nach oben

Cognitive Therapy and Research

Erschienen in:

01.06.2020 | 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

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

Erschienen in: Cognitive Therapy and Research | Ausgabe 3/2020

Einloggen, um Zugang zu erhalten

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.

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.

Alden, L. E., & Taylor, C. T. (2010). Interpersonal processes in social anxiety disorder. In J. G. Beck (Ed.), Interpersonal processes in the anxiety disorders: Implications for understanding psychopathology and treatment (pp. 125–152). Washington, DC: American Psychological Association.CrossRef

Alden, L. E., Taylor, C. T., Mellings, T. M. J. B., & Laposa, J. M. (2008). Social anxiety and the interpretation of positive social events. Journal of Anxiety Disorders,22, 577–590. https://doi.org/10.1016/j.janxdis.2007.05.007.CrossRefPubMed

Antony, M. M., Bieling, P. J., Cox, B. J., Enns, M. W., & Swinson, R. P. (1998). Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychological Assessment,10, 176–181. https://doi.org/10.1037/1040-3590.10.2.176.CrossRef

Avirbach, N., Perlman, B., & Mor, N. (2018). Cognitive bias modification for inferential style. Cognition and Emotion. https://doi.org/10.1080/02699931.2018.1476321.CrossRefPubMed

Beard, C., & Amir, N. (2008). A multi-session interpretation modification program: Changes in interpretation and social anxiety symptoms. Behaviour Research and Therapy,46, 1135–1141. https://doi.org/10.1016/j.brat.2008.05.012.CrossRefPubMedPubMedCentral

Beard, C., Weisberg, R. B., & Amir, N. (2011). Combined cognitive bias modification treatment for social anxiety disorder: A pilot trial. Depression and Anxiety,28, 981–988. https://doi.org/10.1002/da.20873.CrossRefPubMedPubMedCentral

Beard, C., Sawyer, A. T., & Hofmann, S. G. (2012). Efficacy of attention bias modification using threat and appetitive stimuli: A meta-analytic review. Behavior Therapy,43, 724–740. https://doi.org/10.1016/j.beth.2012.01.002.CrossRefPubMedPubMedCentral

Beck, J. S. (2011). Cognitive behavior therapy: Basics and beyond (2nd ed.). New York: Guildford Press.

Boden, M. T., John, O. P., Goldin, P. R., Werner, K., Heimberg, R. G., & Gross, J. J. (2012). The role of maladaptive beliefs in cognitive-behavioral therapy: Evidence from social anxiety disorder. Behaviour Research and Therapy,50, 287–291. https://doi.org/10.1016/j.brat.2012.02.007.CrossRefPubMedPubMedCentral

Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In R. G. Heimberg, M. R. Liebowitz, D. A. Hope, & F. R. Schneier (Eds.), Social phobia: Diagnosis, assessment, and treatment (pp. 69–93). New York: Guilford Press.

Clark, D. M., Ehlers, A., Hackmann, A., McManus, F., Fennell, M., Grey, N., et al. (2006). Cognitive therapy versus exposure and applied relaxation in social phobia: A randomized controlled trial. Journal of Consulting and Clinical Psychology,74, 568–578. https://doi.org/10.1037/0022-006X.74.3.568.CrossRefPubMed

Coffman, C. J., Edelman, D., & Woolson, R. F. (2016). To condition or not condition? Analysing ‘change’ in longitudinal randomised controlled trials. British Medical Journal Open,6, e013096. https://doi.org/10.1136/bmjopen-2016-013096.CrossRef

Enock, P. M., Hofmann, S. G., & McNally, R. J. (2014). Attention bias modification training via smartphone to reduce social anxiety: A randomized, controlled multi-session experiment. Cognitive Therapy and Research,38, 200–216. https://doi.org/10.1007/s10608-014-9606-z.CrossRef

Gregory, B., Wong, Q. J. J., Marker, C. D., & Peters, L. (2018). Maladaptive self-beliefs during cognitive behavioural therapy for social anxiety disorder: A test of temporal precedence. Cognitive Therapy and Research,42, 261–272. https://doi.org/10.1007/s10608-017-9882-5.CrossRef

Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. New York: The Guilford Press.

