Examining the feasibility of cognitive bias modification for patients with cancer and survivors in 3 independent pilot studies

Abstract Objective: Cancer comes with considerable psychological and emotional distress, which can persist long after initial treatment. Yet, few digital interventions targeting emotional distress are available for patients with cancer and survivors. Cognitive bias modification (CBM) is a digital intervention designed to reduce emotional distress by repeatedly training automatic processing of positive and disease-specific information. We examined the feasibility, safety, and clinical potential of CBM as secondary prevention of psychiatric disorders. Methods: Three independent pilot studies were conducted in samples with emotional distress: (i) patients newly diagnosed with hematological cancer at the start of their treatment, (ii) patients with cancer receiving chemotherapy, and (iii) cancer survivors ≥5 years after curative treatment receiving long-term survivorship care. Within each study, patients were randomized to either receive four sessions of computer-based active or control CBM or a nonintervention condition. Self-report measures of emotional distress were administered before, directly after, and one week after the intervention. Intervention feasibility and safety were assessed, as well as the direction of symptom change. Results: The intervention was deemed unfeasible in patients newly diagnosed with cancer and patients receiving chemotherapy. In cancer survivors, however, the intervention was well tolerated and possibly clinically relevant. The intervention was considered safe for all three populations. Conclusions: CBM can be considered as a possible secondary prevention digital intervention for cancer survivors. The intervention seems inappropriate for patients with cancer receiving treatment, possibly because the treatment phase itself is too impactful. Future research could examine the preventative potential of CBM in a clinical trial in cancer survivors.