An experimental study to identify key psychological mechanisms that promote and predict resilience in the aftermath of treatment for breast cancer.

OBJECTIVE: Women living with and beyond breast cancer (BC) frequently encounter cancer-related information in day-to-day life. The extent they are emotionally resilient to this information differs between women. Identifying key modifiable psychological mechanisms predicting resilience in these women could highlight targets for interventions to improve resilience in others. This study investigates resilience over time in women living beyond BC and how this relates to individual differences in the way the brain processes information. METHODS: Seventy women within a year of finishing first-line treatment for BC (clinical and community recruitment) completed computerised tasks to assess the tendency to attend to cancer information (dot-probe task), the tendency to draw negative cancer-related interpretations from ambiguous information (ambiguous scenarios task) and extent of executive functioning (attentional network task). Questionnaires were completed assessing resilience, and other clinically relevant psychological variables (fear of cancer recurrence, distress, quality of life, and worry) at the time of the laboratory tasks (T1) and again 6 months later (T2). RESULTS: The only cognitive process associated with self-reported resilience was interpretation bias. Generating more negative cancer-related interpretations of ambiguous information at T1 significantly predicted resilience at T2, whilst controlling for T1 resilience and other clinically relevant variables. Furthermore, resilience scores were relatively stable over time and moderately correlated with other clinically relevant variables. CONCLUSIONS: This study is the first to identify a key cognitive mechanism that predicts resilience in women living beyond BC. This finding suggests interventions to reduce cancer-related interpretations of ambiguous information could promote resilience in women living beyond BC.

Maximizing potential impact of experimental research into cognitive processes in health psychology: A systematic approach to material development.

BACKGROUND: There is an abundance of research into cognitive processing biases in clinical psychology including the potential for applying cognitive bias modification techniques to assess the causal role of biases in maintaining anxiety and depression. Within the health psychology field, there is burgeoning interest in applying these experimental methods to assess potential cognitive biases in relation to physical health conditions and health-related behaviours. Experimental research in these areas could inform theoretical development by enabling measurement of implicit cognitive processes that may underlie unhelpful illness beliefs and help drive health-related behaviours. However, to date, there has been no systematic approach to adapting existing experimental paradigms for use within physical health research. Many studies fail to report how materials were developed for the population of interest or have used untested materials developed ad hoc. The lack of protocol for developing stimuli specificity has contributed to large heterogeneity in methodologies and findings. PURPOSE: In this article, we emphasize the need for standardized methods for stimuli development and replication in experimental work, particularly as it extends beyond its original anxiety and depression scope to other physical conditions. METHOD: We briefly describe the paradigms commonly used to assess cognitive biases in attention and interpretation and then describe the steps involved in comprehensive/robust stimuli development for attention and interpretation paradigms using illustrative examples from two conditions: chronic fatigue syndrome and breast cancer. CONCLUSIONS: This article highlights the value of preforming rigorous stimuli development and provides tools to aid researchers engage in this process. We believe this work is worthwhile to establish a body of high-quality and replicable experimental research within the health psychology literature. Statement of contribution What is already known on this subject? Cognitive biases (e.g., tendencies to attend to negative information and/or interpret ambiguous information in negative ways) have a causal role in maintaining anxiety and depression. There is mixed evidence of cognitive biases in physical health conditions and chronic illness; one reason for this may be the heterogeneous stimuli used to assess attention and interpretation biases in these conditions. What does this study add? Steps for comprehensive/robust stimuli development for attention and interpretation paradigms are presented. Illustrative examples are provided from two conditions: chronic fatigue syndrome and breast cancer. We provide tools to help researchers develop condition-specific materials for experimental studies.