BACKGROUND: Long-term chemotherapy-related cognitive dysfunction (CRCD) affects a large number of cancer survivors. To the authors' knowledge, to date there is no established treatment for this survivorship problem. The authors herein report results of a small randomized controlled trial of a cognitive behavioral therapy (CBT), Memory and Attention Adaptation Training (MAAT), compared with an attention control condition. Both treatments were delivered over a videoconference device. METHODS: A total of 47 survivors of female breast cancer who reported CRCD were randomized to MAAT or supportive therapy and were assessed at baseline, after treatment, and at 2 months of follow-up. Participants completed self-report measures of cognitive symptoms and quality of life and a brief telephone-based neuropsychological assessment. RESULTS: MAAT participants made gains in perceived (selfreported) cognitive impairments (P 5 .02), and neuropsychological processing speed (P 5 .03) compared with supportive therapy controls. A large MAAT effect size was observed at the 2-month follow-up with regard to anxiety concerning cognitive problems (Cohen's d for standard differences in effect sizes, 0.90) with medium effects noted in general function, fatigue, and anxiety. Survivors rated MAAT and videoconference delivery with high satisfaction. CONCLUSIONS: MAAT may be an efficacious psychological treatment of CRCD that can be delivered through videoconference technology. This research is important because it helps to identify a treatment option for survivors that also may improve access to survivorship services. Cancer 2016;122:1782-91. V C 2016 American Cancer Society.KEYWORDS: breast cancer, chemotherapy, cognitive behavioral therapy, cognitive dysfunction, survivorship. INTRODUCTIONTwo decades of research have indicated that a large subgroup of cancer survivors experience long-standing cognitive dysfunction after the completion of chemotherapy.1,2 Although the exact prevalence of chemotherapy-related cognitive dysfunction (CRCD) remains unknown, the body of evidence suggests that approximately 25% to 40% of chemotherapy recipients demonstrate persistent mild to moderate cognitive changes.1 Cognitive effects can endure for years and adversely affect survivor quality of life (QOL); disruption to employment (reduced hours or termination) and social and family life is common.3,4 Greater than 650,000 patients receive chemotherapy annually and owing largely to improved cancer screening and treatment, the number of individuals living with a cancer diagnosis in the United States is estimated to reach 18 million by 2022.5 These numbers highlight the need for effective CRCD treatment. Memory and Attention Adaptation Training (MAAT) is a cognitive behavioral therapy (CBT) designed to treat patients with CRCD. MAAT not only addresses survivor cognitive performance but also emphasizes the promotion of adaptive behavior changes in work life, home life, and social activity to compensate for cognitive difficulties. In the CRCD literature, the neurop...

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This study explored menstrual symptoms, somatic focus, negative affect, and psychophysiological responding across the menstrual cycle in women with panic disorder and controls. Women with and without panic disorder completed a psychophysiological task and self-report measures of menstrual symptoms, somatic focus, and negative affect on 4 occasions across 2 menstrual cycles (twice during intermenstrual and premenstrual phases). Women in the panic disorder group exhibited greater skin conductance magnitude and more frequent skin conductance responses to anxiety-provoking stimuli during the premenstrual phase than did controls. Compared to controls, women with panic disorder endorsed more severe menstrual symptoms relating to bodily sensations, anxiety sensitivity, state and trait anxiety, fear of body sensations, and illness-related concerns. The applicability of anxiety sensitivity to understanding the relation of menstrual reactivity and panic disorder is discussed.

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