A pilot randomized controlled trial of cognitive bias modification to reduce fear of breast cancer recurrence
Open accessAbstract
BACKGROUND: The most common, persistent concern among survivors of breast cancer is the fear that their disease will return, yet to the authors' knowledge, few interventions targeting fear of cancer recurrence (FCR) have been developed to date. The current pilot study examined the feasibility, acceptability, and preliminary efficacy of a home‐delivered cognitive bias modification intervention to reduce FCR. The intervention, called Attention and Interpretation Modification for Fear of Breast Cancer Recurrence (AIM‐FBCR), targeted 2 types of cognitive biases (ie, attention and interpretation biases). METHODS: A total of 110 survivors of breast cancer were randomized to receive 8 sessions of 1 of 2 versions of AIM‐FBCR or a control condition program. Computer‐based assessments of cognitive biases and a self‐report measure of FCR were administered before the intervention, after the intervention, and 3 months after the intervention. RESULTS: Improvements in health worries (P = .019) and interpretation biases (rates of threat endorsement [P<.001] and reaction times for threat rejection [P = .007]) were found in those survivors who received AIM‐FBCR compared with the control arm. Although only 26% of participants who screened into the study agreed to participate, the trial otherwise appeared feasible and acceptable, with 83% of those who initiated the intervention completing at least 5 of 8 sessions, and 90% reporting satisfaction with the computer‐based program used. CONCLUSIONS: The results of the current pilot study suggest the promise of AIM‐FBCR in reducing FCR in survivors of breast cancer. Future research should attempt to replicate these findings in a larger‐scale trial using a more sophisticated, user‐friendly program and additional measures of improvement in more diverse samples. Cancer 2017;123:1424–1433. © 2016 American Cancer Society.
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Ten reviewed interventions were entirely self-guided.
“10 interventions were entirely self-guided. [33, 35, 36, 39–41, 47, 51, 54, 55].”
From Web-based interventions for fear of cancer recurrence: A scoping review with a focus on suggestions for the development and evaluation of future interventions (2024) · cites this paper as [36]
The Method > Treatment Conditions section describes a computer-based intervention with seven of eight sessions completed at home, consistent with largely self-guided use. It also says the first session was completed in the clinic and staff selected material to personalize the tasks, so this paper does not establish that its intervention was entirely self-guided. As one of ten cited studies, it cannot establish the review’s total count. (LLM, conf=0.80)
Experimental — accuracy not yet measuredOnly three reviewed studies reported directly on technical difficulties encountered by participants, most often access and navigation issues.
“Interestingly, only three studies included in our review reported directly on technical difficulties encountered by participants [36, 50, 53], most often access and navigation issues.”
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Self-citation
- Authors
- Lichtenthal, W. G., Corner, G. W., Slivjak, E. T., Roberts, K. E., Li, Y., Breitbart, W., Lacey, S., Tuman, M., DuHamel, K. N., Blinder, V. S., & Beard, C.
- Affiliations
- Memorial Sloan Kettering Cancer Center (US)
- University of Southern California (US)
- Harvard University (US)
- Corresponding author
- Lichtenthal, Wendy G.
- ORCID
- Venue
- Cancer
- Publisher
- Wiley
- Published
- 2017-01-05
- Volume
- 123
- Issue
- 8
- Pages
- 1424-1433
- ISSN
- 0008-543X (ISSN-L)
- 1097-0142
- PMC
- PMC5391320
- OpenAlex
- W2567934534
- Cited by
- 70
- References
- 48
- Citations by year
- 2026: 7 · 2025: 7 · 2024: 8 · 2023: 4 · 2022: 11 · 2021: 9 · 2020: 8 · 2019: 7 · 2018: 5 · 2017: 4
- FWCI
- 2.89
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Cancer (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- T.J. Martell Foundation
- National Cancer Institute (P30 CA008748)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
- Keywords
- cognitive bias modification, fear of cancer recurrence, breast cancer survivors, attentional bias, interpretation bias, computer-based intervention, feasibility and acceptability, health worry
- MeSH terms
- Aged, Breast Neoplasms, Cognition, Combined Modality Therapy, Fear, Female, Home Care Services, Humans, Middle Aged, Neoplasm Recurrence, Local, Neoplasm Staging, Pilot Projects, Cognitive Behavioral Therapy, Treatment Outcome
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