Change In Interpretation Bias Research Articles

A Single-Session Online Cognitive Bias Modification of Interpretations Modified for Adults With Anxiety and Depressive Symptoms

Anxiety and depression are common, co-occurring, and costly mental health disorders. Cognitive bias modification aims to modify biases to reduce associated symptoms. Few studies have targeted multiple biases associated with both anxiety and depression, and those that have lacked a control condition. This study piloted a single-session online cognitive bias modification (known as CBM-IA) designed to target two biases associated with anxiety and depression—interpretation bias and attribution style—in adults with varying levels of anxiety and depressive symptoms. Participants (18–26 years) with at least mild levels of anxiety/stress and depressive symptoms on the DASS-21 were randomly allocated to an intervention (n = 23) or a control (n = 22) condition. The training consisted of a single-session online CBM-IA to encourage positive interpretations and a positive attribution style.Interpretation bias, attribution style, anxious and depressive mood states, and anxiety, stress and depressive symptoms improved at posttraining and at follow-up, irrespective of condition. Changes in interpretation bias from pre- to posttraining were significantly associated with changes in anxious mood state. CBM-IA, as implemented in this single-session pilot study, did not significantly reduce targeted biases and symptoms compared to a control condition. This adds to the mixed evidence on the efficacy of single-session CBM-I for altering biases and symptoms.

A Pilot Feasibility Open Trial of an Interpretation Bias Intervention for Parents of Anxious Children

Interpretation bias is a transdiagnostic mechanism underlying anxiety. Theoretical models highlight the role of parental interpretation bias in predicting and maintaining child anxiety. However, very few studies have examined parent interpretation bias as a treatment target. The current pilot study tested the feasibility and acceptability of an interpretation bias intervention delivered by a smartphone app, called HabitWorks, in parents of anxious children who self-reported at least mild symptoms of anxiety and negative interpretation bias.Parents of anxious youth (ages 8 to 16) were recruited from the waitlists of three child anxiety clinics. They were asked to complete interpretation modification exercises via the HabitWorks app 3 times per week for 1 month. Participants completed assessments at pre- and post-intervention and 1-month follow-up to assess changes in interpretation bias, anxiety symptoms, and overall perceptions of HabitWorks.Participants (N = 14) (Mage = 44.36; 14.29% men, 85.71% women) completed an average of 13.29 exercises out of the 12 prescribed. Acceptability ratings were high. Interpretation bias, as measured by an assessment version of the intervention exercise, significantly improved from pre- to posttreatment, and these improvements were maintained at the 1-month follow-up. Anxiety symptoms significantly improved from the “mild” severity range to the “none to minimal” range.In this pilot feasibility study in parents of anxious youth, HabitWorks was a feasible and acceptable low-intensity intervention. These preliminary results support a future controlled trial of HabitWorks for parents. Future studies are also needed to test whether targeting interpretation bias in parents has downstream effects on maladaptive parent behaviors and ultimately, child interpretation bias and anxiety.

Feasibility and Acceptability of Cognitive Bias Modification for Interpretation as an Adjunctive Treatment for OCD and Related Disorders: A Pilot Randomized Controlled Trial

Cognitive models implicate interpretation bias in the development and maintenance of obsessive compulsive and related disorders (OCRDs), and research supports Cognitive Bias Modification for Interpretation (CBM-I) in targeting this mechanism. However, prior studies in OCRDs have been limited to nonclinical populations, adolescents, and adults in a laboratory setting. This study evaluated the feasibility and acceptability of CBM-I as an adjunctive intervention during intensive/residential treatment (IRT) for adults with OCRDs. We modified a lab-based CBM-I training for adults seeking IRT for OCRDs, and conducted a feasibility trial (N = 4) and subsequent pilot RCT; participants (N = 31) were randomized to receive CBM-I or psychoeducation. Benchmarks were met for feasibility, acceptability, and target engagement. From pre- to post-intervention, the CBM-I group showed a large effect for change in interpretation bias (d = .90), whereas this effect was trivial (d = .06) for psychoeducation. This was the first study to evaluate CBM-I in naturalistic treatment for adults seeking IRT for OCRDs. Findings support the feasibility and acceptability of CBM-I in this novel sample and setting. A larger scale RCT is needed to determine whether CBM-I can enhance OCRD treatment response.

