title: Attentional bias and metacognitions in cancer survivors with high fear of cancer recurrence.
abstract: BACKGROUND
  Fear of cancer recurrence (FCR) is a common and severe problem amongst cancer survivors, but mechanisms to explain its development and maintenance are still lacking. The self-regulatory executive function (S-REF) model suggests that metacognitions and attentional bias to cancer-related words may explain high FCR. Thus, this study aimed to explore relationships between FCR, metacognitions and attentional bias in a mixed group of cancer survivors.
  
  
  METHODS
  Sixty-three early-stage breast or prostate cancer survivors, diagnosed within 6 months to 5 years prior to participation and who had completed all hospital-based treatment with no evidence of cancer recurrence were recruited through two metropolitan oncology clinics. Participants completed a questionnaire battery and the dot-probe task.
  
  
  RESULTS
  Survivors with clinical FCR had significantly greater positive beliefs about worry (10.1 vs 7.4, p = 0.002) and beliefs about the uncontrollability and danger of worry (12.0 vs 7.7, p = 0.000) than those with non-clinical FCR, whereas the total metacognition score significantly predicted FCR in multiple regression analysis (β = 0.371, p = 0.001). No significant differences were detected between participants scoring above and below clinical FCR levels in attention bias indices.
  
  
  CONCLUSIONS
  This study found partial support for the S-REF model of FCR, with metacognitions but not attentional bias found to be related to FCR. Further research is needed to explore attentional biases in more detail.
authors.affiliation: Centre for Medical Psychology and Evidence-Based Decision Making, School of Psychology, The University of Sydney, Sydney, NSW, Australia; Psycho-Oncology Cooperative Research Group (PoCOG), The University of Sydney, Sydney, NSW, Australia; School of Psychology, The University of Sydney, Sydney, NSW, Australia.
authors.forename: P
authors.initials: P
authors.lastname: Butow
authors.forename: S
authors.initials: S
authors.lastname: Kelly
authors.forename: B
authors.initials: B
authors.lastname: Thewes
authors.forename: G
authors.initials: G
authors.lastname: Hruby
authors.forename: L
authors.initials: L
authors.lastname: Sharpe
authors.forename: J
authors.initials: J
authors.lastname: Beith
mesh_terms: D000368:Aged; D001007:Anxiety / Q000523:psychology; D001288:Attention; D001943:Breast Neoplasms / Q000523:psychology*; D003863:Depression / Q000523:psychology; D056344:Executive Function; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D000067489:Metacognition; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000523:psychology*; D009483:Neuropsychological Tests; D011471:Prostatic Neoplasms / Q000523:psychology*; D012044:Regression Analysis; D000068356:Self-Control / Q000523:psychology; D013315:Stress, Psychological / Q000523:psychology; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*
keywords: attentional bias; cancer; fear of recurrence