The role of cognitive biases in the maintenance and management to fear of cancer recurrence or progression

Cancer survivors are faced with a wide range of survivorship issues and fear of cancer recurrence/progression (FCR/P) is amongst the most reported long-term consequences. However, little is known about the interplay of processing biases in terms of FCR/P. Hence, the broad aim of the research is to gain understanding on the role of cognitive biases in the maintenance and development of FCR/P. The thesis is comprised of five parts. In Study 1, a meta-analysis on attentional bias amongst cancer patients was conducted and a scoping review to highlight the potential gaps in this area. Studies 2 and 3 tested the Cancer Threat Interpretation model in ovarian and breast cancer sample respectively. Study 3 was an extension to the Study 2 with a larger sample size and examined other predictors of FCR/P. Study 4 tested the efficacy of an online booklet to manage clinical FCR/P. Finally, study 5 tested Cognitive Bias Modification (CBM-I) versions (pain and cancer-specific) compared to placebo in a sample of people with ovarian or breast cancer (N=174). Study 1 found that people with cancer display a larger attentional bias compared to people without cancer. This bias was stronger in survivors who were distressed versus those who were not. The review also highlighted a lack of evidence for interpretation and memory biases. Following these, a series of two empirical studies suggested the presence of interpretation bias (IB) in both breast and ovarian cancer patients. Furthermore, IB moderated the relationship between pain and FCR/P in breast cancer sample. Study 4 found that FCR did not reduce FCR/P in women with ovarian cancer. The review in Chapter 7 found no evidence for any minimal intervention for FCR/P. To fill this gap, results from Study 5 provided promising support for both versions of CBM-I to manage clinical FCR/P. The present research has several theoretical and clinical implications which will be beneficial in advancing this emerging field of research