Effects Of Cognitive Bias Modification Research Articles

Persistent Double Standards in Evaluating the Effectiveness of Cognitive Bias Modification: A Commentary on Wiers et al. (2018)

Persistent Double Standards in Evaluating the Effectiveness of Cognitive Bias Modification: A Commentary on Wiers et al. (2018)

Modifying a negative interpretation bias for ambiguous social scenarios that depict the risk of rejection in women with anorexia nervosa

BackgroundA heightened sensitivity to social rejection might contribute towards the interpersonal difficulties and symptoms that characterise Anorexia Nervosa (AN). This paper examines the effect of Cognitive Bias Modification for Interpretation biases (CBM-I) training on a negative interpretation bias for ambiguous social scenarios that involve the risk of rejection and eating behaviour. MethodWomen with AN received a single session of CBM-I training to develop a more benign interpretational style or a control condition (which included 50:50 negative and benign resolutions). To measure participant's interpretation bias for social stimuli, a sentence completion task was used pre and post-training (a near-transfer outcome measure). A test meal was given after the training and salivary cortisol (stress) levels were measured as far-transfer outcome measures. ResultsCBM-I training led to a significant reduction in a negative interpretation bias in both conditions. No effect on eating behaviour or stress was found, which may be expected as the training conditions did not significantly differ in interpretation bias change. LimitationsThe control condition may have inadvertently reduced a negative interpretation bias as it involved listening to benign resolutions to ambiguous social scenarios for 50% of the trials. ConclusionsIt is possible to modify a negative interpretation bias for social stimuli. To clarify the effect of CBM-I training on AN symptomatology, repeated, more intensive, and ecologically-valid training interventions may be required. This is because any change in eating behaviour may not be immediate, particularly in a population with a low body mass index and long-illness durations.

Impulsivity and approach tendencies towards cigarette stimuli: Implications for cigarette smoking and cessation behaviors among youth.

Impulsivity is associated with smoking, difficulties quitting smoking, and approach tendencies toward cigarette stimuli among adolescents. We examined the effects of impulsivity on (a) the association between approach tendencies and adolescents' smoking status and (b) the effectiveness of Cognitive Bias Modification (CBM), a smoking cessation intervention focused on changing approach tendencies, among adolescent smokers. We conducted a secondary analysis of evidence from 2 previous published studies: Study 1: a cross-sectional study comparing impulsivity and approach tendencies between adolescent smokers (n = 67) and nonsmokers (n = 58); Study 2: a treatment study that randomized 60 adolescent smokers to receive either CBM or sham training. Impulsivity was measured using the Barratt Impulsiveness Scale (BIS) and the Experiential Discounting Task (EDT). We found higher impulsivity, as determined by the BIS but not the EDT, increased adolescents' odds of being smokers. We observed that the interaction between EDT and approach tendencies also significantly predicted smoking status, however post hoc comparisons were not significant. Adolescents with higher BIS scores receiving CBM had increased odds of being abstinent at the end of treatment, but we found no association between EDT and treatment outcome. Our findings suggest that approach-bias modification (a form of CBM) may be more effective in impulsive adolescent smokers. Differences in findings for BIS and EDT highlight the complexity of the construct of impulsivity. Future studies with larger samples are needed to further disentangle the effects of different aspects of impulsivity on smoking behaviors and cessation outcomes among youth. (PsycINFO Database Record

Effects of cognitive bias modification on social anxiety: A meta-analysis.

BackgroundCognitive bias modification (CBM), a set of techniques for modifying bias in information processing—is considered a novel intervention for social anxiety disorder (SAD), which has drawn considerable interest from researchers. However, the effects of CBM on SAD are not consistent. Some studies have demonstrated significant positive effects compared to control groups, while others have found no such effects.AimsWe conducted a meta-analysis aimed at quantitatively assessing the effects of CBM on SAD at post-test.MethodThrough a systematic literature search by two independent raters, 34 articles (36 randomized studies) including 2,550 participants were identified. A multilevel modeling approach was employed to assess the effects of CBM on SAD, and to explore the potentially crucial procedures and sample characteristics that enhance the effectiveness of benign training.ResultsIn general, there were small but significant effects of CBM on the primary symptoms of SAD (g = 0.17), cognitive bias (CB) toward threat (g = 0.32), and reactivity in stressful situations (g = 0.25), but non-significant effects on secondary symptoms. However, the interpretation modification program was more effective than was attentional bias modification in reducing SAD primary symptoms and negative CB. Laboratory training procedures produced larger primary symptom reductions compared to Internet-based training, whereas the percentage of contingency and feedback about training performance boosted cognitive effects only. Finally, the following groups were more likely to benefit from CBM: younger participants (primary symptoms and cognitive effects), women (primary symptom effects), and samples with stronger CB (stressor effects). The quality of the randomized controlled trials was less than desirable, as there was some indication of publication bias in our study.ConclusionsCurrent findings broadly supported cognitive theories of SAD that consider a bidirectional or mutually reinforcing relationship between symptoms and CBs. However, the small therapeutic effect observed here indicates that it is necessary to develop more reliable and efficient CBM interventions that are specific to SAD.

