Cancer fear and the interpretation of ambiguous information related to cancer

Miles, Anne; Voorwinden, Sanne; Mathews, Andrew; Hoppitt, Laura; Wardle, Jane

doi:10.1080/02699930802091116

Cited by 22 publications

(17 citation statements)

References 23 publications

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“…Avoiding information may be rational in some contexts (Sweeny et al, 2010 ), but in the context of cancer it may prove detrimental to personal health if it leads to unawareness of cancer warning signs and delays in help-seeking, or non-attendance at cancer screening (Quaife et al, 2014 ). Disengagement with cancer information may be amplified by cancer fear, which is associated with a negative bias towards interpretation of cancer information (Miles, Voorwinden, Mathews, Hoppitt, & Wardle, 2009 ), poorer recall of cancer information (Miles et al, 2007 ) and lower rates of successful cancer information-seeking (Beckjord, Finney Rutten, Arora, Moser, & Hesse, 2008 ). Our study suggests that fear and stress may cluster in low SES subgroups to produce disengagement with cancer-related information, and may thus help inform efforts to reduce inequalities in cancer outcomes (von Wagner, Good, Whitaker, & Wardle, 2011 ), including socio-economic inequalities, for this age group who are at high risk of developing cancer.…”

Section: Discussionmentioning

confidence: 99%

Does psychosocial stress exacerbate avoidant responses to cancer information in those who are afraid of cancer? A population-based survey among older adults in England

Vrinten

Boniface

et al. 2017

Psychology & Health

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Objective: Communication of cancer information is an important element of cancer control, but cancer fear may lead to information avoidance, especially when coping is low. We examined the association between cancer fear and cancer information avoidance, and tested whether this was exacerbated by psychosocial stress. Design: Cross-sectional survey of 1258 population-based adults (58-70 years) in England. Main outcome measures: Cancer fear (intensity and frequency), perceived psychosocial stress and cancer information avoidance. Control variables were age, gender, ethnicity, marital status and education. Results: A quarter (24%) of respondents avoided cancer information. Ordinal logistic regression analyses showed main effects of psychosocial stress (OR = 1.17, 95% CI 1.07-1.29) and cancer fear: cancer information avoidance was lowest in those with no cancer fear (13%), followed by those with moderate (24%; OR = 2.15, 95% CI: 1.49-3.12), and high cancer fear (35%; OR = 3.90, 95% CI: 2.65-5.73). In the adjusted model, the interaction between cancer fear and stress was significant (OR = 1.14, 95% CI 1.004-1.29, p < .05): 40% of those with high fear/high stress avoided cancer information compared with 29% with high fear/low stress. Conclusion: Cancer fear and psychosocial stress interact to produce disengagement with cancer-related information, highlighting the importance of affective processes to cancer control efforts.

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Section: Discussionmentioning

confidence: 99%

Does psychosocial stress exacerbate avoidant responses to cancer information in those who are afraid of cancer? A population-based survey among older adults in England

Vrinten

Boniface

et al. 2017

Psychology & Health

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“…The stimulus pool for the assessments and interventions was developed by compiling stimuli from previous studies of cognitive biases [16][17][18] and piloting them with 10 women endorsing FCR (CARS 3). The study team removed the least emotionally charged stimuli, yielding a final set of 83 neutral-threat word pairs, 107 meaning-threat word pairs, and 78 threat-neutral word/ambiguous sentence pairs, all matched for length and frequency of use.…”

Section: Stimulimentioning

confidence: 99%

“…Studies focusing on cancer suggest that cognitive biases may contribute to FCR in survivors and that such biases may be an important target for intervention. [14][15][16][17] A substantial literature has shown that cognitive biases can be altered through brief, computerized interventions referred to as cognitive bias modification (CBM), which involve the rapid presentation of stimuli (eg, 500 milliseconds [ms]) and repeated practice (eg, 360 trials) on cognitive tasks designed to encourage shifts in attention or interpretation. [18][19][20] CBM has demonstrated efficacy in improving a variety of conditions, including social anxiety, panic, and generalized anxiety disorders.…”

Section: Introductionmentioning

confidence: 99%

A pilot randomized controlled trial of cognitive bias modification to reduce fear of breast cancer recurrence

