Psycho-Oncology Psycho-Oncology 24: 496 (2015) Published online in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/pon.3789
Letter to the Editor
Attentional biases in cancer survivors: directions for future research Dear Editor, SaiTin and Wiwanitkit make three points. First, that health threat can affect attentional biases. Fear of cancer recurrence (FCR) is a cancer-specific form of health anxiety. Our question of whether FCR resulted in an attention bias (AB) to illness-specific stimuli was prompted by recent evidence suggesting that the specificity of biases is important. Second, they suggest that we should have measured general attentional ability. Hakamata and colleagues [1] recently demonstrated a relationship between general attentional ability and AB. They found that attentional domain and processing speed scores predicted 16% of the variance in AB in healthy people. Could this also have affected our results? Possibly. Many participants in our study had received chemotherapy and processing speed is affected by such treatment. Our results may be different, had we controlled for general attentional ability or processing speed, although, this remains speculative. We agree that this would be a useful direction for future research. Third, they argue that the dot-probe is not a reliable way of assessing AB. ABs derived from the dot-probe have been shown to have poor reliability. However, poor reliability also affects the Stroop task. Raw reaction times on both tasks are highly correlated but difference scores are not (ABs: dot-probe; interference scores: Stroop). Conceptually, the Stroop is not an unambiguous measure of AB. Each trial presents a single stimulus (i.e., threat or neutral), and an AB is assumed if the participant responds more slowly on threat than neutral trials. However, the presence of threatening stimuli in anxious individuals leads to slower responses, akin to a freeze response. Hence, slowed responding could demonstrate an AB or a freeze response. In the dot-probe, both threatening and neutral stimuli are presented on each trial. An
Copyright © 2015 John Wiley & Sons, Ltd.
AB is assumed when responses are faster to probes replacing the threatening stimuli than the neutral stimuli. Nonetheless, the dot-probe gives only a snapshot of attention; future research would benefit from more direct assessment of AB, such as eye-tracking. Interestingly, The Stroop study of Custer et al. also failed to find an effect of FCR on interference; therefore, the task cannot explain the lack of effect. The study of AB in cancer patients is in its infancy. We would welcome future research that investigated the conditions under which attentional biases may be observed in cancer survivors and hope that our study and the recent study by Custer and colleagues might be an impetus for further research.
Reference 1. Hakamata Y Matsui M Tagaya H Does neurocognitive function affect cognitive bias toward an emotional stimulus? Association between general attentional ability and attentional bias toward threat. Front Psycho 2014;5:881–886.
Louise Sharpe1, Belinda Thewes1,2,3 and Phyllis Butow1,2,3 1 School of Psychology, The University of Sydney, Sydney, NSW, Australia 2 Centre for Medical Psychology and Evidence-Based Decision Making, School of Psychology, The University of Sydney, Sydney, NSW, Australia 3 Psycho-Oncology Cooperative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia E-mail: [email protected] DOI: 10.1002/pon.3789
Copyright of Psycho-Oncology is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
Letter to the Editor
Attentional biases in cancer survivors: directions for future research Dear Editor, SaiTin and Wiwanitkit make three points. First, that health threat can affect attentional biases. Fear of cancer recurrence (FCR) is a cancer-specific form of health anxiety. Our question of whether FCR resulted in an attention bias (AB) to illness-specific stimuli was prompted by recent evidence suggesting that the specificity of biases is important. Second, they suggest that we should have measured general attentional ability. Hakamata and colleagues [1] recently demonstrated a relationship between general attentional ability and AB. They found that attentional domain and processing speed scores predicted 16% of the variance in AB in healthy people. Could this also have affected our results? Possibly. Many participants in our study had received chemotherapy and processing speed is affected by such treatment. Our results may be different, had we controlled for general attentional ability or processing speed, although, this remains speculative. We agree that this would be a useful direction for future research. Third, they argue that the dot-probe is not a reliable way of assessing AB. ABs derived from the dot-probe have been shown to have poor reliability. However, poor reliability also affects the Stroop task. Raw reaction times on both tasks are highly correlated but difference scores are not (ABs: dot-probe; interference scores: Stroop). Conceptually, the Stroop is not an unambiguous measure of AB. Each trial presents a single stimulus (i.e., threat or neutral), and an AB is assumed if the participant responds more slowly on threat than neutral trials. However, the presence of threatening stimuli in anxious individuals leads to slower responses, akin to a freeze response. Hence, slowed responding could demonstrate an AB or a freeze response. In the dot-probe, both threatening and neutral stimuli are presented on each trial. An
Copyright © 2015 John Wiley & Sons, Ltd.
AB is assumed when responses are faster to probes replacing the threatening stimuli than the neutral stimuli. Nonetheless, the dot-probe gives only a snapshot of attention; future research would benefit from more direct assessment of AB, such as eye-tracking. Interestingly, The Stroop study of Custer et al. also failed to find an effect of FCR on interference; therefore, the task cannot explain the lack of effect. The study of AB in cancer patients is in its infancy. We would welcome future research that investigated the conditions under which attentional biases may be observed in cancer survivors and hope that our study and the recent study by Custer and colleagues might be an impetus for further research.
Reference 1. Hakamata Y Matsui M Tagaya H Does neurocognitive function affect cognitive bias toward an emotional stimulus? Association between general attentional ability and attentional bias toward threat. Front Psycho 2014;5:881–886.
Louise Sharpe1, Belinda Thewes1,2,3 and Phyllis Butow1,2,3 1 School of Psychology, The University of Sydney, Sydney, NSW, Australia 2 Centre for Medical Psychology and Evidence-Based Decision Making, School of Psychology, The University of Sydney, Sydney, NSW, Australia 3 Psycho-Oncology Cooperative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia E-mail: [email protected] DOI: 10.1002/pon.3789
Copyright of Psycho-Oncology is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