Asymmetrical transfer effects of cognitive bias modification: Modifying attention to threat influences interpretation of emotional ambiguity, but not vice versa

Background and objectivesIt is well established that attention bias and interpretation bias each have a key role in the development and continuation of anxiety. How the biases may interact with one another in anxiety is, however, poorly understood. Using cognitive bias modification techniques, the present study examined whether training a more positive interpretation bias or attention bias resulted in transfer of effects to the untrained cognitive domain. Differences in anxiety reactivity to a real-world stressor were also assessed. MethodsNinety-seven first year undergraduates who had self-reported anxiety were allocated to one of four groups: attention bias training (n = 24), interpretation bias training (n = 26), control task training (n = 25) and no training (n = 22). Training was computer-based and comprised eight sessions over four weeks. Baseline and follow-up measures of attention and interpretation bias, anxiety and depression were taken. ResultsA significant reduction in threat-related attention bias and an increase in positive interpretation bias occurred in the attention bias training group. The interpretation bias training group did not exhibit a significant change in attention bias, only interpretation bias. The effect of attention bias training on interpretation bias was significant as compared with the two control groups. There were no effects on self-report measures. LimitationsThe extent to which interpretive training can modify attentional processing remains unclear. ConclusionsFindings support the idea that attentional training might have broad cognitive consequences, impacting downstream on interpretive bias. However, they do not fully support a common mechanism hypothesis, as interpretive training did not impact on attentional bias.

The Cognitive and Emotional Effects of Cognitive Bias Modification in Interpretations in Behaviorally Inhibited Youth

Cognitive bias modification (CBM) procedures follow from the view that interpretive biases play an important role in the development and maintenance of anxiety. As such, understanding the link between interpretive biases and anxiety in youth at risk for anxiety (e.g., behaviorally inhibited children) could elucidate the mechanisms involved in the development of pediatric anxiety. However, to date, the majority of CBM-I work only studies adult populations. The present article presents the results of a CBM study examining effects of positive interpretive bias modification on mood, stress vulnerability, and threat-related attention bias in a group of behaviorally inhibited children (n = 45). Despite successful modification of interpretive bias in the at-risk youth, minimal effects on stress vulnerability or threat-related attention bias were found. The current findings highlight the need for continued research on cognitive biases in anxiety.

Effects of varenicline and cognitive bias modification on neural response to smoking-related cues: study protocol for a randomized controlled study.

BackgroundSmoking-related cues can trigger drug-seeking behaviors, and computer-based interventions that reduce cognitive biases towards such cues may be efficacious and cost-effective cessation aids. In order to optimize such interventions, there needs to be better understanding of the mechanisms underlying the effects of cognitive bias modification (CBM). Here we present a protocol for an investigation of the neural effects of CBM and varenicline in non-quitting daily smokers.Methods/DesignWe will recruit 72 daily smokers who report smoking at least 10 manufactured cigarettes or 15 roll-ups per day and who smoke within one hour of waking. Participants will attend two sessions approximately one week apart. At the first session participants will be screened for eligibility and randomized to receive either varenicline or a placebo over a seven-day period. On the final drug-taking day (day seven) participants will attend a second session and be further randomized to one of three CBM conditions (training towards smoking cues, training away from smoking cues, or control training). Participants will then undergo a functional magnetic resonance imaging scan during which they will view smoking-related pictorial cues. Primary outcome measures are changes in cognitive bias as measured by the visual dot-probe task, and neural responses to smoking-related cues. Secondary outcome measures will be cognitive bias as measured by a transfer task (modified Stroop test of smoking-related cognitive bias) and subjective mood and cigarette craving.DiscussionThis study will add to the relatively small literature examining the effects of CBM in addictions. It will address novel questions regarding the neural effects of CBM. It will also investigate whether varenicline treatment alters neural response to smoking-related cues. These findings will inform future research that can develop behavioral treatments that target relapse prevention.Trial registrationRegistered with Current Controlled Trials: ISRCTN65690030. Registered on 30 January 2014.

