Combined cognitive bias modification treatment for social anxiety disorder: a pilot trial
Open accessAbstract
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.
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Trial repetition, boredom, and disengagement are serious concerns for CBM training.
“Trial repetition, boredom, and disengagement are serious concerns for CBM training (Beard et al., 2011).”
From Acceptability and Co-Development of an Online Cognitive Bias Modification Intervention for Emerging Adults With Hazardous Alcohol Use and Social Anxiety: A Mixed Methods Study (2020) · cites this paper as Beard et al., 2011
The Introduction reports patient comments that CBM-A may have limited acceptability because it is boring, and the Discussion recommends making the task more engaging. The Methods describe repeated practice as necessary for training, but the paper does not identify trial repetition itself as a problem or establish disengagement as a serious concern; the Discussion says participants were mostly satisfied. (LLM, conf=0.85)
Experimental — accuracy not yet measuredThis level of training in either ApBM or IBM is feasible to provide and has been associated with significant improvements in alcohol use and anxiety in extant literature.
“This level of training in either ApBM or IBM is feasible to provide and has been associated with significant improvements in alcohol use and anxiety in extant literature, respectively (Amir and Taylor, 2012; Beard and Amir, 2008; Beard et al., 2011; Eberl et al., 2013; Eberl et al., 2014).”
From Acceptability and Co-Development of an Online Cognitive Bias Modification Intervention for Emerging Adults With Hazardous Alcohol Use and Social Anxiety: A Mixed Methods Study (2020) · cites this paper as Beard et al., 2011
Only a handful of studies have examined the effects of mindfulness on cognitive biases.
“Even though Beard et al. (2011) lists mindfulness training as a CBM exercise, only a handful of studies have examined the effects of mindfulness on cognitive biases.”
From Mindfulness Training Alters Emotional Memory Recall Compared to Active Controls: Support for an Emotional Information Processing Model of Mindfulness (2012) · cites this paper as Beard et al., 2011
The Methods section describes CBM attention and interpretation tasks, but does not list mindfulness training as a CBM exercise. A search for mindfulness and for studies of its effects on cognitive biases found no passage addressing either point. The sentence attributes the exercise classification to Beard et al.; its statement about the number of mindfulness studies is not clearly attributed to this source. (LLM, conf=0.76)
Experimental — accuracy not yet measured
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Cites
Assessment of client/patient satisfaction: development of a general scale
Larsen, D. L., Attkisson, C. C., Hargreaves, W. A., & Nguyen, T. D. (1979) · Evaluation and Program Planning · doi:10.1016/0149-7189(79)90094-6 · Cited by 2,887 · cited 1× · see citing works
“Second, we examined a Client Satisfaction Questionnaire (CSQ[23]), an eight-item commonly used measure of treatment satisfaction.”
MethodPsychometric properties of the credibility/expectancy questionnaire
Devilly, G. J., & Borkovec, T. D. (2000) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/s0005-7916(00)00012-4 · Cited by 2,295 · cited 3× · see citing works
“90) and is predictive of some outcomes in clinical trials.[22] We administered the CEQ immediately following the first AIM/PC session.”
BackgroundMethodResultLiebowitz, M. R. (2015) · Modern Trends in Pharmacopsychiatry · doi:10.1159/000414022 · Cited by 2,266 · see citing works
Hoffman, S. G., & Smits, J. A. J. (2008) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v69n0415 · Cited by 1,420 · see citing works
Rebooting psychotherapy research and practice to reduce the burden of mental illness
Kazdin, A. E., & Blase, S. L. (2011) · Perspectives on Psychological Science · doi:10.1177/1745691610393527 · Cited by 1,254 · cited 1× · see citing works
“Thus, CBM may be an important part of our portfolio (see[30]) of treatments as it may be useful for patients who do not respond to or cannot access current treatments and for patients or providers who find existing treatments unacceptable.”
BackgroundPsychometric properties of the Liebowitz Social Anxiety Scale
HEIMBERG, R. G., HORNER, K. J., JUSTER, H. R., SAFREN, S. A., BROWN, E. J., SCHNEIER, F. R., & LIEBOWITZ, M. R. (1999) · Psychological Medicine · doi:10.1017/s0033291798007879 · Cited by 968 · cited 1× · see citing works
“The LSAS has good psychometric properties[15] and is a widely used measure in SAD treatment outcome research.”
