Aims Anxious people show an attentional bias towards threatening information. The present study investigated whether an attentional bias exists for cancer-related stimuli in breast cancer survivors. Moreover, the study investigated if different levels of fear of recurrence among breast cancer survivors would lead to different patterns of selective attention.
Methods Forty-six breast cancer survivors with high and 37 with low levels of fear of recurrence and 40 healthy female hospital employees as control subjects participated in the study. Specificity of attentional biases was investigated using a modified Emotional Stroop Task with printed text colors of cancer-related, hospital-related, negative, positive and neutral words. In addition, the original Stroop Task, including incongruent color words, was added as a baseline measure of cognitive processing speed and flexibility. Self-report measures were used to assess fear of recurrence, depression and anxiety, fatigue and the reaction to the traumatic experience of cancer.
Results Compared to control participants, breast cancer survivors showed increased interference for cancer-related words (p < .001, mean difference 46.38, 95% CI 27.36 - 65.39), but not for other word types nor for cognitive processing speed and flexibility. Survivors with high levels of fear of recurrence did not differ from those with low levels on attentional bias (p = .421, mean difference -11.84, 95% CI -40.97 - 17.28). On all questionnaires, high fear level breast cancer survivors scored significantly higher than the low fear level breast cancer survivors and the control group.
Conclusions These findings suggest that there is a specific attentional bias for cancer-related words in breast cancer survivors independent of their level of fear of recurrence. In contrast to other studies, a relationship between anxiety level and selective attention was not found. Implications for future research involve the investigation of interventions that focus on the modification of this attentional bias.