Cognitive bias modification of interpretations: A viable treatment for child and adolescent anxiety? (original) (raw)
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Journal of Child and Family Studies, 2015
Cognitive bias modification of interpretations (CBM-I) programs, in which individuals are trained to interpret ambiguous scenarios in a benign way, appear effective in altering anxiety-related cognitive biases in both children and adults. In this experimental study, we explored the effectiveness of a novel CBM-I training tool for children, which involves joint discussions of ambiguous information with a same-gender peer. 10-to 11-year-old boys and girls (n = 20) were provided with ambiguous social vignettes, each followed by two interpretations, and then asked to select one of them after a brief discussion with a same-gender peer. A further group of participants did not participate in any training but only completed pretraining and posttraining measures (n = 18). Results indicated that children who completed the interpretation training made less negative interpretations, endorsed less negative emotional consequences, reported less social anxiety, and performed better in a stressful task compared with the no-intervention group. Clinical implications of the results are briefly discussed.
Journal of child psychology and psychiatry, and allied disciplines, 2017
Emerging evidence suggests that cognitive bias modification of interpretations (CBM-I) is effective in altering interpretation biases and reducing anxiety in adults. Less is known about the impact of CBM-I in young people, but some recent findings, including a meta-analysis of combined cognitive bias modification of interpretation and attention techniques, have cast doubt on its clinical utility. Given the current debate, this meta-analysis sought to establish the independent effects of CBM-I on interpretations biases and anxiety in youth. Studies were identified through a systematic literature search of PsycINFO, Ovid MEDLINE, PsycARTICLES, Web of Science and EMBASE between January 1992 and March 2017. Eligible studies aimed to target interpretation biases; did not combine CBM-I with another intervention; included a control condition; randomly allocated participants to conditions; assessed interpretation bias and/or anxiety as an outcome; included individuals up to age 18; and did ...
J Child Psychol Psychiat, 2010
Background: Negative biases in the interpretation of ambiguous material have been linked to anxiety and mood problems. Accumulating data from adults show that positive and negative interpretation styles can be induced through cognitive bias modification (CBM) paradigms with accompanying changes in mood. Despite the therapeutic potential of positive training effects, training paradigms have not yet been explored in adolescents. Methods: Eighty-two healthy adolescents (aged 13-17 years) were randomly allocated to either positive or negative CBM training. To assess training effects on interpretation bias, participants read ambiguous situations followed by test sentences with positive or negative interpretations of the situation. Participants rated the similarity of these sentences to the previously viewed ambiguous situations. Training effects on negative and positive affect were assessed using visual analogue scales before and after training. Results: After training, adolescents in the negative condition drew more negative and fewer positive interpretations of new ambiguous situations than adolescents in the positive condition. Within the positive condition, adolescents endorsed more positive than negative interpretations. In terms of mood changes, positive training resulted in a significant decrease in negative affect across participants, while the negative condition led to a significant decrease in positive affect among male participants only. Conclusion: This is the first study to demonstrate the plasticity of interpretation bias in adolescents. The immediate training effects on mood suggest that it may be possible to train a more positive interpretation style in youth, potentially helping to protect against anxiety and depressive symptoms.
Cognitive bias modification training in adolescents: effects on interpretation biases and mood
Journal of child psychology and psychiatry, and allied disciplines, 2011
Background: Negative biases in the interpretation of ambiguous material have been linked to anxiety and mood problems. Accumulating data from adults show that positive and negative interpretation styles can be induced through cognitive bias modification (CBM) paradigms with accompanying changes in mood. Despite the therapeutic potential of positive training effects, training paradigms have not yet been explored in adolescents.Methods: Eighty-two healthy adolescents (aged 13–17 years) were randomly allocated to either positive or negative CBM training. To assess training effects on interpretation bias, participants read ambiguous situations followed by test sentences with positive or negative interpretations of the situation. Participants rated the similarity of these sentences to the previously viewed ambiguous situations. Training effects on negative and positive affect were assessed using visual analogue scales before and after training.Results: After training, adolescents in the negative condition drew more negative and fewer positive interpretations of new ambiguous situations than adolescents in the positive condition. Within the positive condition, adolescents endorsed more positive than negative interpretations. In terms of mood changes, positive training resulted in a significant decrease in negative affect across participants, while the negative condition led to a significant decrease in positive affect among male participants only.Conclusion: This is the first study to demonstrate the plasticity of interpretation bias in adolescents. The immediate training effects on mood suggest that it may be possible to train a more positive interpretation style in youth, potentially helping to protect against anxiety and depressive symptoms.