Lichtenthal

Corner

Slivjak

et al. 2017

Cancer

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Background The most common, persistent concern among breast cancer survivors is the fear that their disease will return, yet few interventions targeting fear of cancer recurrence (FCR) have been developed. This pilot study examined the feasibility, acceptability, and preliminary efficacy of a home-delivered cognitive bias modification (CBM) intervention to reduce FCR. The intervention, Attention and Interpretation Modification for Fear of Breast Cancer Recurrence (AIM-FBCR), targeted two types of cognitive biases (i.e., attention and interpretation biases). Methods Breast cancer survivors (n=110) were randomized to receive eight sessions of one of two versions of AIM-FBCR or a control condition program. Computer-based assessments of cognitive biases and a self-report measure of FCR were administered pre-intervention, post-intervention, and 3 months post-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 who received AIM-FBCR as compared to the control arm. While only 26% of participants who screened into the study agreed to participate, the trial otherwise appeared feasible and acceptable, with 83% of those who began the intervention completing at least 5 of 8 sessions, and 90% reporting satisfaction with the computer-based program used. Conclusions This pilot study suggests the promise of AIM-FBCR in reducing FCR in breast cancer survivors. 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. ClinicalTrials.gov Identifier: NCT01517945.

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“…The chronic pain literature, in particular, has employed these experimental methods to test the role of hypervigilance to pain (Crombez, Van Ryckeghem, Eccleston, & Van Damme, 2013) as well as pain-related interpretations of ambiguous information (Schoth & Liossi, 2016). Experimental research has begun to be carried out in other long-term conditions such as chronic fatigue syndrome (CFS) (Hughes et al, 2016), irritable bowel syndrome (Afzal, Potokar, Probert, & Munaf o, 2006;Chapman & Martin, 2011;Tkalcic, Domijan, Pletikosic, Setic, & Hauser, 2014), and fear of cancer recurrence (Butow et al, 2015;Custers et al, 2015;DiBonaventura, Erblich, Sloan, & Bovbjerg, 2010;Miles, Voorwinden, Mathews, Hoppitt, & Wardle, 2009). However, to date, evidence for cognitive biases in these areas has been mixed.…”

Section: What Does This Study Add?mentioning

confidence: 99%

“…Attention: Initial AB material was pooled from cognitive biases studies in cancer populations (Butow et al, 2015;Custers et al, 2015;Glinder, Beckjord, Kaiser, & Compas, 2007) as well as healthy populations with anxiety about cancer (DiBonaventura et al, 2010). Interpretation: For the development of ambiguous situations for the IB task, initial topic areas were generated from searching cancer survivorship literature (Costanzo et al, 2007;Fenlon et al, 2015;Miles et al, 2009).…”

Section: Examplementioning

confidence: 99%

Maximizing potential impact of experimental research into cognitive processes in health psychology: A systematic approach to material development

Hughes

Gordon

Chalder

et al. 2016

British J Health Psychol

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This article highlights the value of preforming rigorous stimuli development and provides tools to aid researchers engage in this process. We believe this work is worthwhile to establish a body of high-quality and replicable experimental research within the health psychology literature. Statement of contribution What is already known on this subject? Cognitive biases (e.g., tendencies to attend to negative information and/or interpret ambiguous information in negative ways) have a causal role in maintaining anxiety and depression. There is mixed evidence of cognitive biases in physical health conditions and chronic illness; one reason for this may be the heterogeneous stimuli used to assess attention and interpretation biases in these conditions. What does this study add? Steps for comprehensive/robust stimuli development for attention and interpretation paradigms are presented. Illustrative examples are provided from two conditions: chronic fatigue syndrome and breast cancer. We provide tools to help researchers develop condition-specific materials for experimental studies.

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Cancer fear and the interpretation of ambiguous information related to cancer

Cited by 22 publications

References 23 publications

Does psychosocial stress exacerbate avoidant responses to cancer information in those who are afraid of cancer? A population-based survey among older adults in England

Does psychosocial stress exacerbate avoidant responses to cancer information in those who are afraid of cancer? A population-based survey among older adults in England

A pilot randomized controlled trial of cognitive bias modification to reduce fear of breast cancer recurrence

Maximizing potential impact of experimental research into cognitive processes in health psychology: A systematic approach to material development

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