Disentangling the mediating role of modifying interpretation bias on emotional distress using a novel cognitive bias modification program

BackgroundNegative interpretation bias is a potential risk factor for emotional disorders. In this study, we tested a clinically inspired 4-session online Cognitive Bias Modification-Interpretation (CBM-IClin) program to modify negative interpretation biases. MethodsWe randomized one hundred and twenty-one volunteer young adults (Mean age = 21.6 years, SD = 3.5; 85 % women) with varying levels of emotional distress to either an experimental or waitlist control group. Mediation analyses were used to disentangle the associations between the intervention, changes in interpretation biases (assessed by both a self-report and an experimental task), and changes in measures of cognitive vulnerability and symptoms of depression and anxiety. ResultsThe results showed that the CBM-IClin could change negative interpretation biases. Also, it had a direct effect on the change in negative memory bias, an indirect effect on the change in depression symptoms via the change in interpretation bias, and both direct and indirect effects on the change in self-reported dysfunctional attitudes. LimitationsThe study included a non-clinical sample of participants and it did not control for some potential confounding factors (e.g., attentional disorders). Furthermore, participants’ engagement during the sessions at home was not supervised. ConclusionsThe CBM-IClin is a potential tool to prevent and intervene in emotional disorders in young adults and could complement other traditional CBM procedures or clinical interventions.

Efficacy of the Chinese version interpretation bias modification training in an unselected sample: A randomized trial

Training individuals to interpret ambiguous information in positive ways might be an effective method of reducing social anxiety. However, little research had been carried out in Chinese samples, and the effect of interpretation training on other processes such as attentional bias also remained unclear. This study examined the effect of interpretation bias modification program (IMP) on interpretation bias, social anxiety and attentional bias, and the possible mediation effects. 51 healthy adults were randomly assigned to either a 5-session IMP training that guided them to endorse benign interpretation in ambiguous scenarios or an interpretation control condition (ICC). Self-reported measures of social anxiety symptoms, attentional bias and interpretation bias were evaluated before and after training. Results showed that compared to control group, IMP group generated more positive interpretations and less negative interpretations after training (F(1,49) = 7.65, p<0.01, ηp2 = 0.14; F(1,49) = 14.60, p<0.01, ηp2 = 0.23respectively). IMP yielded greater interpretation bias reduction (F(1,49) = 12.84, p<0.01, ηp2 = 0.21) and social anxiety reduction (F(1,49) = 21.39, p<0.01, ηp2 = 0.30) than ICC, but change in attentional bias was not significant between IMP and the control group. Change in interpretation bias did not show a significant mediation effect in the relationship between training condition and social anxiety reduction. This study provided preliminary evidence for the efficacy of the Chinese version of IMP training. Possible methodological issues and interpretations underlying the findings were discussed. This study was registered in Chinese Clinical Trial Registry (www.chitr.org.cn), a WHO approved registry. The title of registration trial was "A Study on the efficiency of cognitive bias and attentional bias training on fear and phobia" and the registration number was ChiCTR2100045670.

Which variations of a brief cognitive bias modification session for interpretations lead to the strongest effects?

Brief computerized programs that train less threatening interpretations (termed Cognitive Bias Modification for Interpretations, or CBM-I) can shift interpretation biases and subsequent anxiety symptoms. However, results have been inconsistent, particularly for studies conducted over the Internet. The current exploratory study tests 13 variations of a single brief session of CBM-I, a non-CBM-I cognitive flexibility condition, a neutral condition, and a no task control condition in an analogue sample with moderate to severe anxiety. Results suggest that all conditions, except the neutral scenarios condition and the alternative way to improve cognitive flexibility, led to changes in interpretations (when compared to the no task control condition). Only conditions geared toward increasing imagery during CBM-I and targeting flexibility related to emotional material differed from the no task control condition on other post-training measures. Presenting valenced interpretations of ambiguous information during brief CBM-I, regardless of the format, can lead to changes in interpretation bias. However, most conditions did not differ from the no task control condition on other post-training assessments (and differences that did occur may be due to chance). Future trials should consider further testing of CBM-I that targets flexibility related to emotional material, and should include an increased number of sessions and trials.

