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Breast cancer diagnosis and treatment can lead to longer term cognitive and emotional vulnerability, making the ability to efficiently adapt to setbacks critical. Whilst cancer-related cognitive impairments (CRCI) are often reported amongst breast cancer survivors, investigation into the capacity to efficiently process errors is limited. The present study investigated the neurocognitive correlates of cognitive-control related performance monitoring, an important function influencing behavioural adjustment to mistakes. 62 participants (30 Breast Cancer Survivors, 32 Non-Cancer) completed a modified flanker task designed to challenge response inhibition as we measured neurocognitive indices of performance monitoring (ERN, the error-related negativity; CRN, the correct-response negativity; Pe, the error positivity). Findings indicated a blunted CRN and larger ∆ERN in the breast cancer survivors compared to the non-cancer group, in the absence of performance effects. This was followed by a larger Pe in the breast cancer survivors' group, indicating an exaggerated performance monitoring response. For women affected by breast cancer, findings suggest an early disrupted neural response to monitoring cognitive performance, followed by the requirement for more effortful processing in the conscious response to errors, indicating deficits in neurocognitive efficiency. These findings have important implications for developing cognitive rehabilitation programmes for breast cancer survivors affected by cognitive dysfunction to assist in the monitoring and adjustment of performance required to meet established goals in the face of adversity.

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RESUMEN

The outbreak of Coronavirus disease 2019 (COVID-19) has negatively impacted global economies and employment. In the UK, it is predicted that approximately eight million jobs were furloughed as a result of the outbreak and the associated restriction of movement or shielding measures. This study aimed to investigate the impact of changes in employment status on cognitive and emotional health as well as perceptions of work. Furthermore, it examined the relationships between women's job security and anxiety, depression and cognitive function. Women living with breast cancer (N = 234) completed online questionnaires to measure their cognitive function, general emotional well-being, COVID-19 related emotional vulnerability (COVID-EMV), work ability and COVID-19 related perceptions of work. Our results revealed that threat to job security was predictive of depression and cognitive function in the entire sample Such that those with higher levels of perceived job security had lower depression and better cognitive function. Further, women who were furloughed or unable to continue work reported higher job insecurity compared to those who had worked throughout the pandemic. Greater rumination was also associated with worse anxiety and depression as well as poorer cognitive function. Finally, moderation analysis highlighted that women who had better cognitive functioning were less likely to experience anxiety when their job security was high. Given our findings, we suggest that employers provide women with accessible interventions to enhance cognitive and emotional resilience and thus help protect against the detrimental effects of job insecurity created by the COVID-19 outbreak.

RESUMEN

The Coronavirus disease 2019 (COVID-19) outbreak generated an unprecedented set of emotional challenges for women diagnosed with breast cancer. In the United Kingdom (UK), the pandemic significantly disrupted oncology services as resources were reassigned to care for COVID-19 patients. In addition to service disruptions, many women received a UK Government letter advising them to shield for 12-weeks. We aimed to explore the effect of disruption to scheduled oncology services and the UK Government shielding letter on emotional and cognitive vulnerability. A further aim was to investigate the relationship between COVID-19 related emotional vulnerability (COVID-EMV) and anxiety, depression and perceived cognitive function. Women diagnosed with primary breast cancer (N = 234) completed a series of online questionnaires to assess their cognitive and emotional wellbeing as well as their COVID-EMV. Results indicated that disrupted oncology services had a significant impact on COVID-EMV, anxiety and depression, with those experiencing disruptions expressing higher general emotional vulnerability as well as COVID-EMV. Further, the UK Government letter had a significant effect on perceived cognitive function; those who received the letter reported poorer cognitive function. Regression analyses revealed that after allowing for the effects of sociodemographic and clinical variables, women's COVID-EMV significantly predicted worse outcomes of anxiety, depression and perceived cognitive function. Our findings indicate that concerns about COVID-19 amongst women affected by breast cancer leads to increased risk of developing affective disorder, such as anxiety and depression symptomatology, among this sample. We advocate the rapid implementation of accessible interventions designed to promote emotional resilience in the breast cancer population.

RESUMEN

OBJECTIVES: Breast cancer enhances anxiety and depressive vulnerability, profoundly impairing the quality of life in survivors. Hinging on recent research that training attentional control can reduce emotional vulnerability, we assess how improving cognitive function could reduce emotional vulnerability in female survivors of breast cancer. METHODS: Participants took part in a course of adaptive dual n-back cognitive training (Training Group) or a non-adaptive active control group (Active Control) for 12 days across a 2-week period. Transfer-related training gains were assessed immediately after the intervention, at a shorter 1-month follow-up and at a longer follow-up time of approximately 15 months post intervention, to assess sustainability of training effects. RESULTS: Adaptive cognitive training reduced anxiety and rumination with effects evident at shorter and longer term follow-up assessments. CONCLUSIONS: Our results are among the first to suggest that adaptive cognitive training can reduce emotional vulnerability in breast cancer, with the potential to enhance quality of life in survivorship. Our findings have profound implications for designing interventions targeting cognitive function in populations who have suffered from cancer.

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