Heeren, A., Mogoaşe, C., Philippot, P., & McNally, R. J. (2015). Attention bias modification for social anxiety: A systematic review and meta-analysis. Clinical Psychology Review,40, 76–90. https://doi.org/10.1016/j.cpr.2015.06.001.CrossRefPubMed

Hofmann, S. G. (2007). Cognitive factors that maintain social anxiety disorder: A comprehensive model and its treatment implications. Cognitive Behaviour Therapy,36, 193–209. https://doi.org/10.1080/16506070701421313.CrossRefPubMedPubMedCentral

Khalili-Torghabeh, S., Fadardi, J. S., Mackintosh, B., Reynolds, S., & Mobini, S. (2014). Effects of a multi-session cognitive bias modification program on interpretative biases and social anxiety symptoms in a sample of Iranian socially-anxious students. Journal of Experimental Psychopathology,5, 514–527. https://doi.org/10.5127/jep.037713.CrossRef

Lang, T. J., Moulds, M. L., & Holmes, E. A. (2009). Reducing depressive intrusions via a computerized cognitive bias modification of appraisals task: Developing a cognitive vaccine. Behaviour Research and Therapy,47, 139–145. https://doi.org/10.1016/j.brat.2008.11.002.CrossRefPubMed

Liu, H., Li, X., Han, B., & Liu, X. (2017). Effects of cognitive bias modification on social anxiety: A meta-analysis. PLoS ONE,12, e0175107. https://doi.org/10.1371/journal.pone.0175107.CrossRefPubMedPubMedCentral

Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the depression anxiety and stress scales (2nd ed.). Sydney: Psychological Foundation.

MacLeod, C., & Mathews, A. (2012). Cognitive bias modification approaches to anxiety. Annual Review of Clinical Psychology,8, 189–217. https://doi.org/10.1146/annurev-clinpsy-032511-143052.CrossRefPubMed

Mathews, A., & Mackintosh, B. (2000). Induced emotional interpretation bias and anxiety. Journal of Abnormal Psychology,109, 602–615. https://doi.org/10.1037//0021-843X.109.4.602.CrossRefPubMed

Mattick, R. P., & Clarke, J. C. (1998). Development and validation of measures of social phobia scrutiny fear and social interaction anxiety. Behaviour Research and Therapy,36, 455–470. https://doi.org/10.1016/S0005-7967(97)10031-6.CrossRefPubMed

McFarland, C., & Ross, M. (1982). Impact of causal attributions on affective reactions to success and failure. Journal of Personality and Social Psychology,43, 937–946. https://doi.org/10.1037/0022-3514.43.5.937.CrossRef

Mobini, S., Reynolds, S., & Mackintosh, B. (2013). Clinical implications of cognitive bias modification for interpretative biases in social anxiety: An integrative literature review. Cognitive Therapy and Research,37, 173–182. https://doi.org/10.1007/s10608-012-9445-8.CrossRef

Mobini, S., Mackintosh, B., Illingworth, J., Gega, L., Langdon, P., & Hoppitt, L. (2014). Effects of standard and explicit cognitive bias modification and computer-administered cognitive-behaviour therapy on cognitive biases and social anxiety. Journal of Behavior Therapy and Experimental Psychiatry,45, 272–279. https://doi.org/10.1016/j.jbtep.2013.12.002.CrossRefPubMedPubMedCentral

Moscovitch, D. A., & Huyder, V. (2011). The negative self-portrayal scale: Development, validation, and application to social anxiety. Behavior Therapy,42, 183–196. https://doi.org/10.1016/j.beth.2010.04.007.CrossRefPubMed

Murphy, R., Hirsch, C. R., Mathews, A., Smith, K., & Clark, D. M. (2007). Facilitating a benign interpretation bias in a high socially anxious population. Behaviour Research and Therapy,45, 1517–1529. https://doi.org/10.1016/j.brat.2007.01.007.CrossRefPubMed

Naim, R., Kivity, Y., Bar-Haim, Y., & Huppert, J. D. (2018). Attention and interpretation bias modification treatment for social anxiety disorder: A randomized clinical trial of efficacy and synergy. Journal of Behavior Therapy and Experimental Psychiatry,59, 19–30. https://doi.org/10.1016/j.jbtep.2017.10.006.CrossRefPubMed

