Attention Bias Modification for the Improvement of Anxiety in Adolescent and Young Adult Cancer Survivors

Anxiety and Negative Attentional Bias in Adolescent and Young Adult Cancer Survivors

This clinical trial studies how well attention bias modification (ABM) improves anxiety in adolescent and young adult (AYA) cancer survivors. Cancer-related anxiety is the most prevalent mental health problem affecting AYA cancer survivors. Cancer-related anxiety is associated with long-term negative outcomes such as poor quality of life, depression, distress, substance use, sleep problems, fatigue, and pain. ABM uses techniques to help patients change the way they react to environmental triggers that may cause a negative reaction. ABM uses brief self-guided smartphone applications. Patients complete repetitive association reaction-time tasks targeting automatic and unconscious negative attention biases to retrain attention away from perceived threat and towards a neutral or positive stimuli. Gratitude-finding and savoring activities are also provided to maintain and increase positive emotions. Using ABM plus gratitude-finding and savoring activities may improve anxiety in AYA cancer survivors.

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM I: Patients engage in ABM over 10 minutes twice a week (BIW) and respond daily to text messaging prompts activity for 4 weeks.

ARM II: Patients engage in inert attention task sessions over 10 minutes BIW for 4 weeks. Patients also receive and respond to text messaging prompts QD for 4 weeks.

After completion of study intervention, patients are followed up at 4 weeks. After completion of this 4 week follow up survey, patients are given access to all components of ABM and texts on study.

Inclusion Criteria:

• Age 15-29 years
• Diagnosis of cancer malignancy
• Received active/curative cancer treatment OR received/actively receiving cancer survivorship care at Seattle Children's Hospital (SCH) or other study referring site (e.g. St. Jude)
• Currently off active/curative cancer treatment
• Patient able to understand/read/write English language
• Cognitively able to participate in ABM intervention and complete surveys
• Patient has access to smartphone able to send and receive text messages
• Patient has access to computer or smartphone for Inquisit program

Exclusion Criteria:

• Patients on active/curative cancer treatment
• Cognitively or physically unable to participate in ABM intervention and surveys
• Patients who cannot understand/read/write English will be excluded from the research because the ABM intervention is currently only available in English
• Furthermore, patients who do not have access to technology (smartphone/computer) will be excluded from the study as this technology is absolutely required to engage in the study intervention