Danielle Wing Lam Ng1,2, Richard Fielding1,2, Wendy Wing Tak Lam1,2. 1. Division of Behavioural Sciences, Centre for Psycho-Oncological Research and Training, School of Public Health, The University of Hong Kong, Hong Kong, China. 2. Li Ka Shing Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, China.
Abstract
OBJECTIVES: A sample of women with persistent distress following breast cancer (BC) previously exhibited attentional bias (AB) away from supraliminally presented cancer-or threat-related information, responses consistent with avoidance coping, and showed negative interpretation bias. Here, we attempt to characterize the nature of supraliminal AB and interpretation bias in that sample of women by comparing against healthy controls. METHODS: Extending our previous work, we compared AB patterns for supraliminally presented negatively valenced words and cancer-related information (CRI) assessed by modified dot-probe tasks and negative interpretation bias assessed by an ambiguous cue task between 140 BC women previously identified as featuring low-stable or persistent high anxiety and 150 age-matched non-BC healthy controls having HADS-defined low or high anxiety (HADS-anxiety scores = 8). RESULTS: Attentional avoidance of non-cancer-related negatively valenced words was seen among the anxious BC group, while heightened attention toward such words was seen in anxious healthy controls, F(3, 282) = 3.97, p = 0.009. However, all anxious women in both BC and healthy groups directed attention away from CRI under supraliminal conditions. Interpretation bias scores were significantly higher in BC women with high anxiety vs. healthy controls with high anxiety, F(3, 282) = 13.26, p < 0.001. CONCLUSION: Women with high anxiety generalized conscious attentional avoidance responses to negatively valenced stimuli, indicating a likely hypersensitivity to potential threat in ambiguous cues and exaggerated threat perception. This may cause (or reflect) maladaptive emotional regulation. Attention focus training, reducing threat salience or modifying threat appraisal, may help women alleviate anxiety levels after BC.
OBJECTIVES: A sample of women with persistent distress following breast cancer (BC) previously exhibited attentional bias (AB) away from supraliminally presented cancer-or threat-related information, responses consistent with avoidance coping, and showed negative interpretation bias. Here, we attempt to characterize the nature of supraliminal AB and interpretation bias in that sample of women by comparing against healthy controls. METHODS: Extending our previous work, we compared AB patterns for supraliminally presented negatively valenced words and cancer-related information (CRI) assessed by modified dot-probe tasks and negative interpretation bias assessed by an ambiguous cue task between 140 BC women previously identified as featuring low-stable or persistent high anxiety and 150 age-matched non-BC healthy controls having HADS-defined low or high anxiety (HADS-anxiety scores = 8). RESULTS: Attentional avoidance of non-cancer-related negatively valenced words was seen among the anxious BC group, while heightened attention toward such words was seen in anxious healthy controls, F(3, 282) = 3.97, p = 0.009. However, all anxious women in both BC and healthy groups directed attention away from CRI under supraliminal conditions. Interpretation bias scores were significantly higher in BC women with high anxiety vs. healthy controls with high anxiety, F(3, 282) = 13.26, p < 0.001. CONCLUSION: Women with high anxiety generalized conscious attentional avoidance responses to negatively valenced stimuli, indicating a likely hypersensitivity to potential threat in ambiguous cues and exaggerated threat perception. This may cause (or reflect) maladaptive emotional regulation. Attention focus training, reducing threat salience or modifying threat appraisal, may help women alleviate anxiety levels after BC.
Authors: Yair Bar-Haim; Yael Holoshitz; Sharon Eldar; Tahl I Frenkel; David Muller; Dennis S Charney; Daniel S Pine; Nathan A Fox; Ilan Wald Journal: Am J Psychiatry Date: 2010-04-15 Impact factor: 18.112
Authors: Wendy W T Lam; George A Bonanno; Anthony D Mancini; Samuel Ho; Miranda Chan; Wai Ka Hung; Amy Or; Richard Fielding Journal: Psychooncology Date: 2010-10 Impact factor: 3.894