Nowakowski, M. E., Antony, M. M., & Koerner, N. (2015). Modifying interpretation biases: Effects on symptomatology, behavior, and physiological reactivity in social anxiety. Journal of Behavior Therapy and Experimental Psychiatry,49, 44–52. https://doi.org/10.1016/j.jbtep.2015.04.004.CrossRefPubMed

Peters, L., Sunderland, M., Andrews, G., Rapee, R. M., & Mattick, R. P. (2012). Development of a short form Social Interaction Anxiety (SIAS) and Social Phobia Scale (SPS) using nonparametric item response theory: The SIAS-6 and the SPS-6. Psychological Assessment,24, 66–76. https://doi.org/10.1037/a0024544.CrossRefPubMed

Rapee, R. M., & Heimberg, R. G. (1997). A cognitive-behavioral model of anxiety in social phobia. Behaviour Research and Therapy,35, 741–756. https://doi.org/10.1016/s0005-7967(97)00022-3.CrossRefPubMed

Rapee, R. M., & Lim, L. (1992). Discrepancy between self- and observer ratings of performance in social phobics. Journal of Abnormal Psychology,101, 728–731. https://doi.org/10.1037/0021-843X.101.4.728.CrossRefPubMed

Rapee, R. M., Gaston, J. E., & Abbott, M. J. (2009). Testing the efficacy of theoretically derived improvements in the treatment of social phobia. Journal of Consulting and Clinical Psychology,77, 317–327. https://doi.org/10.1037/a0014800.CrossRefPubMed

Rodebaugh, T. L., Heimberg, R. G., Brown, P. J., Fernandez, K. C., Blanco, C., Schneier, F. R., et al. (2011). More reasons to be straightforward: Findings and norms for two scales relevant to social anxiety. Journal of Anxiety Disorders,25, 623–630. https://doi.org/10.1016/j.janxdis.2011.02.002.CrossRefPubMedPubMedCentral

Spielberger, C. D., Gorsuch, R. L., Lushene, R., Vagg, P. R., & Jacobs, G. A. (1983). Manual for the state-trait anxiety inventory. Palo Alto: Consulting Psychologists Press.

Stevens, E. S., Behar, E., & Jendrusina, A. A. (2018). Enhancing the efficacy of cognitive bias modification for social anxiety. Behavior Therapy,49, 995–1007. https://doi.org/10.1016/j.beth.2018.02.004.CrossRefPubMed

Tran, T. B., Siemer, M., & Joormann, J. (2011). Implicit interpretation biases affect emotional vulnerability: A training study. Cognition and Emotion,25, 546–558. https://doi.org/10.1080/02699931.2010.532393.CrossRefPubMed

Turner, S. M., Johnson, M. R., Beidel, D. C., Heiser, N. A., & Lydiard, R. B. (2003). The social thoughts and beliefs scale: A new inventory for assessing cognitions in social phobia. Psychological Assessment,15, 384–391. https://doi.org/10.1037/1040-3590.15.3.384.CrossRefPubMed

Twisk, J., Bosman, L., Hoekstra, T., Rijnhart, J., Welten, M., & Heymans, M. (2018). Different ways to estimate treatment effects in randomised controlled trials. Contemporary Clinical Trials Communications,10, 80–85. https://doi.org/10.1016/j.conctc.2018.03.008.CrossRef

Vigneau, F., & Cormier, S. (2008). The factor structure of the state-trait anxiety inventory: An alternative view. Journal of Personality Assessment,90, 280–285. https://doi.org/10.1080/00223890701885027.CrossRefPubMed

Wechsler, D. (2008). Wechsler Adult Intelligence Scale-Fourth Edition. San Antonio, TX: Pearson Assessment.

Wong, Q. J. J., & Rapee, R. M. (2016). The aetiology and maintenance of social anxiety disorder: A synthesis of complementary theoretical models and formulation of a new integrated model. Journal of Affective Disorders,203, 84–100. https://doi.org/10.1016/j.jad.2016.05.069.CrossRefPubMed

Wong, Q. J. J., Moulds, M. L., & Rapee, R. M. (2014). Validation of the self-beliefs related to social anxiety (SBSA) scale: A replication and extension. Assessment,21, 300–311. https://doi.org/10.1177/1073191113485120.CrossRefPubMedPubMedCentral

Wong, Q. J. J., Gregory, B., & McLellan, L. F. (2016). A review of scales to measure social anxiety disorder in clinical and epidemiological studies. Current Psychiatry Reports,18, 38. https://doi.org/10.1007/s11920-016-0677-2.CrossRefPubMed

Wong, Q. J. J., Gregory, B., McLellan, L. F., Kangas, M., Abbott, M. J., Carpenter, L.,… Rapee, R. M. (2017). Anticipatory processing, maladaptive attentional focus, and postevent processing for interactional and performance situations: Treatment response and relationships with symptom change for individuals with social anxiety disorder. Behavior Therapy,48, 651–663. https://doi.org/10.1016/j.beth.2017.03.004.

