Does interpretation bias moderate the relationship between pain and fear of cancer recurrence?

Pradhan, Poorva; Sharpe, Louise; Butow, Phyllis; Coutts-Bain, Daelin; Heathcote, Lauren C.

doi:10.1037/hea0001217

Cited by 10 publications

(16 citation statements)

References 46 publications

(77 reference statements)

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“…They also align with cross‐sectional studies showing that survivors who report more somatic symptoms, including pain and fatigue, are also more fearful of cancer recurrence 5,19,38,39 . In addition, these findings align with recent studies showing that FCR is associated with a catastrophic appraisal of pain 18 and a tendency to interpret ambiguous health‐related information derived from bodily sensations as threatening 21 . Fear of recurrence may bias attention towards and motivate monitoring of bodily sensations, lowering the detection thresholds for these sensations, hence fuelling increased fear of recurrence.…”

Section: Discussionsupporting

confidence: 86%

The bodily threat monitoring scale: Development and preliminary validation in adult and childhood cancer survivors

Heathcote,

Webster,

Loecher

et al. 2023

Psycho-Oncology

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ObjectiveBodily threat monitoring is a core clinical feature of Fear of cancer recurrence (FCR) and is targeted in psycho‐oncology treatments, yet no comprehensive self‐report measure exists. The aim of this study was the theory‐informed development and initial validation of the Bodily Threat Monitoring Scale (BTMS).MethodsAdult survivors of breast and gynaecological cancers (Study 1: N = 306, age = 37–81 years) and childhood cancer survivors (Study 2: N = 126, age = 10–25 years) completed the BTMS, designed to assess how individuals monitor for and interpret uncertain symptoms as indicating that something is wrong with their body. Participants completed measures to assess construct and criterion validity of the BTMS, and childhood cancer survivors (Study 2) completed the BTMS again 2 weeks later to assess test‐retest reliability.ResultsThe 19‐item BTMS demonstrated excellent internal consistency across adult and childhood cancer samples (α = 0.90–0.96). Factor analyses indicated two subscales capturing 1. Monitoring of bodily sensations and 2. Threatening interpretations of bodily sensations. Two‐week stability estimates were acceptable. For construct validity, the BTMS correlated with body vigilance and anxiety sensitivity. The BTMS also demonstrated criterion validity, yielding significant associations with FCR, intolerance of uncertainty, help‐seeking behaviours, and quality of life. The BTMS was associated with FCR while controlling for body vigilance and anxiety sensitivity, indicating a unique contribution of this theory‐informed measure.ConclusionsThe BTMS shows evidence of sound psychometric properties and could be used to elucidate the role of bodily threat monitoring in the maintenance and management of FCR.

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Section: Discussionsupporting

confidence: 86%

The bodily threat monitoring scale: Development and preliminary validation in adult and childhood cancer survivors

Heathcote,

Webster,

Loecher

et al. 2023

Psycho-Oncology

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“…36 Evidence of elevated fear of progression in people with endometriosis was supported by our own findings. The mean Fear of Progression Questionnaire-Short Form scores of our sample of individuals with endometriosis (M 5 38/60) were higher than those reported in cancer (M 5 29-32/60), 11,29 suggesting this is a serious concern for people with endometriosis. On the one hand, this is surprising in that unlike cancer, endometriosis is not typically life-threatening.…”

Section: Discussioncontrasting

confidence: 58%

Fear of progression, imagery, interpretation bias, and their relationship with endometriosis pain

Todd,

Pickup,

Coutts-Bain

2023

Pain

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Endometriosis is a chronic gynaecological condition, of which pain is both the most common and most debilitating symptom. As with other forms of pain, there is increasing recognition of the role of psychological processes in bridging the gap between pain and pain impact, and yet these processes are not well understood in endometriosis. The aim of this study was to investigate the relevance of fear of progression, imagery, and interpretation bias in endometriosis, and their contribution to pain interference. A total of 221 participants (mean age = 38 years, SD = 7.8) with endometriosis were recruited from Endometriosis Australia. This cross-sectional study included relevant demographics and endometriosis characteristics; questionnaires to measure fear of progression, imagery, interpretation bias, and pain; and the word association task to measure interpretation bias. Participants reported high scores on the Fear of Progression Questionnaire (M = 38/60), higher than that has been found in cancer. Controlling for age and pain intensity, we found that imagery, interpretation bias, and their interaction were associated with increased fear of progression and that fear of progression was associated with greater pain-related interference. In exploratory analysis, we also found that the frequency and distress of endometriosis-related intrusive imagery were associated with greater fear of progression and pain interference, after controlling for age and pain intensity. These findings provide the first support of the importance of fear of progression in people with endometriosis and suggest possible pathways for causal investigation.

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“…Schoth and Liossi 28 conducted a small systematic review and meta-analysis on studies of interpretation bias in people with chronic pain, finding a difference in interpretation biases of people with chronic pain compared to those without (Hedge's g = 0.67). Since then, interpretation biases have been observed in other samples, including adolescents with chronic pain, 17 university students with chronic pain, 9 people with chronic headache, 27 cancer-related pain, 25,26 and diabetes-related chronic pain, 32 although Blaisdale-Jones et al 5 failed to find an overall interpretation bias effect. In our study, many participants were not in pain at the time of assessment, since on average participants experienced pain for an estimated 14 days of the month.…”

Section: Discussionmentioning

confidence: 99%

“…For example, the ambiguous word “needle” could be responded to with the word “sew” or “injection.” Participants' responses were coded “1,” if health threat relevant, and “0,” if not consistent with previous research. 25,35 Two authors independently coded a portion of responses, with near-perfect agreement (kappa = 0.908). Any inconsistencies were resolved with discussion, and a coding scheme was created.…”

Section: Methodsmentioning

confidence: 99%

Interpretation bias in endometriosis-related pain

Pickup,

Sharpe,

Todd

2023

Pain

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Endometriosis-related pain has been predominantly medically managed, which has hindered understanding of psychological factors involved in these pain experiences. Models of chronic pain highlight the biased interpretation of ambiguous information as health threat related (interpretation bias) as an important process in the development and maintenance of chronic pain. Whether interpretation bias may also be similarly implicated in endometriosis-related pain is unclear. The current study aimed to address this gap in the literature by (1) comparing interpretation biases between a sample of participants with endometriosis and a control sample of participants without medical conditions and pain, (2) exploring relationships between interpretation bias and endometriosis-related pain outcomes, and (3) exploring whether interpretation bias moderated the relationship between endometriosis-related pain severity and pain interference. The endometriosis and healthy control samples comprised 873 and 197 participants, respectively. Participants completed online surveys assessing demographics, interpretation bias, and pain-related outcomes. Analyses revealed that interpretation bias was significantly stronger among individuals with endometriosis relative to controls, with a large effect size. Within the endometriosis sample, interpretation bias was significantly associated with increases in pain-related interference, however, interpretation bias was not associated with any other pain outcomes and did not moderate the relationship between pain severity and pain interference. This study is the first to evidence biased interpretation styles among individuals with endometriosis and to show this bias is associated with pain interference. Whether interpretation bias varies over time and whether this bias can be modified through scalable and accessible interventions to alleviate pain-related interference are avenues for future research.

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Does interpretation bias moderate the relationship between pain and fear of cancer recurrence?

Cited by 10 publications

References 46 publications

The bodily threat monitoring scale: Development and preliminary validation in adult and childhood cancer survivors

The bodily threat monitoring scale: Development and preliminary validation in adult and childhood cancer survivors

Fear of progression, imagery, interpretation bias, and their relationship with endometriosis pain

Interpretation bias in endometriosis-related pain

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