title: A pilot randomized controlled trial of cognitive bias modification to reduce fear of breast cancer recurrence.
abstract: 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.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Wendy G
authors.initials: WG
authors.lastname: Lichtenthal
authors.affiliation: Department of Psychology, University of Southern California, Los Angeles, California.
authors.forename: Geoffrey W
authors.initials: GW
authors.lastname: Corner
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Elizabeth T
authors.initials: ET
authors.lastname: Slivjak
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Kailey E
authors.initials: KE
authors.lastname: Roberts
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Yuelin
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: William
authors.initials: W
authors.lastname: Breitbart
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Lacey
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Malwina
authors.initials: M
authors.lastname: Tuman
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Katherine N
authors.initials: KN
authors.lastname: DuHamel
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Victoria S
authors.initials: VS
authors.lastname: Blinder
authors.affiliation: Department of Psychiatry, McLean Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Courtney
authors.initials: C
authors.lastname: Beard
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology / Q000523:psychology* / Q000628:therapy; D003071:Cognition; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D005239:Fear; D005260:Female; D006699:Home Care Services; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D010865:Pilot Projects; D016896:Treatment Outcome
keywords: breast cancer; cognitive bias modification; fear of recurrence; health worries; survivorship