Reaching new heights: Comparing interpretation bias modification to exposure therapy for extreme height fear.

Abstract

Objective Cognitive models of anxiety disorders posit that biases in interpretation maintain, and potentially cause, anxiety. This study tested whether it is possible to decrease height fear symptoms through cognitive bias modification for interpretations (CBM-I). Additionally, the clinical utility of CBM-I was tested by comparing it to an already established treatment: exposure therapy. Method Extremely height fearful (N = 110) individuals participated in the study. Acrophobic symptoms were measured before and after two sessions of CBM-I, and compared to the standard treatment for acrophobia (exposure therapy), a combination of CBM-I and exposure therapy, and a Control condition. Results In line with hypotheses, participants in the three active conditions showed greater response to treatment than the Control condition in height-relevant interpretation bias, symptoms, and behavioral avoidance on a height stressor, with few differences between the active conditions. Further, symptom change was mediated by change in interpretation bias. Conclusions Overall, findings suggest that different pathways to fear reduction (exposure vs. shifting interpretations) can lead to similar reductions in height fear. This study provides the first evidence that directly shifting cognitive processing, even with no therapist involvement, can reduce symptoms as effectively as the gold standard, therapist-directed exposure therapy.

Role of Fear Domain Match and Baseline Bias in Interpretation Training for Contamination Fear

“…Following other studies from our lab (e.g., Steinman & Teachman, 2014), we used multiple iterations of the training set to reinforce the modification of interpretation bias. After completing the first round as described above, participants were then instructed to read each scenario and comprehension question out loud (similar to Steinman & Teachman, 2014). The third time, participants saw the same scenarios but with a blank space in place of the final word fragment.…”

Interpretation bias modification for youth and their parents: A novel treatment for early adolescent social anxiety

“…The adult anxiety literature has shown that directly reducing negative cognitive biases through CBM-I can lead to reductions in anxiety symptoms, highlighting a causal role for cognitive biases in anxiety and, in turn, the clinical utility of CBM-I (MacLeod & Mathews, 2012; Steinman & Teachman, 2014). Thus, several child and adolescent studies have adapted the ambiguous scenario paradigm that has commonly been used in adult CBM-I studies.…”

Interpretation Bias Modification for Youth and their Parents: A Novel Treatment for Early Adolescent Social Anxiety

“…Cognitive bias modification for threat interpretation (CBM-I) refers to computerized training in interpreting ambiguity in a benign way, so as to reduce threat-related interpretations and increase benign interpretations of ambiguous situations in participants' everyday life (Mathews & Mackintosh, 2000). The adult anxiety literature has shown that directly reducing negative cognitive biases through CBM-I can lead to reductions in anxiety symptoms, highlighting a causal role for cognitive biases in anxiety and, in turn, the clinical utility of CBM-I (MacLeod & Mathews, 2012;Steinman & Teachman, 2014). Thus, several child and adolescent studies have adapted the ambiguous scenario paradigm that has commonly been used in adult CBM-I studies.…”