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02-01-2020 | Original Article

Cognitive Bias Modification for the Induction of Negative Versus Benign Interpretations of the Self in Individuals with Elevated Social Anxiety: Effects on Self-related and Anxiety Outcomes

Auteurs: Natasha Reyes, Kelsie A. Boulton, Jin Han, Michelle Torok, Quincy J. J. Wong

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 3/2020

Abstract

Studies of cognitive bias modification for interpretations in the social anxiety literature typically examine the effects of inducing a benign interpretation of ambiguous social situations. This study modifies and extends cognitive bias modification procedures to specifically alter interpretations of the self (CBM-IS) associated with social anxiety disorder and examined the effects of negative CBM-IS versus benign CBM-IS. Participants with elevated social anxiety were randomly allocated to a negative or benign CBM-IS condition. After CBM-IS training, participants were assessed on induced interpretations of the self, completed a speech task, and rated their performance. Negative self-esteem and anxiety were assessed at baseline, post-training, and post-speech. As predicted, negative CBM-IS induced a negative interpretation of the self whereas benign CBM-IS induced a benign interpretation of the self. There were also three key differential effects: (a) a baseline to post-training increase in negative self-esteem following negative CBM-IS but not benign CBM-IS, although the negative self-esteem difference between conditions was no longer evident at post-speech, (b) a greater increase in anxiety from post-training to post-speech following negative CBM-IS relative to benign CBM-IS, and (c) more negative self-ratings of speech performance following negative CBM-IS relative to benign CBM-IS. These findings validate the new CBM-IS procedures, and highlight the potential of these procedures for testing models of social anxiety disorder and for therapeutic intervention to reduce social anxiety.

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The original intention to include the baseline measurement also as a covariate in the model was to allow modelling of the expectation that the two CBM-IS conditions should be equal at baseline given random allocation to condition. Another statistical model that incorporates this idea is constrained longitudinal data analysis (Coffman et al. 2016; Twisk et al. 2018). This model uses a mixed modelling repeated measures analysis framework, and when applied to our data, models the change in the dependent variable of interest (RSES or STAI-S) across our three time-points, allows a test of whether change over time depended on CBM-IS condition (i.e., time × condition interaction effect of the model), and constrains the baseline measurement of the dependent variable to be equal in the two CBM-IS conditions without needing to resort to the inclusion of additional covariates. We report the results of the constrained longitudinal data analysis of the RSES and the STAI-S, in particular in relation to the time × condition interaction, in subsequent footnotes. For a full report of the constrained longitudinal data analyses, please contact the study authors.

In the constrained longitudinal data analysis model examining the RSES over time, there was also a significant time × condition interaction, B = 2.21, t(113.03) = 2.36, p = .020, indicating a similar pattern of results to the time × condition interaction reported in the main text.

In the constrained longitudinal data analysis model examining the STAI-S over time, there was also a significant Time x Condition interaction, B = 0.75, t(119.52) = 2.64, p = .009, indicating a similar pattern of results to the Time x Condition interaction reported in the main text.

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Titel: Cognitive Bias Modification for the Induction of Negative Versus Benign Interpretations of the Self in Individuals with Elevated Social Anxiety: Effects on Self-related and Anxiety Outcomes
Auteurs: Natasha Reyes
Kelsie A. Boulton
Jin Han
Michelle Torok
Quincy J. J. Wong
Publicatiedatum: 02-01-2020
Uitgeverij: Springer US
Gepubliceerd in: Cognitive Therapy and Research / Uitgave 3/2020
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI: https://doi.org/10.1007/s10608-019-10074-3

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