Investigating the therapeutic potential of cognitive bias modification for high anxiety sensitivity

MacDonald, Emma M.; Koerner, Naomi; Antony, Martin M.; Vickers, Kristin S.; Mastorakos, Tessie; Kuo, Janice R.

doi:10.1016/j.jbtep.2019.101521

Cited by 5 publications

(5 citation statements)

References 41 publications

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“…Previous studies have explored the training effect of CBM-I on negative interpretation bias, but the results were not consistent. One study showed that CBM-I could effectively reduce the negative interpretation bias in individuals with social anxiety ( Yeung & Sharpe, 2019 ); the other reported that CBM-I has no significant effect on the interpretation bias of individuals with anxiety disorders ( MacDonald et al, 2020 ). In this regard, it has been pointed out that the consistency/inconsistency of the materials and tasks used in the intervention and outcome evaluation may have a confounding effect ( Hertel & Mathews, 2011 ), the more similar the two sets of materials and tasks, the larger the estimated effect size ( Gonsalves et al, 2019 ).…”

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confidence: 99%

Modification of hostile interpretation bias and self-reported aggression in juvenile delinquents: A randomized controlled trial

Ren

Zhao

et al. 2021

International Journal of Clinical and Health Psychology

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Background/Objective The social information processing model holds that aggressive behavior is closely related to the hostile interpretation of ambiguous social cues, suggesting the possibility that an intervention that reduces hostile interpretations could reduce aggression. This study in Mainland China evaluated the remediating effects of cognitive bias modification for interpretation (CBM-I) on the hostile interpretation bias and self-reported aggressive behaviors of male juvenile delinquents, taking into account initial hostile interpretation bias as a possible moderator of the intervention effect. Method Fifty-six male juvenile delinquents aged 16-18 were recruited and randomly assigned to the CBM-I group ( n = 28) or the Waiting-List group ( n = 28). Interpretation bias and self-reported aggressive behavior were assessed at pre-test and post-test. Results The positive interpretations of participants in the CBM-I group were significantly increased compared with participants in the Waiting-List group. The intervention effect of CBM-I on self-reported physical aggression was significant only for juvenile delinquents with high pre-test hostile interpretation bias. Conclusions CBM-I can significantly improve the positive interpretation bias of juvenile delinquents, and reduce the self-reported physical aggression for some male juvenile delinquents. The results have implications for providing low-cost and high-efficiency intervention for juvenile delinquents’ self-reported aggression behavior.

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confidence: 99%

Modification of hostile interpretation bias and self-reported aggression in juvenile delinquents: A randomized controlled trial

Ren

Zhao

et al. 2021

International Journal of Clinical and Health Psychology

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“…To my knowledge, no one has yet systematically explored the likelihood of ceiling effects in BATs more generally. While ceiling effects have occurred in some studies (e.g., MacDonald et al, 2013MacDonald et al, , 2020, they do not occur in others (e.g., Antony et al, 2001). For example, MacDonald et al (2013) found that 71% of participants remained in a BAT targeting anxiety sensitivity for the maximum allotted time at pretreatment despite researchers attempting to make the BAT more difficult by increasing the maximum time limit used in previous studies (MacDonald et al, 2013).…”

Section: Treatment Gainsmentioning

confidence: 99%

“…For example, MacDonald et al (2013) found that 71% of participants remained in a BAT targeting anxiety sensitivity for the maximum allotted time at pretreatment despite researchers attempting to make the BAT more difficult by increasing the maximum time limit used in previous studies (MacDonald et al, 2013). This pattern persisted for over half of participants (58%) even when BATs were tailored to each participant by allowing them to select the BAT that best addressed their particular feared outcome (MacDonald et al, 2020). In contrast, Antony et al (2001) found that participants with spider phobia completing an eight-step BAT ranging in difficulty from looking at a spider in a jar to letting the spider walk on one's hand completed, on average, 4 of 8 steps at pretreatment.…”

Section: Treatment Gainsmentioning

confidence: 99%

“…One possible solution to the problem of a ceiling effect would be to make the BAT more difficult. However, the difficulty level needed is potentially allusive given unsuccessful attempts to eliminate ceiling effects by increasing difficulty level or tailoring BATs to individual participants (e.g., MacDonald et al, 2013MacDonald et al, , 2020. Alternatively, participants who complete a certain number of steps on the BAT at pretreatment could be excluded from the study (e.g., Öst et al, 2001).…”