Cognitive bias modification of interpretation training for Chinese undergraduates with depressive symptoms

Because depression is highly prevalent among Chinese undergraduates, it is crucial to develop an approach for early intervention and prevention. Cognitive bias modification of interpretation (CBM-I) has been shown to be an effective approach to alleviate anxiety. However, its utility in improving depression needs further verification. The current study sought to evaluate the efficacy of a four-session CBM-I program of depression prevention for Chinese undergraduates. Forty Chinese participants with depressive symptoms (Self-Rating Depression Scale, SDS ≥ 50) were randomly assigned to receive either a CBM-I training or a waitlist control condition. Test results of Ambiguous Scenarios Test for Depression-Related Bias and SDS indicate that the CBM-I training group have more positive interpretations and fewer symptoms of depression after the training compared to the control group. In addition, significant correlation was found between changes in depressive symptoms and changes in interpretation bias. The effect of the CBM-I on depressive symptoms was partially mediated by the change in interpretation bias. The study findings highlight the potential of CBM-I protocol as a brief, simple, and accessible approach for preventing depression.

Positive Thinking is Not Adaptive Thinking: A Cognitive-Behavioral Take on Interpretation Bias Modification for Social Anxiety

Interpretation biases are a core feature of social anxiety. Used to automatically train positive interpretation biases, the existing versions of Cognitive Bias Modification for Interpretation (CBM-I) render mixed results. The current study presents the development and testing of a one-session novel adaptation of CBM-I for social anxiety that provides an adaptive instead of a positive meaning to socially loaded situations. Informed by Rational-Emotive Behavior Therapy and latest theoretical upgrades, we argue that biases exist on a continuum from adaptive to maladaptive and defining them by valence may fuel unrealistic positive illusions. A hundred forty volunteers with high social anxiety were randomized to the CBM-I or to the sham-training condition. Baseline, post-training, and during impromptu speech assessments of self-reported anxiety were made, while adaptive interpretation bias was measured at baseline and post-training. First, near-transfer effects in favor of the CBM-I group were found. Second, no far-transfer effects were found regarding the anxiety experienced during the speech. Third, a main finding was that changes in interpretation bias fully mediated training effects on anxiety. To our knowledge, this is the first CBM-I study to evidence that experimentally induced changes in interpretation mediate changes in anxiety. The therapeutic potential of this new adaptation of CBM-I requires testing in clinical samples.

The Effect of Confidence on Dropout Rate and Outcomes in Online Cognitive Bias Modification

Cognitive bias modification training for interpretation bias (CBM-I) trains less threat-oriented interpretation patterns using basic learning principles and can be delivered completely online. Thus, CBM-I may increase accessibility of treatment options for anxiety problems. However, online interventions are often affected by pronounced dropout rates, and findings regarding the effectiveness of CBM-I, especially when delivered online, are mixed. Therefore, it is important to identify further predictors of dropout rate and intervention outcomes. The current study uses data from an exclusively online, multi-session CBM-I feasibility trial to investigate the effects of perceived confidence in the likely helpfulness of a CBM-I program (rated at baseline) on subsequent dropout rate, and change in interpretation bias and anxiety symptoms for N = 665 individuals high in trait anxiety. Results showed that higher baseline confidence ratings predicted lower dropout rate, as expected. Partially in line with hypotheses, there was some evidence that higher confidence ratings at baseline predicted greater changes on some interpretation bias measures, but results were not consistent across all measures and fit indices. Inconsistent with hypotheses, confidence did not predict change in anxiety symptoms. Possible explanations for why the nonsignificant findings may have occurred, as well as implications of confidence in online interventions being an early predictor of high risk for dropout, are discussed.

