Training less threatening interpretations over the Internet: Does the number of missing letters matter?

J Behav Ther Exp Psychiatry. 2015 Dec;49(Pt A):53-60. doi: 10.1016/j.jbtep.2014.12.004. Epub 2014 Dec 30.

Abstract

Background and objectives: Cognitive Bias Modification to reduce threat interpretations (CBM-I) trains individuals to resolve ambiguous scenarios via completion of word fragments that assign benign meanings to scenarios. The current study tested: 1) whether Internet-based CBM-I can shift interpretations to be more positive/less negative, and 2) whether varying the number of letters missing in the word fragments (assumed to increase task difficulty) moderates CBM-I's effects.

Methods: Participants (N = 350) completed a brief online version of CBM-I, followed by assessments of interpretation bias, fear of negative evaluation, and anticipatory anxiety. Participants were randomly assigned to 1 of 5 conditions: control (half of scenarios ended positively, half negatively), or 4 positive conditions (all scenarios ended positively, but word fragments varied on number of letters missing, from 0 to 3).

Results: Relative to the control condition, all positive conditions led to more positive/less negative interpretations. When analyses were re-run with only a highly socially anxious subset of the sample (n = 100), conditions in which the final word of scenarios was missing 0, 1, or 2 letters led to more positive/less negative interpretations compared to the control condition, but the condition missing 3 letters did not differ from the control condition. There were no differences between conditions on other outcome measures.

Limitations: Training was brief, and an unselected sample was used.

Conclusions: Results suggest a brief Internet-based CBM-I paradigm can shift interpretation bias, but not necessarily other anxiety-relevant outcomes. Making the task too difficult may blunt effects for highly socially anxious individuals.

Keywords: Cognitive Bias Modification; Interpretation; Social anxiety; e-Health.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Attention / physiology*
  • Bias*
  • Cognitive Behavioral Therapy / methods*
  • Feedback, Psychological / physiology*
  • Female
  • Humans
  • Internet*
  • Interpersonal Relations
  • Male
  • Middle Aged
  • Phobic Disorders / psychology
  • Phobic Disorders / therapy*
  • Psychiatric Status Rating Scales
  • Treatment Outcome
  • Young Adult