São Paulo State University (UNESP),, São Paulo, Brazil
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Abstract
Objective: The use of acceptance and commitment therapy has shown favourable results in cancer patients. However, the role of psychological flexibility has yet to be determined. Methods: 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. Results: 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 posttraumatic growth. Fatigue was related to insomnia. Conclusion: Psychological flexibility appears to be a relevant variable to be taken into account in the treatment of cancer patients.
Summary
Keywords
Cancer, Fatigue, insomnia, oncology, post-traumatic-growth, Psychological flexibility
Received
16 December 2025
Accepted
17 February 2026
Copyright
© 2026 Garcia-Torres, Solís, Castillo-Mayén, Siles, González, Jablonski, Bernabé, Jaén Moreno and Aranda. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Francisco Garcia-Torres; María José Jaén Moreno
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