{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T13:10:39Z","timestamp":1779887439093,"version":"3.53.1"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psycho-Oncology"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study tested (1) whether intolerance of uncertainty (IU) and negative metacognitive beliefs independently differentiate fear of cancer recurrence (FCR) status, and (2) whether mediation by cognitive\u2010attentional syndrome (CAS) elements modify the relationships of IU and metacognitive beliefs with FCR status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Baseline data from 384 participants (collected \u223c15.6\u00a0months post\u2010diagnosis) pooled from a prospective longitudinal study and an FCR intervention trial were analyzed. Measures included FCRI\u2010SF (FCR), MCQ\u201030 (metacognitive beliefs), IUS\u201012 (IU), and CAS\u20101 (CAS). FCR status was classified based on the FCRI\u2010SF scores as non\u2010clinical (&lt;\u00a013), subclinical (13\u201321), and clinically significant (\u2265\u00a022). Fully adjusted multinomial logistic regression examined direct effects of IU and metacognitive domains on FCR status and indirect effects via CAS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared to the non\u2010clinical group (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0116), subclinical (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0190) and clinically\u2010significant (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a078) FCR groups showed greater negative beliefs about worry (OR range 1.297\u20131.500,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), higher IU (OR 1.050\u20131.066,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.037), increased use of CAS metacognitive strategies (OR 1.077\u20131.108,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.021\u2010&lt;\u00a00.001), and less perceived need to control thoughts (OR 0.847\u20130.857,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.003\u20130.027). Clinically\u2010significant FCR was additionally associated with poorer cognitive confidence (OR 1.122,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.030). CAS partially mediated associations of FCR status with negative beliefs about worry, cognitive confidence, and IU, and fully mediated the association with need to control thoughts.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>IU and negative metacognitive beliefs can characterize individuals vulnerable to differentially\u2010elevated FCR. CAS centrally mediates the relationships between FCR, IU, and metacognition. Cognitive\u2010behavioral interventions for FCR explicitly targeting CAS should disrupt the impact of IU and metacognitive beliefs on FCR.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pon.70475","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T12:35:01Z","timestamp":1777466101000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Role of Metacognition, Intolerance of Uncertainty, and Cognitive\u2010Attentional Syndrome in Differentiating Fear of Cancer Recurrence"],"prefix":"10.1002","volume":"35","author":[{"given":"Wendy W. T.","family":"Lam","sequence":"first","affiliation":[{"name":"Division of Behavioural Sciences Centre for Psycho\u2010Oncological Research and Training School of Public Health The University of Hong Kong  Hong Kong Hong Kong"},{"name":"LKS Faculty of Medicine HKU Jockey Club Institute of Cancer Care The University of Hong Kong  Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4919-0610","authenticated-orcid":false,"given":"Danielle W. L.","family":"Ng","sequence":"additional","affiliation":[{"name":"Division of Behavioural Sciences Centre for Psycho\u2010Oncological Research and Training School of Public Health The University of Hong Kong  Hong Kong Hong Kong"},{"name":"LKS Faculty of Medicine HKU Jockey Club Institute of Cancer Care The University of Hong Kong  Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ceci","family":"Guo","sequence":"additional","affiliation":[{"name":"Division of Behavioural Sciences Centre for Psycho\u2010Oncological Research and Training School of Public Health The University of Hong Kong  Hong Kong Hong Kong"},{"name":"LKS Faculty of Medicine HKU Jockey Club Institute of Cancer Care The University of Hong Kong  Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Ng","sequence":"additional","affiliation":[{"name":"Division of Behavioural Sciences Centre for Psycho\u2010Oncological Research and Training School of Public Health The University of Hong Kong  Hong Kong Hong Kong"},{"name":"LKS Faculty of Medicine HKU Jockey Club Institute of Cancer Care The University of Hong Kong  Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Fielding","sequence":"additional","affiliation":[{"name":"Division of Behavioural Sciences Centre for Psycho\u2010Oncological Research and Training School of Public Health The University of Hong Kong  Hong Kong Hong Kong"},{"name":"LKS Faculty of Medicine HKU Jockey Club Institute of Cancer Care The University of Hong Kong  Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi Chung","family":"Foo","sequence":"additional","affiliation":[{"name":"Department of Surgery The University of Hong Kong  Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ava","family":"Kwong","sequence":"additional","affiliation":[{"name":"Department of Surgery The University of Hong Kong  Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5389-9297","authenticated-orcid":false,"given":"Siu\u2010Man","family":"Simon Ng","sequence":"additional","affiliation":[{"name":"Department of Surgery The Chinese University of Hong Kong  Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dacita","family":"Suen","sequence":"additional","affiliation":[{"name":"Department of Surgery The University of Hong Kong  Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2885-3369","authenticated-orcid":false,"given":"Sara","family":"Fung","sequence":"additional","affiliation":[{"name":"Department of Surgery Kwong Wah Hospital Hong Kong Hospital Authority  Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oi Kwan","family":"Chun","sequence":"additional","affiliation":[{"name":"Department of Surgery Kwong Wah Hospital Hong Kong Hospital Authority  Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen K. L.","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Obstetric and Gynaecology The University of Hong Kong  Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy W. L.","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology The University of Hong Kong  Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy T. Y.","family":"Chang","sequence":"additional","affiliation":[{"name":"Comprehensive Oncology Centre Hong Kong Sanatorium &amp; Hospital  Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520\u2010016\u20103272\u20105"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5921"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2009.22.5151"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2017.06.003"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.4880"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.4168"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0005\u20107967(96)00050\u20102"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/16506070902991791"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.3252"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.3659"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5073"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520\u2010018\u20104294\u2010y"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.70076"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10865\u2010019\u201000129\u2010x"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5234"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11764\u2010015\u20100512\u20105"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11031\u2010019\u201009774\u2010w"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2016.02.007"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2011.05.001"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2013.01.006"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10608\u2010005\u20101648\u20109"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888\u2010024\u201006201\u20104"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.6102"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5976"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2010.04.003"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102022\u2010065075"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1159\/000547888"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520\u2010008\u20100444\u2010y"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2006.03.014"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s41811\u2010019\u201000056\u20104"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.12691\/ajams\u20108\u20102\u20101"},{"key":"e_1_2_10_33_1","volume-title":"Methodology in the Social Sciences","author":"Hayes A. 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