Abstract:
Objective: Paediatric cancer is a risk for psychopathology including post-traumatic stress disorder, anxiety, and depression. This study aimed to delineate how attentional, memory, and working memory biases predict psychopathology among paediatric oncology patients, relative to healthy peers.
Method: 120 children (active treatment n≈40; remission n≈40; healthy controls n≈40) completed three computerized tasks: emotional Stroop (attentional bias), recognition test (memory bias), N-back task (working memory). The tasks contain: cancer, non-cancer negative and neutral stimuli, to explore whether the biases are specific to the illness. In addition, the children completed Semi-structured K-SADS interviews and questionnaires assessed psychopathology symptom severity.
Results: About half of children with cancer (45 % active; 53 % remission) met DSM-5 criteria versus 16 % of controls. Attentional cancer bias correlated strongly with higher depression, anxiety, and PTSD scores among children in active treatment (r≈.48–.57, p<.01) and in remission (r≈.44–.59, p<.01), but not in controls (r≈.00–.04, ns). Memory bias exhibited similar group-specific associations during treatment (r≈.42–.59, p<.01) in remission (r≈.29–.46, p.07–.002) and absent in healthy children. Working memory bias also predicted symptoms in both clinical groups (r≈.45–.61, p<.005) but not in controls. Logistic models confirmed that greater cancer-picture RT bias was associated with 6- to 12-fold increased odds of meeting DSM-5 criteria in patient groups (all p<.01).
Conclusions: Cancer-related cognitive biases predict greater distress in active and remission- paediatric cancer patients. These results underscore the potential of cognitive bias–modification interventions as adjunctive therapies to enhance psychological well?being in children with cancer.
