How Anxious are You Right Now? Using Ecological Momentary Assessment to Evaluate the Effects of Cognitive Bias Modification for Social Threat Interpretations

Abstract

Reducing one’s tendency to interpret ambiguous situations negatively can improve symptoms of social anxiety. This study examines the effectiveness of a 1-week period of online Cognitive Bias Modification for Interpretations (CBM-I) for socially anxious individuals. In addition to measuring intervention effectiveness through traditional trait measures, this study investigates whether associated state measures are sensitive to intervention effects in daily life. One-hundred and six participants scoring high on a measure of trait social anxiety completed two in-lab sessions separated by 5 weeks of ecological momentary assessment, with 51 participants randomly assigned to receive the online CBM-I intervention halfway through the 5-week monitoring period. CBM-I training was more effective than monitoring alone in reducing trait negative interpretation bias, indicating target engagement. However, this change was not reliably accompanied by changes on other cognitive processing style outcomes. Further, while trait and state social anxiety symptoms and fear of negative evaluation improved, these changes were not unique to the CBM-I intervention group. This study demonstrates the challenges and opportunities associated with investigating intervention effects in daily life.