Interpretation Bias Across Body Dysmorphic, Social Anxiety and Generalized Anxiety Disorder\u2014A Multilevel, Diffusion Model Account

Fanny Alexandra Dietel,Anne Möllmann,Paul-Christian Bürkner,Sabine Wilhelm,Ulrike Buhlmann

doi:10.1007/s10608-020-10180-7

Abstract

BackgroundInterpretation biases are suggested to be transdiagnostic phenomena, but have rarely been compared across different disorders and current concerns.MethodsWe investigated explicit, decision-based, and more implicit, reaction time-based interpretation bias in individuals with body dysmorphic disorder (BDD; N = 29), social anxiety disorder (SAD; N = 36), generalized anxiety disorder (GAD; N = 22), and non-clinical controls (NC; N = 32), using an adapted Word Sentence Association Paradigm (WSAP).ResultsResults indicated that interpretation bias occurred transdiagnostically, while content-specific bias patterns varied meaningfully across groups. BDD and SAD shared explicit and, more inconsistently, implicit interpretation biases for appearance-related and social situations. The GAD group exhibited an explicit and implicit negative interpretation bias for general situations, and an additional implicit lack of positive bias. Mechanistic Wiener diffusion model analyses revealed that interpretation bias patterns were mainly driven by speeded information uptake, potentially mirroring disorder-specific associative memory organization.ConclusionsThese findings have important implications for understanding interpretation biases as both etiological and treatment factors.

Highlights

The tendency to misinterpret ambiguous situations, termed interpretation bias, is proposed to maintain a range of emotional disorders (e.g., Mathews and MacLeod 2005).Electronic supplementary material The online version of this article contains supplementary material, which is available to authorized users.Consistently, interpretation biases are considered to be transdiagnostic phenomena (Craske et al 2009; Harvey et al 2004; Mansell et al 2008), emerging from aberrant information processing that is guided by underlying dysfunctional beliefs and current concerns
In reference to classic cognitive models, we explored the contributive value of decisional processes in implicit interpretation bias, which may be interpreted as indices of associative memory underlying interpretations (McKoon and Ratcliff 2012; White et al 2010)
This study investigated the phenomenology of interpretation bias across different clinical disorders (i.e., body dysmorphic disorder (BDD), social anxiety disorder (SAD), generalized anxiety disorder (GAD), vs. non-clinical controls (NC)) and current concerns

Summary

Introduction

The tendency to misinterpret ambiguous situations, termed interpretation bias, is proposed to maintain a range of emotional disorders (e.g., Mathews and MacLeod 2005). The Word Sentence Association Paradigm (WSAP; Beard and Amir 2009) was designed to yield different explicit and implicit interpretation bias indices In this task, participants are asked to judge as fast as possible if an ambiguous sentence and a positive or negative interpretation are related. Cognitive-behavioral models of GAD identify intolerance of ambiguity as a catalyst for habitual negative interpretations and worry (see Hirsch et al 2016, for an overview) It remains unclear how individuals with GAD respond to concerns present in other disorders. Using an adapted version of the WSAP (Hindash and Amir 2012), we assessed decision rates and RT for positive and negative interpretations in three categories central to these disorders: appearance-related, social, and generally threatening situations. We further assumed that these disorder-specific patterns would be reflected in concurrent RT, i.e., faster endorsement and slower rejection of negative interpretations, and the reverse pattern for positive interpretations, as compared to NC

Participants

Procedure

Design and Statistical Analyses

A Priori Power Analysis

Results

Discussion