A systematic review of the word sentence association paradigm (WSAP)

https://doi.org/10.1016/j.jbtep.2019.04.003Get rights and content

Highlights

  • Reviewed 41 studies that used the WSAP.

  • WSAP showed good reliability and validity.

  • CBM-I version of WSAP showed large pre-post training effect sizes.

Abstract

Background and objectives

The Word Sentence Association Paradigm (WSAP) was originally designed to assess and modify interpretive biases (IB) in socially anxious individuals. Researchers have since modified the WSAP for use across various populations. Despite its widespread use, no studies have systematically reviewed the WSAP to determine its validity and reliability. Methods: We review variations to the WSAP, populations in which the WSAP has been used, reliability data, and effect sizes across 41 studies published between 2008 and March 2018.

Results

Results indicate that the WSAP has been utilized to target 18 disorders and symptoms in adults and children. Modifications include stimulus content, timing parameters, and presentation order of word and sentence pairs. Reported internal consistency and test-retest reliability suggest good to excellent reliability. Medium to large effect sizes were reported when comparing control samples to those with psychopathology and in pre-post comparisons of the modification version of the WSAP. Limitations: Studies varied regarding which indices of the WSAP were presented and specific task parameters used, making it challenging to compare effects.

Conclusions

The WSAP is a reliable and valid instrument for assessing and modifying interpretive biases with unique characteristics compared with other IB assessment and modification tasks.

Section snippets

Eligibility criterion

Eligible studies were peer-reviewed publications that included the WSAP task or a variation of the WSAP task as either an assessment of IB, modification of IB, or both.

Information sources and search

In March 2018, databases (i.e. PubMed, PsychInfo, PsychArticles, Academic Search Premier, Google Scholar, and the Brown University Library Article Search) were searched simultaneously with the keywords “WSAP” and “Word AND Sentence AND Association AND Paradigm” to identify studies published between 2008 and 2018. The WSAP task

Results

Our search yielded 41 papers that used the WSAP from 2008 until March of 2018.

Discussion

This systematic review yielded 41 studies that have used the WSAP to assess and modify IB across a variety of populations, age groups, and clinical symptoms. Across these studies, the WSAP demonstrated acceptable to excellent reliability, and consistently differentiated interpretive styles between healthy and clinical groups. Finally, our review identified several common changes to the task parameters that differ from the original task.

Conclusion

This review suggests that the WSAP is a reliable and valid assessment of IB across a variety of populations, and that it can also be used to modify IB. The WSAP has unique features compared with other IB assessment and modification tasks. Researchers should consider these features when selecting a measure of IB and CBM-I task. Future research is warranted to provide healthy norms and clinical cut-points, as well as to directly compare different types of IB assessments and CBM-I.

Conflict of interest

All authors declare no conflicts of interest. This study was supported by National Institute of Mental Health, USA (MH097820) awarded to Drs. Beard and Weisberg.

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    Contributed equally to this work.

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