Section: Treatment Gainsmentioning

confidence: 99%

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Cognitive Restructuring Before Versus After Exposure: The Effect on Expectancy and Outcome in Individuals with Claustrophobia

Krause

2024

Preprint

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<p>Several strategies have been proposed for optimizing learning during exposure therapy. One strategy, expectancy violation, is thought to facilitate learning by maximizing the discrepancy between expected and actual outcomes of exposure. In the inhibitory learning model, Craske et al. (2014) suggest that engaging in cognitive restructuring (CR) prior to exposure will prematurely reduce expectancy (i.e., how much one believes a feared outcome will occur) and mitigate outcomes. Instead, they recommend reserving CR for after exposure to consolidate learning. To the best of my knowledge, this assumption has not been tested. The goal of this study was to examine whether CR before exposure prematurely reduces expectancy and mitigates outcomes. Participants (N = 93) endorsing all DSM-5 criteria or all DSM-5 criteria except clinically significant distress or impairment for specific phobia (enclosed places) attended an intervention bookended by pretreatment and posttreatment assessments, and a 1-month follow-up assessment. Participants were randomized to one of two interventions (1) the CR Before condition: 15 minutes of CR before exposure or (2) the CR After condition: 15 minutes of CR after exposure. A 15-minute filler task of self-report questionnaires was used as a no-treatment comparison: the CR Before condition completed the filler task after exposure and the CR After condition completed the filler task before exposure. Participants rated their expectancy (e.g., “I might suffocate,” “I might become trapped”) from 0% to 100% before and after engaging in either CR or the filler task before exposure. Next, participants engaged in six 5- minute tailored exposure trials using a claustrophobic chamber. The Claustrophobia Questionnaire (Radomsky et al., 2001), a Behavioural Approach Test, and the Claustrophobia General Cognitions Questionnaire (Febrarro & Clum, 1995) were used to measure treatment outcomes. It was hypothesized that the CR Before condition would experience greater expectancy reduction than the CR After condition before exposure, and therefore less improvement in claustrophobia outcomes at posttreatment and follow-up than the CR After condition. Results demonstrated that the CR Before condition had greater expectancy reduction than the CR After condition. However, both groups experienced similar and large significant improvement at posttreatment with gains achieved at follow-up. Implications are discussed.</p>

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“…In the form of CBM used here, participants repeatedly practice a task that involves listening to ambiguous scenarios that eventually guide participants to a benign (nonthreatening) interpretation (see Hirsch et al, 2020, and the present Method section for details). In several lab-based experimental studies, researchers have found that such repeated practice leads to more benign interpretations being made on near-transfer tasks (i.e., tests of interpretation bias), accompanied by far-transfer effects involving reductions in worry and anxiety (Hayes et al, 2010; Hirsch et al, 2018; Feng et al, 2020; although see e.g., MacDonald et al, 2020; Salemink et al, 2014; Wilver & Cougle, 2019, who reported similar improvements in both CBM and control conditions).…”

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confidence: 99%

Internet-delivered interpretation training reduces worry and anxiety in individuals with generalized anxiety disorder: A randomized controlled experiment.

Hirsch

Krahé

Whyte

et al. 2021

Journal of Consulting and Clinical Psychology

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Generalized anxiety disorder (GAD) is a debilitating condition, characterized by negative interpretations about ambiguous situations. This study tested whether entirely internetdelivered interpretation training (cognitive bias modification; CBM) vs. control promotes ResultsThe per-protocol analyses included N=186 participants (CBM n=94; control n=92). As predicted, we found moderate-to-large training effects on the primary outcome of interpretation bias at T1. Secondary outcomes of negative thought intrusions at T1 and selfreported symptoms at T2 were all significantly lower in the CBM vs. control condition. All but one effect (trait RNT) was sustained at T3. ConclusionsIn this randomized controlled study, we found that fully online interpretation training ameliorated core features of GAD in individuals with or without comorbid depression up to three months post-training.

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Investigating the therapeutic potential of cognitive bias modification for high anxiety sensitivity

Cited by 5 publications

References 41 publications

Modification of hostile interpretation bias and self-reported aggression in juvenile delinquents: A randomized controlled trial

Modification of hostile interpretation bias and self-reported aggression in juvenile delinquents: A randomized controlled trial

Cognitive Restructuring Before Versus After Exposure: The Effect on Expectancy and Outcome in Individuals with Claustrophobia

Internet-delivered interpretation training reduces worry and anxiety in individuals with generalized anxiety disorder: A randomized controlled experiment.

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