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

Abstract

Cognitive Bias Modification for anxious interpretations (CBM-I) is a computerized training program designed to reduce threatening interpretations of ambiguous information. In addition to testing the efficacy of CBM-I for contamination fear on various cognitive outcomes and emotional vulnerability, the current study examined whether the content of CBM-I must match a person's fear domain to be efficacious, and examined the moderating role of preexisting interpretation bias on CBM-I's efficacy. Participants (n = 121) high in contamination fear were assigned to one session of either CBM-I focused on contamination fear content, CBM-I focused on height fear content, or a sham control condition. Planned contrasts indicated that fear domain match does tend to enhance CBM-I's effects: compared to the heights condition, those in the contamination training condition improved on five of the eight cognitive bias-related variables, though there was no change on measures of emotional vulnerability. In contrast, there was little difference between the heights training and sham conditions. Minimal evidence was found for baseline interpretation bias as a moderator. Results support the use of CBM-I that matches the fear domain of the participant, regardless of baseline bias level.

The Impact of Modifying Interpretive Bias on Contamination-Related Obsessive–Compulsive Symptoms

“…As predicted, our positive training led to a greater increase in adaptive interpretive bias towards ambiguous contamination-related situations whereas the neutral training did not. This finding converges with those reported by Beadel et al (2016) and Conley and Wu (2018), who were also able to train an adaptive bias in individuals with contamination concerns, despite using either a different set of training items or CBM-I methodology. Importantly, like Conley and Wu (2018), we showed that our positive training, relative to neutral training, was associated with less avoidance of contaminants on our behavioural approach tasks.…”

“…Importantly, like Conley and Wu (2018), we showed that our positive training, relative to neutral training, was associated with less avoidance of contaminants on our behavioural approach tasks. Our results showing the cognitive changes due to CBM-I also echoes Beadel et al (2016), such that our positive training led to a reduction in contamination-related cognitions as measured by the Contamination Cognitions Scale (Deacon & Olatunji, 2007). These findings appear promising for the clinical utility of CBM-I in individuals with contamination concerns.…”

“…Unfortunately, CBM-I's clinical application in OCD is currently limited partly because these studies have reported mixed findings regarding its impact on symptom reduction and behaviour. Two studies examining the effectiveness of CBM-I specifically in individuals with heightened contamination concerns have similarly reported mixed results (Beadel et al, 2016;Conley & Wu, 2018). These studies matched the CBM-I training material to the target population and showed that this significantly reduced contamination-related interpretive bias, relative to control training (Beadel et al, 2016;Conley & Wu, 2018) and when the training material was not related to contamination concerns (i.e., acrophobia; Beadel et al, 2016).…”

“…Two studies examining the effectiveness of CBM-I specifically in individuals with heightened contamination concerns have similarly reported mixed results (Beadel et al, 2016;Conley & Wu, 2018). These studies matched the CBM-I training material to the target population and showed that this significantly reduced contamination-related interpretive bias, relative to control training (Beadel et al, 2016;Conley & Wu, 2018) and when the training material was not related to contamination concerns (i.e., acrophobia; Beadel et al, 2016). However, only Conley and Wu (2018) showed that CBM-I was associated with less behavioural avoidance of contaminants on their behavioural approach task.…”