Social anxiety is the most prevalent anxiety disorder of late adolescence, yet current treatments reach only a minority of youth with the disorder. Effective and easy-to-disseminate treatments are needed. This study pilot tested the efficacy of a novel, online cognitive bias modification for interpretation (CBM-I) intervention for socially anxious youth and their parents. The CBM-I intervention targeted cognitive biases associated with early adolescents' maladaptive beliefs regarding social situations, and with parents' intrusive behavior, both of which have been theoretically linked with the maintenance of social anxiety in youth. To investigate the efficacy of intervening with parents and/or children, clinically diagnosed early adolescents (ages 10-15; N = 18) and their mothers were randomly assigned to one of three conditions: the first targeted early adolescents' cognitive biases related to social anxiety (Child-only condition); the second targeted parents' biases associated with intrusive behavior (Parent-only condition); and the third targeted both youth and parents' biases in tandem (Combo condition). The use of a multiple baseline design allowed for the efficient assessment of causal links between the intervention and reduction in social anxiety symptoms in youth. Results provided converging evidence indicating modest support for the efficacy of CBM-I, with no reliable differences across conditions. Taken together, results suggest that online CBM-I with anxious youth and/or their parents holds promise as an effective and easily administered component of treatment for child social anxiety that deserves further evaluation in a larger trial.
Behaviour Research and Therapy, 2009
We report on an experimental manipulation of interpretation bias in socially anxious youths. A non-clinical sample of 10–11-year-olds selected for high social anxiety was trained over three sessions to endorse benign rather than negative interpretations of potentially threatening social scenarios. This group was subsequently less likely to endorse negative interpretations of new ambiguous social situations than children in a test–retest condition. Children who received interpretation training also showed reduced trait social anxiety and reported significantly less anxiety about an anticipated interpersonal encounter, compared with the control group.
Experimental modification of interpretation bias in socially anxious children
We report on an experimental manipulation of interpretation bias in socially anxious youths. A nonclinical sample of 10-11-year-olds selected for high social anxiety was trained over three sessions to endorse benign rather than negative interpretations of potentially threatening social scenarios. This group was subsequently less likely to endorse negative interpretations of new ambiguous social situations than children in a test-retest condition. Children who received interpretation training also showed reduced trait social anxiety and reported significantly less anxiety about an anticipated interpersonal encounter, compared with the control group.
Cognitive bias modification training in adolescents reduces anxiety to a psychological challenge
Clinical Child Psychology and Psychiatry, 2013
Background: Anxiety disorders commonly occur in adolescence with disabling consequences. As adolescent anxiety predicts adult anxiety and mood disorders, there are growing efforts to identify suitable tools for prevention. Prior data show the effectiveness of Cognitive Bias Modification of Interpretations (CBM-I) training in generating positive interpretative styles of ambiguous information in adolescents. Here, we assess the effects of positive CBM-I training on anxious mood responses to a psychological challenge performed under time constraints and anticipated social evaluation. Methods: Fifty adolescents were randomly assigned to receive positive or negative computerised cognitive training. Training involved reading and listening to 60 ambiguous scenarios that were resolved via completion of a word fragment in a positive or negative direction. After training, all adolescents completed an interpretation bias test and performed a difficult mental arithmetic task while believing that they were being videotaped for teaching purposes. Before and after training, and before and after the psychological challenge, adolescents completed anxiety ratings using visual analogue scales. Results: Data from the interpretation bias test showed that training was successful at inducing positive and negative interpretations in each training group respectively. There were no effects of training group on changes in anxious mood before and after training. However anxious mood changes assayed before and after the psychological challenge revealed training effects: compared to negatively-trained adolescents, positively-trained adolescents showed attenuated anxiety levels post but not pre-stressor. Conclusion: These results confirmed previous data that computerised CBM-I training can generate positive and negative interpretative styles in adolescents. These data also showed that induced interpretations could impact on anxious responses precipitated by a psychological challenge. These data have implications for using CBM-I training as a preventative tool targeting emotional well-being across all adolescents.
Modifying Threat-related Interpretive Bias in Adolescents
Journal of Abnormal Child Psychology, 2011
Socially anxious feelings sharply increase during adolescence and such feelings have been associated with interpretive biases. Studies in adults have shown that interpretive biases can be modified using Cognitive Bias Modification procedures (CBM-I) and subsequent effects on anxiety have been observed. The current study was designed to examine whether the CBM-I procedure has similar effects in adolescents. Unselected adolescents were randomly allocated to either a positive interpretation training (n=88) or a placebo-control condition (n=82). Results revealed that the training was successful in modifying interpretations and effects generalized to a new task. The interpretive bias effects were most pronounced in individuals with a threat-related interpretive bias at pre-test. No effects on state anxiety were observed. The current findings are promising with regard to applying bias modification procedures to adolescents, while further research is warranted regarding emotional effects.