Effects of cognitive load during interpretation bias modification on interpretation bias and stress reactivity

Background and objectivesInterpretation bias modification can affect stress reactivity, yet results have not been consistent. This inconsistency may be partly due to variability in the degree to which training procedures alter interpretation at a more automatic, rather than strategic, level of processing, and a mismatch in available resources between the training and the stress situation. We tested this possibility by investigating whether imposing a secondary cognitive load during interpretation bias modification would strengthen training-induced effects on both interpretation bias and emotional reactivity. MethodWe trained 71 participants in a single session to interpret ambiguity either positively or negatively. Half of our participants did so while performing a cognitively demanding secondary task. We assessed the effects of these different training regimes on interpretation bias and both self-reported and physiological indices of stress reactivity. ResultsPositive and negative interpretation bias modification resulted in training-congruent changes in interpretation bias. There were no group differences in self-reported stress reactivity, but positive interpretation training did improve recovery from stress as indexed by the heart rate measurement. Countering our hypothesis, the addition of cognitive load during the training increased neither the induced interpretive change nor its emotional impact. LimitationsSample size was relatively small, though sufficient to detect medium sized effects. ConclusionsAdding cognitive load to interpretation bias modification does not alter training-induced change in interpretation bias or emotional reactivity.

Effect of an upright (vs. stooped) posture on interpretation bias, imagery, and emotions

Background and objectivesAdopting an upright (vs. stooped) posture has been related to positive effects on emotional and cognitive processes. However, there is no evidence concerning the effect of posture on two key processes associated with the maintenance of depression: interpretation bias and vividness of mental imagery. The objectives were to investigate the effect of adopting an upright (vs. stooped) posture on interpretation bias and vividness of positive and negative mental imagery, and to explore the interplay between these processes and depression-related emotions. MethodsThe sample consisted of 54 participants (Mage = 22.00, 64.8% women), who were randomly assigned to the upright or stooped condition. Participants answered self-report measures while they were adopting a specific posture. Posture was monitored through inertial technology. ResultsMain results were that: upright (vs. stooped) posture led to more positive interpretations of ambiguous information and increased positive emotions related to depression (happiness, optimism and vigor); time in an upright position was associated with change in interpretation bias and vividness of positive mental imagery; and level of depressive symptomatology moderated the effect of posture on the change in interpretation bias. LimitationsLimitations are related to the use of non-clinical sample, the use of short-term measurements, and the lack of an experimental condition adopting the usual posture. ConclusionsPosture interacts with mechanisms involved in the maintenance of depression, as well as with depression-related emotions. This study has clinical implications that should be continued explored in order to clarify the role of manipulating the posture in individuals with depressive symptomatology.

Investigating the Role of Interpretation Bias in Mindfulness-Based Treatment of Adults With Generalized Anxiety Disorder.

Although mindfulness-based interventions (MBIs) have garnered empirical support for a wide range of psychological conditions, the psychological processes that mediate the relationship between MBIs and subsequent symptomatic improvement are less well-understood. In the present study we sought to examine, for the first time, the relationship between mindfulness, negative interpretation bias as measured by the homophone task, and anxiety among adults with Generalized Anxiety Disorder (GAD). Forty-two individuals with GAD completed measures of mindfulness, interpretation bias, and anxiety before and after treatment with Mindfulness-based Stress Reduction (MBSR). Contrary to prior research, we did not find evidence of an indirect relationship between baseline levels of mindfulness and anxiety via negative interpretation bias. MBSR did result in significant reductions in negative interpretation bias from baseline to post-treatment; however, we did not find evidence of an indirect relationship between changes in mindfulness and changes in anxiety via changes in interpretation bias. Taken together, these results provide minimal support for the hypothesized relationship between mindfulness, negative interpretation bias, and anxiety among adults with GAD. Limitations and specific suggestions for further inquiry are discussed.