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.

The effect of cognitive bias modification for interpretation on avoidance of pain during an acute experimental pain task

Research confirms that patients with chronic pain show a tendency to interpret ambiguous stimuli as pain related. However, whether modifying these interpretive pain biases impacts pain outcomes is unknown. This study aimed to demonstrate that interpretation biases towards pain can be modified, and that changing these biases influences pain outcomes in the cold pressor task. One hundred and six undergraduate students were randomly allocated to receive either threatening or reassuring information regarding the cold pressor. They also were randomly allocated to 1 of 2 conditions in the Ambiguous Scenarios Task, in which they were trained to have either a threatening interpretation of pain (pain bias condition) or a nonthreatening interpretation of pain (no pain bias condition). Therefore, the study had a 2 (threat/reassuring)×2 (pain bias/no pain bias) design. Analyses showed that a bias was induced contingent on condition, and that the threat manipulation was effective. Participants in the pain bias condition hesitated more before doing the cold pressor task than those in the no pain bias condition, as did those in the threat compared with the reassurance condition. The major finding was that interpretive bias mediated the relationship between bias condition and hesitance time, supporting the causal role of interpretive biases for avoidance behaviors in current chronic pain models. No differences were found on other pain outcomes regarding bias or threat, and the efficacy of the bias modification was not impacted by different levels of threat. These results suggest that cognitive bias modification should be further explored as a potential intervention in pain.

Rumination Moderates the Effects of Cognitive Bias Modification of Attention

Whereas research on cognitive bias modification of attention has produced promising results, it remains unclear how and for whom such techniques may be most effectively implemented. This study examined how trait rumination moderated the effects of two attention training tasks on biased attention, assessed via eye tracking, and subsequent stress reactivity. Using a modified dot-probe task, participants were trained to develop a negative attention bias, a positive attention bias, or no attention bias. Though neither the train-negative nor the train-positive conditions produced significant main effects on attention biases or emotional reactivity, rumination was found to moderate training efficacy, such that train-positive participants reporting high levels of rumination demonstrated greater early-stage positive attention biases at post-training, as compared to controls. Further, train-negative and train-positive participants who reported low levels of rumination demonstrated greater positive affect following an acute stressor as compared to controls. Theoretical and clinical implications of results are discussed.

A meta-analysis of the effect of cognitive bias modification on anxiety and depression.

Cognitive biases have been theorized to play a critical role in the onset and maintenance of anxiety and depression. Cognitive bias modification (CBM), an experimental paradigm that uses training to induce maladaptive or adaptive cognitive biases, was developed to test these causal models. Although CBM has generated considerable interest in the past decade, both as an experimental paradigm and as a form of treatment, there have been no quantitative reviews of the effect of CBM on anxiety and depression. This meta-analysis of 45 studies (2,591 participants) assessed the effect of CBM on cognitive biases and on anxiety and depression. CBM had a medium effect on biases (g = 0.49) that was stronger for interpretation (g = 0.81) than for attention (g = 0.29) biases. CBM further had a small effect on anxiety and depression (g = 0.13), although this effect was reliable only when symptoms were assessed after participants experienced a stressor (g = 0.23). When anxiety and depression were examined separately, CBM significantly modified anxiety but not depression. There was a nonsignificant trend toward a larger effect for studies including multiple training sessions. These findings are broadly consistent with cognitive theories of anxiety and depression that propose an interactive effect of cognitive biases and stressors on these symptoms. However, the small effect sizes observed here suggest that this effect may be more modest than previously believed.

Cognitive bias modification: Induced interpretive biases affect memory.

Previous research has shown that it is possible to experimentally induce interpretive biases using ambiguous scenarios. This study extends past findings by examining the effects of cognitive bias modification for interpretation on subsequent scenario recall. Participants were trained to interpret emotionally ambiguous passages in either a positive or negative direction. Transfer of the training to novel scenarios was tested. After training, participants were also asked to recall details from these novel scenarios. The results indicate that the training was effective in inducing the intended group differences in interpretive bias. Importantly, participants exhibited memory biases that corresponded to their training condition. These results suggest that manipulating interpretive biases can result in corresponding changes in memory. Findings from this study highlight the importance of future research on the relation among cognitive biases and on the possibility of modifying cognitive biases in emotional disorders.