Courtney Beard

Background:Cognitive bias modification (CBM) is a novel treatment for anxiety disorders that utilizes computerized tasks to train attention and interpretation biases away from threat. To date, attitudes toward and acceptability of CBM have not been systematically examined.Method:We conducted qualitative interviews with 10 anxious primary care patients to examine attitudes toward and initial impressions of CBM. Interviews explored general impressions, as well as reactions to the treatment rationale and two computer programs, one targeting attention bias and one targeting interpretation bias. Three clinical psychologists independently coded transcripts and collaboratively developed categories and themes guided by grounded theory.Results:A number of facilitators and barriers emerged related to engaging in treatment in general, computerized treatment, and CBM specifically. Participants stated that the written rationale for CBM seemed relevant and helpful. However, after interacting with the attention modification program, participants frequently expressed a lack of understanding about how the program would help with anxiety. Participants reported greater understanding and engagement with the interpretation modification program.Conclusions:Participants reported a number of positive characteristics of CBM, but it may need improvements regarding its treatment rationale and credibility. Future qualitative studies with individuals who complete a CBM treatment are warranted. Implications for future CBM development and dissemination are discussed.

Background: Cognitive Bias Modification (CBM) is a promising treatment for Social Anxiety Disorder (SAD). However, previous randomized trials have not systematically examined the combination of CBM for attention (CBM‐A) and interpretation (CBM‐I) or the credibility and acceptability of these protocols. Methods: We conducted a randomized, double‐blind placebo‐controlled trial (N = 32) to examine the efficacy of a CBM treatment called Attention and Interpretation Modification (AIM) for SAD. AIM comprised eight, twice weekly computer sessions with no therapist contact. During AIM, participants (1) completed a dot probe task in which probes always followed neutral faces when paired with a disgust face, thereby directing attention away from threat and (2) completed a word–sentence association task in which they received positive feedback for making benign interpretations of word–sentence pairs and negative feedback for making negative interpretations. We also assessed participants' perceived credibility of and satisfaction with AIM. Results: Participants receiving AIM reported significantly reduced self‐reported (Liebowitz Social Anxiety Scale) symptoms of social anxiety relative to the placebo. These gains were also evident on a behavioral measure (performance on an impromptu speech). AIM met our benchmarks for credibility and acceptability in this community sample, although credibility ratings were modest. Participants reported that CBM‐I was more helpful than CBM‐A. Conclusions: A combined CBM treatment produced medium‐to‐large effects on social anxiety. Participants rated AIM as moderately credibly and acceptable. Should these findings be replicated in larger samples, AIM has the potential to be a widely accessible and efficacious treatment for SAD. Depression and Anxiety, 2011.

Cognitive bias modification (CBM) is an innovative approach to modifying cognitive biases that confer vulnerability to anxiety. CBM interventions are designed to directly modify attention and inter...

Background: Social Phobia (SP) is a prevalent disorder in primary‐care settings. To date, few researchers have examined the natural course of SP in primary care. We examined the natural course and predictors of recovery in a large sample of primary‐care patients. Methods: Data are obtained from the Primary Care Anxiety Project, a naturalistic, longitudinal study of anxiety disorders in primary‐care patients. This report pertains to 182 patients with SP at intake. We examined intake demographic and clinical variables as predictors of recovery within the 5 years of follow‐up. Results: The probability of recovery from SP during the 5‐year follow‐up period was .40. At intake, a longer duration of SP episode, comorbid Panic Disorder with Agoraphobia, and lower psychosocial functioning predicted lower rates of recovery. Conclusions: These findings highlight the chronicity of SP, as well as factors that may affect its naturalistic course. It is imperative that primary‐care physicians and mental health specialists assess for and treat SP in their practices. Future research is warranted to further examine the effect of medical and psychiatric comorbidity on SP course. Depression and Anxiety, 2010.

Cognitive models suggest that attention processes maintain sexual dysfunction. However, few published studies have examined attention bias, and even fewer have studied female participants with sexual dysfunction. Using the Female Sexual Function Index, the authors classified undergraduates as experiencing sexual dysfunction (n = 28) or not (n = 28). The authors assessed whether participants showed attention bias for sexual words using a modified dot-probe task. As expected, female participants with sexual dysfunction showed an attention bias to sexual words, whereas control participants did not. The authors discuss implications for models of sexual dysfunction and clinical intervention.

Cognitive models of social anxiety predict that interpretation bias mediates the relationship between level of social anxiety and state anxiety in response to social-evaluative threat. We tested this prediction in 67 socially anxious undergraduates. Participants completed self-report measures of social anxiety and interpretation bias, and 2 days later they completed an impromptu speech. Mediational analyses supported the hypothesis that interpretation bias mediates the effect of social anxiety on state anxiety in response to the speech. This relationship was specific to negative interpretation of ambiguous social scenarios. The current findings support cognitive models of social phobia and add to the empirical base supporting the role of interpretation bias in social anxiety.