Effects of interpretation bias modification on unregulated and regulated emotional reactivity

Background and objectivesAlthough induced changes in interpretation bias can lead to reduced levels of stress reactivity, results are often inconsistent. One possible cause of the inconsistencies in the effects of interpretation bias modification (IBM) on stress reactivity is the degree to which participants engaged in emotion regulation while being exposed to stressors. In this study, we distinguished between the effects of IBM on natural, unregulated stress reactivity and the effects of IBM on people's ability to up- or downregulate this stress reactivity. MethodBoth in the context of general anxiety (Experiment 1, N = 59) and social anxiety (Experiment 2, N = 54), we trained participants to interpret ambiguous scenarios in either a positive or a negative manner, and we assessed the effects on unregulated and regulated stress reactivity. ResultsAlthough we found relatively consistent training-congruent changes in interpretation bias in both experiments, these changes had no effect on either unregulated or regulated stress reactivity. LimitationsIn both experiments, we used healthy student samples and relatively mild emotional stressors. ConclusionsIn line with previous research, our findings suggest that the effects of IBM on unregulated stress reactivity may be small and inconsistent. Differences in the extent to which participants engaged in emotion regulation during stressor exposure are unlikely to account for these inconsistencies.

Believing Is Seeing: A Proof-of-Concept Semiexperimental Study on Using Mobile Virtual Reality to Boost the Effects of Interpretation Bias Modification for Anxiety.

BackgroundCognitive Bias Modification of Interpretations (CBM-I) is a computerized intervention designed to change negatively biased interpretations of ambiguous information, which underlie and reinforce anxiety. The repetitive and monotonous features of CBM-I can negatively impact training adherence and learning processes.ObjectiveThis proof-of-concept study aimed to examine whether performing a CBM-I training using mobile virtual reality technology (virtual reality Cognitive Bias Modification of Interpretations [VR-CBM-I]) improves training experience and effectiveness.MethodsA total of 42 students high in trait anxiety completed 1 session of either VR-CBM-I or standard CBM-I training for performance anxiety. Participants’ feelings of immersion and presence, emotional reactivity to a stressor, and changes in interpretation bias and state anxiety, were assessed.ResultsThe VR-CBM-I resulted in greater feelings of presence (P<.001, d=1.47) and immersion (P<.001, ηp2=0.74) in the training scenarios and outperformed the standard training in effects on state anxiety (P<.001, ηp2=0.3) and emotional reactivity to a stressor (P=.03, ηp2=0.12). Both training varieties successfully increased the endorsement of positive interpretations (P<.001, drepeated measures [drm]=0.79) and decreased negative ones. (P<.001, drm=0.72). In addition, changes in the emotional outcomes were correlated with greater feelings of immersion and presence.ConclusionsThis study provided first evidence that (1) the putative working principles underlying CBM-I trainings can be translated into a virtual environment and (2) virtual reality holds promise as a tool to boost the effects of CMB-I training for highly anxious individuals while increasing users’ experience with the training application.

A randomized controlled trial of multi-session online interpretation bias modification training: Short- and long-term effects on anxiety and depression in unselected adolescents.

IntroductionNegatively biased interpretations play an important role in anxiety and depression, which are highly prevalent in adolescence, and changing such biases might thus reduce or prevent emotional disorders. We investigated the short- and long-term effects of an online interpretation bias modification training in unselected adolescents to explore its potential in preventing anxiety and depression.MethodsParticipants (N = 173) were randomly allocated to eight online sessions of interpretation or placebo training. Interpretation bias was assessed pre- and post-training. Primary outcomes of anxiety and depression, and secondary measures of emotional resilience were assessed pre- and post-training and at three, six, and twelve months follow-up.ResultsCompared to placebo, interpretation training marginally increased positive interpretations. Irrespective of training condition, symptoms of anxiety and depression showed a decline post-training and at follow-up, and indices of resilience showed an increase. Change in interpretation bias, baseline interpretation bias, stressful life events, or number of training sessions completed did not moderate the effects on anxiety or depression.ConclusionsResults suggest that interpretation training as implemented in this study has no added value in reducing symptoms or enhancing resilience in unselected adolescents.

