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

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Highlights

  • Evaluated the efficacy of an Internet-based Cognitive Bias Modification paradigm.

  • Findings suggest it is possible to modify interpretations over the Internet.

  • Desirable difficulty of training varied by baseline social anxiety severity.

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.

Section snippets

Participants

Three hundred and fifty participants (64.9% female) were recruited over the Internet, via Amazon.com's Mechanical Turtk (mTurk), in exchange for $0.40.1 Participants reported citizenship from 16 countries, with the majority of participants (92.9%) reporting U.S. citizenship. Participants'

Descriptive statistics

The training conditions did not differ in terms of baseline social anxiety symptoms, as measured by the SIAS (F(4, 345) = 1.51, p = .199, ηp2 = .02), or baseline interpretation bias, as measured by the BSIQ (F(4, 345) = 1.76, p = .136, ηp2 = .02). Conditions also did not differ in terms of ethnicity (χ2 = 4.50, p = .810), race (χ2 = 23.63, p = .098), education (χ2 = 15.53, p = .486), gender (χ2 = 15.25, p = .054), or whether or not participants reported US citizenship (χ2 = 6.54, p = .162).

Discussion

The current study evaluated the efficacy of a brief, Internet-based CBM-I paradigm to determine if it modified social anxiety-relevant interpretations to be more positive/less negative, and if it reduced fear of negative evaluation and anticipatory anxiety. This study also tested if the amount of active generation required to complete the CBM-I task (operationalized by number of letters missing from word fragments) affected the magnitude of CBM-I effects. Finally, this study evaluated the

Acknowledgments

The authors would like to thank Andrew Mathews and Bundy Mackintosh for sharing their study materials. Also, thanks to Fred Smyth, Emily Umansky, and Sriram Natarajan for their assistance with programming this study. Additionally, thanks to Lauren Hallion and members of the Teachman Program for Anxiety and Cognition Treatment (PACT) Lab, especially Nauder Namaky, for their helpful feedback and suggestions. This study was supported by NIA R01AG033033 grant awarded to Bethany Teachman. Note, B.

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