Efficacy of attention bias modification combined with cognitive behavioral therapy for reducing anxiety in patients with hematopoietic malignancies: a quasi-randomized controlled trial

Abstract

• Anxiety frequently develops among patients with hematopoietic malignancies. • We combined attention bias modification and CBT for anxiety management. • The combined intervention reduced anxiety. • Attenuation of sympathetic activity may mediate patients’ decreased anxiety. Studies have suggested that anxiety is a common psychological problem in patients with cancer. This study tested the hypothesis that an intervention combining attention bias modification (ABM) and cognitive behavioral therapy (CBT) can reduce anxiety and improve physical activity levels among patients with hematopoietic malignancies. A total of 30 patients with hematopoietic malignancies admitted to the hospital were assigned to one of the following groups after matching for age, sex, and type of hematopoietic malignancy: treatment group (ABM + CBT + exercise therapy) or control group (ABM placebo + CBT placebo + exercise therapy). The primary outcome was the change in Profile of Mood States (POMS) scores, and the secondary outcomes were heart rate variability and number of daily steps. Post-treatment measures of the treatment group showed a decrease in the POMS (tension-anxiety) scores and sympathetic nerve activity. There was no significant difference in the number of steps between the groups. An intervention combining ABM and CBT reduced anxiety among patients with hematopoietic malignancies, which was likely mediated by attenuation of sympathetic nervous system activity. However, this intervention did not influence the overall physical activity. Therefore, including a psychological component can enhance the efficacy of an exercise program.