Hostile interpretation training for individuals with alcohol use disorder and elevated trait anger: A controlled trial of a web-based intervention

High trait anger is associated with more severe alcohol use problems, and alcohol has been found to facilitate aggressive behavior among individuals with high trait anger. Treatments focused on a sample with alcohol use disorder with elevated anger could reduce alcohol use problems, as well as violence and aggression. We sought to examine the efficacy of interpretation bias modification for hostility (IBM-H) in a sample with high trait anger and alcohol use disorder (AUD). Fifty-eight individuals with AUD and elevated trait anger were randomly assigned to eight web-based sessions (two per week) of IBM-H or a healthy video control condition (HVC). Measures of interpretation bias, anger, and alcohol use were administered at pre- and post-treatment and at one-month follow-up. IBM-H led to greater improvements in interpretation bias compared to HVC at post and follow-up. IBM-H also led to greater reductions in trait anger than HVC, though this was an indirect effect mediated by changes in interpretation bias. Further, IBM-H led to lower anger expression than HVC; this was a direct (non-mediated) effect. Lastly, both conditions reported decreases in alcohol use and consequences following treatment, though there were no significant differences between them. These findings provide initial support for the utility of IBM-H as a brief non-confrontational intervention for AUD with elevated trait anger. Limitations and future research directions are discussed.

Combined “top-down” and “bottom-up” intervention for anxiety sensitivity: Pilot randomized trial testing the additive effect of interpretation bias modification

ObjectiveAnxiety disorders contribute substantially to the overall public health burden. Anxiety sensitivity (AS), a fear of anxiety-related sensations, is one of the few known malleable risk factors for anxiety pathology. Previous AS reduction treatments have primarily utilized “top-down” (e.g., psychoeducation) interventions. The goal of the current study was to evaluate the effect of adding a “bottom-up” (interpretation bias modification; CBM-I) intervention to an AS psychoeducation intervention. DesignSingle-site randomized controlled trial. Participants completed either a 1) Psychoeducation + active CBM-I or 2) Psychoeducation + control CBM-I intervention. Change in AS was assessed post-intervention and at a one-month follow-up. ParticipantsIndividuals with elevated levels of AS. InterventionSingle-session computer-delivered intervention for AS. ResultsAccounting for baseline ASI-3 scores, post-intervention ASI-3 scores were significantly lower in the combined condition than in the psychoeducation + control CBM-I condition (β = 0.24, p < 0.05; d = 0.99). The active CBM-I plus psychoeducation AS intervention was successful in reducing overall AS (59% post-intervention; p < 0.05, Cohen's d = 0.99) and these reductions were maintained through one-month post-intervention (52%; p < 0.05, Cohen's d = 1.18). Participants in the active condition reported significantly lower rates of panic responding to a vital-capacity CO2 challenge (OR = 6.34, 95% CI = 1.07–37.66). Lastly, change in interpretation bias significantly mediated the relationship between treatment condition and post-treatment AS reductions. ConclusionsThe current intervention was efficacious in terms of immediate and one-month AS reductions. Given its brevity, low-cost, low-stigma and portability, this intervention could lead to reducing the burden of anxiety disorders.

Development and randomized trial evaluation of a novel computer-delivered anxiety sensitivity intervention