Wong, Q. J. J., Certoma, S. P., McLellan, L. F., Halldorsson, B., Reyes, N., Boulton, K.,… Rapee, R. M. (2018a). Development and validation of a measure of maladaptive social-evaluative beliefs characteristic of social anxiety disorder in youth: The Report of Youth Social Cognitions (RYSC). Psychological Assessment,30, 904–915. https://doi.org/10.1037/pas0000539.CrossRefPubMed

Wong, Q. J. J., McEvoy, P. M., & Rapee, R. M. (2018b). Repetitive thinking in social anxiety disorder: Are anticipatory processing and post-event processing facets of an underlying unidimensional construct? Behavior Therapy. https://doi.org/10.1016/j.beth.2018.09.004.CrossRefPubMed

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
verfasst von: Natasha Reyes
Kelsie A. Boulton
Jin Han
Michelle Torok
Quincy J. J. Wong
Publikationsdatum: 01.06.2020
Verlag: Springer US
Erschienen in: Cognitive Therapy and Research / Ausgabe 3/2020
Print ISSN: 0147-5916
Elektronische ISSN: 1573-2819
DOI: https://doi.org/10.1007/s10608-019-10074-3

Neu im Fachgebiet Psychiatrie

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Wartezeit nicht kürzer, aber Arbeit flexibler

Psychotherapie Medizin aktuell

Fünf Jahren nach der Neugestaltung der Psychotherapie-Richtlinie wurden jetzt die Effekte der vorgenommenen Änderungen ausgewertet. Das Hauptziel der Novellierung war eine kürzere Wartezeit auf Therapieplätze. Dieses Ziel wurde nicht erreicht, es gab jedoch positive Auswirkungen auf andere Bereiche.

Chirurginnen und Chirurgen sind stark suizidgefährdet

07.05.2024 Suizid Nachrichten

Der belastende Arbeitsalltag wirkt sich negativ auf die psychische Gesundheit der Angehörigen ärztlicher Berufsgruppen aus. Chirurginnen und Chirurgen bilden da keine Ausnahme, im Gegenteil.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Klinik aktuell Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Klimawandel und Gesundheit: Was Sie in der Hausarztpraxis wissen müssen und tun können

Springer Medizin

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

Abstract

Neu im Fachgebiet Psychiatrie

Darf man die Behandlung eines Neonazis ablehnen?

Wartezeit nicht kürzer, aber Arbeit flexibler

Chirurginnen und Chirurgen sind stark suizidgefährdet

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

Update Psychiatrie

Klimawandel und Gesundheit: Was Sie in der Hausarztpraxis wissen müssen und tun können

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2020

Evaluation of Exposure Instructions to Pain: Should Therapist Focus on Fear Reduction or Expectation Violation?

Anxiety Sensitivity Among Smokers During a Reduction Attempt: The Impact of Hatha Yoga

Predictors of Treatment Outcome in Group or Individual Cognitive Processing Therapy for Posttraumatic Stress Disorder Among Active Duty Military

Validating a Mobile Eye Tracking Measure of Integrated Attention Bias and Interpretation Bias in Youth

Social Avoidance as a Predictor of Psychosocial Functioning in Body Dysmorphic Disorder: A Prospective Longitudinal Analysis

Fearlessness About Death is Related to Diminished Late Positive Potential Responses When Viewing Threatening and Mutilation Images in Suicidal Ideators

Neu im Fachgebiet Psychiatrie

Darf man die Behandlung eines Neonazis ablehnen?

Wartezeit nicht kürzer, aber Arbeit flexibler

Chirurginnen und Chirurgen sind stark suizidgefährdet

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

Update Psychiatrie