Multisession Cognitive Bias Modification Targeting Multiple Biases in Adolescents with Elevated Social Anxiety

Stephen C Lisk,Jennifer Y F Lau,Victoria Pile,Veena Kumari,Simone P W Haller

doi:10.1007/s10608-018-9912-y

Stephen C Lisk, Jennifer Y F Lau + Show 3 more

Open Access

https://doi.org/10.1007/s10608-018-9912-y

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Abstract

Research studies applying cognitive bias modification of attention (CBM-A) and interpretations (CBM-I) training to reduce adolescent anxiety by targeting associated cognitive biases have found mixed results. This study presents a new multi-session, combined bias CBM package, which uses a mix of training techniques and stimuli to enhance user-engagement. We present preliminary data on its viability, acceptability and effectiveness on reducing symptoms and biases using an A–B case series design. 19 adolescents with elevated social anxiety reported on their social anxiety, real-life social behaviours, general anxiety, depression, and cognitive biases at pre/post time-points during a 2-week baseline phase and a 2-week intervention phase. Retention rate was high. Adolescents also reported finding the CBM training helpful, particularly CBM-I. Greater reductions in social anxiety, negative social behaviour, and general anxiety and depression, characterised the intervention but not baseline phase. There was a significant correlation between interpretation bias change and social anxiety symptom change. Our enhanced multi-session CBM programme delivered in a school-setting appeared viable and acceptable. Training-associated improvements in social anxiety will require further verification in a study with an active control condition/group.

Highlights

Social anxiety is prevalent in youth (Wittchen et al 1999), can disrupt academic performance and interpersonal interactions (Owens et al 2008), persist into adulthood, and impact other disabling mental health conditions and quality of life (Woodward and Fergusson 2001)
Cognitive bias modification (CBM) training, which uses computerised tasks to target symptom-linked cognitive biases, has emerged as a potential adjunctive intervention (Butler et al 2015; White et al 2016) that may be amenable to delivery through computerised formats at home (Salemink et al 2014) or in school (Fitzgerald et al 2016)
This study presents a newly developed, multi-session computerised training program that targets multiple cognitive biases using a variety of training techniques and stimuli, for adolescents with elevated social fears

Summary

Introduction

Social anxiety is prevalent in youth (Wittchen et al 1999), can disrupt academic performance and interpersonal interactions (Owens et al 2008), persist into adulthood, and impact other disabling mental health conditions and quality of life (Woodward and Fergusson 2001). Cognitive behavioural therapy (CBT), the current gold-standard treatment, can reduce social anxiety in youth (Scaini et al 2016) but many fail to show clinically significant responses (Kendall et al 2012), respond but subsequently relapse (Ginsburg et al 2014), or find it difficult to access. Identifying more effective, accessible methods so that young people We assess the viability of administering this training tool at school, it’s acceptability to young people and compare changes in biases and symptoms across a baseline and an intervention phase

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