ObjectiveAnxiety disorders contribute substantially to the overall public health burden of psychopathology. Anxiety sensitivity (AS), a fear of anxiety related sensations, is one of the few known malleable risk factors for anxiety pathology. Previous AS reduction treatments have utilized highly trained clinicians. A completely-computerized AS treatment would reduce costs and increase dissemination possibilities. Cognitive bias modification for interpretation biases (CBM-I) interventions have shown clinically significant reductions in anxiety symptoms. Another emerging literature focused on learning has shown context-shifting tasks can greatly increase learning without adding logistical burden to an intervention. The current study evaluated a CBM-I for AS that utilized a context-shifting task to deliver twice the treatment dose of extant interventions. DesignSingle-site randomized controlled trial. Participants completed an intervention appointment, as well as one-week and one-month follow-up assessments. ParticipantsIndividuals with elevated levels of AS. InterventionSingle-session computer-delivered CBM-I for AS. ResultsResults indicate that the CBM-I for AS was successful in reducing overall AS (62% post-intervention) and these reductions were maintained through one-month post-intervention (64%). Results also revealed that individuals in the active condition reported significantly less incidents of panic responding to a physiological straw-breathing challenge and that change in interpretation bias significantly mediated the relationship between treatment condition and post-treatment AS reductions. ConclusionsTaken together, the results show that the current CBM-I intervention was strong in terms of immediate and one-month AS reductions. Given its brevity, low cost, low stigma and portability, this intervention could have substantial impact on reducing the burden of anxiety disorders.

How to boost positive interpretations? A meta-analysis of the effectiveness of cognitive bias modification for interpretation.

The current meta-analysis explores the strength of effects of cognitive bias modification training for interpretation bias (CBM-I) on positive (i.e., adaptive) interpretations and mood as well as the training and sample characteristics influencing these effects. Data-bases were searched with the key words “interpret* bias AND training” and “interpret* bias AND modif*”. Reference lists of identified articles were checked and authors of identified articles were contacted for further relevant articles and unpublished data. Studies were reviewed for inclusion with eligibility criteria being that the study (a) aimed to target interpretation biases through any kind of training, (b) assessed mood and/or interpretation bias as outcome measures, (c) allocated individuals to training conditions at random, and (d) recruited adult samples. A meta-analytic multilevel mixed-effects model was employed to assess standardized mean changes in interpretation bias, negative mood, and emotional reactivity. In addition, several training and sample characteristics were explored for their potential to enhance benign training effectiveness. On average, benign CBM-I resulted in an increase in positive interpretation bias (p<.01) and a decrease in negative mood state (p<.001), but did not affect emotional reactivity. These effects were not consistently different from control conditions with no or neutral training. However, within benign training conditions imagery instructions and more training sessions were related to larger cognitive and mood effects, whereas feedback about training performance and inclusion of non-benign training items (instead of including benign items only) boosted cognitive effects only. Finally, training was more effective in women (cognitive and mood effects) and presumably samples with symptomatic emotional dysregulation (cognitive effects). Although the effects of emotional dysregulation and number of training sessions could not well be distinguished, there is an indication that when used with imagery instructions and more training sessions, benign CBM-I can be employed as a useful complementary treatment to usual psychotherapies.

Cognitive Bias Modification (CBM) of obsessive compulsive beliefs

BackgroundCognitive bias modification (CBM) protocols have been developed to help establish the causal role of biased cognitive processing in maintaining psychopathology and have demonstrated therapeutic benefits in a range of disorders. The current study evaluated a cognitive bias modification training paradigm designed to target interpretation biases (CBM-I) associated with obsessive compulsive disorder (OCD).MethodsWe evaluated the impact of CBM-I on measures of interpretation bias, distress, and on responses to three OC stressor tasks designed to tap the core belief domains of Importance of Thoughts/Control, Perfectionism/Intolerance of Uncertainty, and Contamination/Estimation of Threat in a selected sample of community members reporting obsessive compulsive (OC) symptoms (N = 89).ResultsParticipants randomly assigned to the Positive condition evidenced a change in interpretation bias towards more positive and less negative OC-relevant interpretations following CBM-I compared to participants assigned to the Control condition. Importantly, a positivity bias was not observed for foil scenarios unrelated to the core OC belief domains. Further, participants in the Positive condition reported less distress and urge to neutralize following an OC stressor task designed to tap Importance of Thoughts/Control. No significant difference emerged on the indices of behavioural response to the OC stressor tasks. Severity of OC symptoms did not moderate the effects of positive CBM-I training.ConclusionsCBM-I appears effective in selectively targeting OC beliefs. Results need to be replicated in clinical samples in order for potential therapeutic benefit to be demonstrated.