Lichtenthal Wendy G, Corner Geoffrey W, Slivjak Elizabeth T, Roberts Kailey E, Li Yuelin, Breitbart William, Lacey Stephanie, Tuman Malwina, DuHamel Katherine N, Blinder Victoria S, Beard Courtney
Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York.
Department of Psychology, University of Southern California, Los Angeles, California.
Cancer. 2017 Apr 15;123(8):1424-1433. doi: 10.1002/cncr.30478. Epub 2017 Jan 5.
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).
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.
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.
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.
乳腺癌幸存者中最常见、持续存在的担忧是害怕疾病复发，然而据作者所知，迄今为止针对癌症复发恐惧（FCR）的干预措施很少。当前的一项初步研究检验了一种居家认知偏差修正干预措施在减轻FCR方面的可行性、可接受性和初步疗效。该干预措施名为“乳腺癌复发恐惧的注意力与解释修正”（AIM-FBCR），针对两种认知偏差（即注意力偏差和解释偏差）。
总共110名乳腺癌幸存者被随机分配，接受8节两种版本之一的AIM-FBCR干预或对照项目。在干预前、干预后以及干预后3个月，进行基于计算机的认知偏差评估和FCR的自我报告测量。
与对照组相比，接受AIM-FBCR干预的幸存者在健康担忧方面有所改善（P = 0.019），在解释偏差方面也有改善（威胁认可率[P < 0.001]和威胁拒绝反应时间[P = 0.007]）。尽管筛选进入研究的参与者中只有26%同意参与，但该试验在其他方面似乎是可行且可接受的，启动干预的参与者中有83%完成了8节中的至少5节，90%的参与者对所使用的基于计算机的项目表示满意。
当前初步研究的结果表明AIM-FBCR在减轻乳腺癌幸存者FCR方面具有前景。未来的研究应尝试在更大规模的试验中复制这些发现，使用更复杂、用户友好的项目以及更多样化样本中的其他改善测量指标。《癌症》2017年；123:1424 - 1433。© 2016美国癌症协会
