Depression and insomnia are the most frequent psychological problems among cancer patients. Some studies report that cognitive schemas may differ in the presence of a serious disease such as cancer, even with the development of the same symptoms of depression and insomnia. The understanding of cognitive schema is a critical component for cognitive behavioral therapy, since its main goal is to reconstruct maladaptive thoughts. In this study, cancer patients and healthy participants experiencing similar levels of depression and insomnia were compared to investigate if there were differences in cognitive schema depending on the presence of cancer. A total of 65 cancer patients (42: experiencing depression, 23: experiencing insomnia), 64 people experiencing depression and insomnia without a cancer diagnosis (22: experiencing depression, 42: experiencing insomnia) and 176 people with no cancer and no psychological problems (98: no depression 78: no insomnia) were recruited. To compare differences in cognitive schema, the dysfunctional attitudes scale, positive automatic thought scale and a computer task measuring emotional bias were administered. To analyze the difference in cognitive schema in the presence of cancer, the groups were classified by matching cancer patients to healthy participants complaing of similar levels of depression and insomnia. A one-way ANOVA showed that the depressed cancer patients had significantly higher levels of dysfunctional cognitive schema than the depressed healthy participants (negative bias, dysfunctional attitude). Also, the cancer patients experiencing insomnia showed significantly higher levels of negative bias than the healthy participants experiencing insomnia without cancer. This study implies that people with depressive symptoms and insomnia symptoms with cancer have higher levels of dysfunctional cognitive schema than those without cancer.
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