A systematic review of the word sentence association paradigm (WSAP)
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.
References (62)
- et al.
The effect of single session interpretation modification on attention bias in socially anxious individuals
Journal of Anxiety Disorders
(2010) - et al.
A multi-session interpretation modification program: Changes in interpretation and social anxiety symptoms
Behaviour Research and Therapy
(2008) - et al.
Characteristics of interpretation bias and relationship with suicidality in a psychiatric hospital sample
Journal of Affective Disorders
(2017) - et al.
Cognitive bias modification for attention and interpretation reduces trait and state anxiety in anxious patients referred to an out-patient service: Results from a pilot trial
Journal of Behavior Therapy and Experimental Psychiatry
(2011) - et al.
Cognitive processes in anxiety
Advances in Behaviour Research and Therapy
(1983) - et al.
Development and randomized trial evaluation of a novel computer-delivered anxiety sensitivity intervention
Behaviour Research and Therapy
(2016) - et al.
Hostile interpretation training for individuals with alcohol use disorder and elevated trait anger: A controlled trial of a web-based intervention
Behaviour Research and Therapy
(2017) - et al.
Moving towards the benign: Automatic interpretation bias modification in dysphoria
Behaviour Research and Therapy
(2017) - et al.
Validation of an interpretation bias assessment for body dissatisfaction
Body Image
(2014) - et al.
Pain and multiple facets of anger and hostility in a sample seeking treatment for problematic anger
Psychiatry Research
(2017)
Automaticity and the anxiety disorders
Behaviour Research and Therapy
Refilling the half-empty glass-investigating the potential role of the interpretation modification Paradigm for depression (IMP-D)
Journal of Behavior Therapy and Experimental Psychiatry
Randomized control trial investigating the efficacy of a computer-based intolerance of uncertainty intervention
Behaviour Research and Therapy
Interpretation bias for uncertain threat: A replication and extension
Journal of Behavior Therapy and Experimental Psychiatry
Performance-based interpretation bias in clinically anxious youths: Relationships with attention, anxiety, and negative cognition
Behavior Therapy
Thinking anxious, feeling anxious or both? Cognitive bias moderates the relationship between anxiety disorder status and sympathetic arousal in youth
Journal of Anxiety Disorders
Panic patients reveal idiographic associations between anxiety symptoms and catastrophes in a semantic priming task
Behaviour Research and Therapy
Modification of hostile interpretation bias in depression: A randomized control trial
Behavior Therapy
Hostile interpretation bias in depression
Journal of Affective Disorders
Social phobia and interpretation of social events
Behaviour Research and Therapy
Modifying interpretation biases in body dysmorphic disorder: Evaluation of a brief computerized treatment
Behaviour Research and Therapy
Automaticity in anxiety disorders and major depressive disorder
Clinical Psychology Review
Negative interpretation bias in social phobia
Behaviour Research and Therapy
Preliminary evidence for the enhancement of self-conducted exposures for OCD using cognitive bias modification
Cognitive Therapy and Research
Lack of a benign interpretation bias in social anxiety disorder
Cognitive Behaviour Therapy
Interpretation training in individuals with generalized social anxiety disorder: A randomized controlled trial
Journal of Consulting and Clinical Psychology
Unified protocol for transdiagnostic treatment of emotional disorders therapist guide
Interpretation in social anxiety: When meaning precedes ambiguity
Cognitive Therapy and Research
A pilot open trial of cognitive bias modification for panic disorder
Cognitive Therapy and Research
Translating CBM-I into real-world settings: Augmenting a CBT-based psychiatric hospital program
Behavior Therapy
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A Pilot Feasibility Open Trial of an Interpretation Bias Intervention for Parents of Anxious Children
2022, Cognitive and Behavioral PracticeCitation Excerpt :As a manipulation check, we included an assessment version of the WSAP at baseline, posttreatment and 1-month follow-up timepoints. The WSAP is a commonly used measure of interpretation bias with good internal consistency and test–retest reliability across clinical and nonclinical populations (see Gonsalves et al., 2019, for a review of its psychometric properties). In the assessment version, no feedback is provided about accuracy of responses.
The remediating effect of Attention Bias Modification on aggression in young offenders with antisocial tendency: A randomized controlled trial
2022, Journal of Behavior Therapy and Experimental PsychiatryScrambled but valid? The scrambled sentences task as a measure of interpretation biases in psychopathology: A systematic review and meta-analysis
2022, Clinical Psychology ReviewCitation Excerpt :A useful reference point is provided by the systematic review by Gonsalves, Whittles, Weisberg, and Beard (2019), which investigated the psychometric properties of another well-established measure of IBs, the Word-Sentence-Association Paradigm (WSAP; Beard & Amir, 2009). Across various disorders, Gonsalves et al. (2019) found that small correlations for convergent validity were most common while large correlations were rare; this contrasts with the moderate to large correlations more common for the SST as found in the present review. However, findings for reliability of the WSAP and SST appear comparable, with Gonsalves et al. (2019) noting that acceptable reliability indices were most frequent for the WSAP, but also that this information was seldom reported.
Effects of cognitive bias modification for interpretation on hostile interpretation bias and self-reported aggression in juvenile delinquents
2021, International Journal of Clinical and Health PsychologyCitation Excerpt :Firstly, the impulsivity, irritability, lower punishment sensitivity, and existing hostile beliefs (Guan et al., 2015; Morgan et al., 2014) might impair the juvenile delinquents’ readiness for intervention, elicit ambivalent reactions and greater treatment resistance and thus impede their engagement in therapy, which thereby can diminish therapeutic change (Howells & Day, 2003). Secondly, the CBM-I tasks, during which different feedback was given for positive and hostile interpretations of ambiguous situations, might be helpful to encourage juvenile delinquents to adopt positive interpretations, but less effective in helping them reject hostile interpretations (Gonsalves et al., 2019). Presenting the hostile interpretation option may somehow prompt and amplify the hostile cues that may be implied in ambiguous situations, and therefore might activate the hostile schemas of juvenile delinquents, leading them to expect to be threatened or provoked and thus, think in hostile ways (Gilbert & Daffern, 2010).
HabitWorks: Development of a CBM-I Smartphone App to Augment and Extend Acute Treatment
2021, Behavior TherapyAssociations among interpretation bias, craving, and abstinence self-efficacy in adults with substance use disorders
2019, Drug and Alcohol DependenceCitation Excerpt :The WSAP is a commonly used measure of interpretation bias and includes many of the recommended features in recent reviews (Hirsch et al., 2016; Schoth and Liossi, 2017). It has demonstrated good internal consistency and test-retest reliability across various populations (Gonsalves et al., 2019). Salemink and Wiers (2014) previously used the WSAP to measure alcohol-relevant interpretation bias.
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Contributed equally to this work.