Preventive cognitive bias modification training (IVY) targeting fatigue in people with breast cancer: Pilot study investigating user experience and potential effects

Background: Cancer-related fatigue (CRF) is a frequent and impactful symptom for many people with breast cancer. Cognitive biases are believed to influence CRF and were explored in the current mixed methods pilot study investigating a preventive Cognitive Bias Modification (CBM) training.

Methods: Two data sets were combined resulting in 31 people with recently diagnosed breast cancer (n = 18 intervention group, n = 13 control group). Both groups were measured on self-identity bias and weekly fatigue and vitality before and after the intervention. The intervention group also answered daily fatigue and vitality scales and was interviewed after training. Potential training effects were assessed by exploring time series graphs on self-identity bias, vitality and fatigue, and trajectories of change during training.

Results: Some indications of potential training effects were found on self-identity bias, weekly fatigue, and daily fatigue and vitality. Participants were accepting about the training and app features.

Conclusions: This is the first study to research a preventive CBM targeting fatigue. Although this is a pilot study with small sample size, promising results were found. These results need to be confirmed in an randomized controlled trial with longer follow-up, sufficient control conditions, and a sample size to detect small effect sizes. CBM is a promising intervention for targeting fatigue in patients with breast cancer who show translational potential for other symptoms and patient groups. This study adds the promising potential of CBM as a preventive intervention.