MethodFRESCO, D. M., COLES, M. E., HEIMBERG, R. G., LIEBOWITZ, M. R., HAMI, S., STEIN, M. B., & GOETZ, D. (2001) · Psychological Medicine · doi:10.1017/s0033291701004056 · Cited by 874 · cited 1× · see citing works
“[16] The self-report version correlates strongly with the interview version and also has excellent psychometric properties.[17] Participants completed the LSAS-SR at pretreatment, week 1, week 2, week 3, and posttreatment.”
MethodHakamata, Y., Lissek, S., Bar-Haim, Y., Britton, J. C., Fox, N. A., Leibenluft, E., Ernst, M., & Pine, D. S. (2010) · Biological Psychiatry · doi:10.1016/j.biopsych.2010.07.021 · Cited by 869 · cited 1× · see citing works
“CBM affects cognition via repeated practice on tasks that require rapid processing (for reviews of CBM, see[3–5]).”
MethodBorkovec, T. D., & Costello, E. (1993) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.61.4.611 · Cited by 756 · cited 2× · see citing works
“We assessed perceived credibility of AIM with the Credibility/Expectancy Questionnaire (CEQ[21,22]).”
BackgroundMethodAssessment of patient satisfaction: Development and refinement of a Service Evaluation Questionnaire
Nguyen, T. D., Attkisson, C. C., & Stegner, B. L. (1983) · Evaluation and Program Planning · doi:10.1016/0149-7189(83)90010-1 · Cited by 736 · cited 1× · see citing works
“The CSQ total score ranges from 8 to 32, with higher scores indicating higher satisfaction, and has demonstrated good psychometric properties.[24] Third, we examined a posttreatment Exit Questionnaire developed specifically for this study that assessed perceived helpfulness of each study component using a Likert-scale”
Method. Caution regarding the use of pilot studies to guide power calculations for study proposals.
Kraemer, H. C., Mintz, J., Noda, A., Tinklenberg, J., & Yesavage, J. A. (2006) · Archives of General Psychiatry · doi:10.1001/archpsyc.63.5.484 · Cited by 702 · cited 1× · see citing works
“Second, the effect sizes should be interpreted with caution, given that effect sizes from small samples are known to be unreliable.[28] Larger studies are needed to confirm AIM’s efficacy.”
BackgroundCognitive Behavioral Group Therapy vs Phenelzine Therapy for Social Phobia: 12-Week Outcome
Heimberg, R. G., Liebowitz, M. R., Hope, D. A., Schneier, F. R., Holt, C. S., Welkowitz, L. A., Juster, H. R., Campeas, R., Bruch, M. A., Cloitre, M., et al. (1998) · Archives of General Psychiatry · doi:10.1001/archpsyc.55.12.1133 · Cited by 585 · see citing works
Research review: attention bias modification (ABM): a novel treatment for anxiety disorders
Bar‐Haim, Y. (2010) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2010.02251.x · Cited by 556 · cited 1× · see citing works
“CBM affects cognition via repeated practice on tasks that require rapid processing (for reviews of CBM, see[3–5]).”
MethodDiscrepancy between self- and observer ratings of performance in social phobics.
Rapee, R. M., & Lim, L. (1992) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.101.4.728 · Cited by 549 · see citing works
Attention training for generalized social anxiety disorder
Schmidt, N. B., Richey, J. A., Buckner, J. D., & Timpano, K. R. (2009) · Journal of Abnormal Psychology · doi:10.1037/a0013643 · Cited by 546 · cited 4× · see citing works
“have demonstrated preliminary efficacy of CBM targeting attention bias (CBM-A) in individuals with Social Anxiety Disorder (SAD).[6,7] Both trials utilized the same protocol, which comprised a dot probe task completed in eight, twice weekly computer sessions.”
BackgroundMethodInfluentialMennin, D. S., Fresco, D. M., Heimberg, R. G., Schneier, F. R., Davies, S. O., & Liebowitz, M. R. (2002) · Journal of Anxiety Disorders · doi:10.1016/s0887-6185(02)00134-2 · Cited by 506 · cited 2× · see citing works
“as an optimal cut-off for identifying cases of SAD[12,13] and was chosen to minimize false positives in the screening process.”
MethodAttention training in individuals with generalized social phobia: A randomized controlled trial.
Amir, N., Beard, C., Taylor, C. T., Klumpp, H., Elias, J. A., Burns, M. N., & Chen, X. (2009) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0016685 · Cited by 455 · cited 3× · see citing works
“have demonstrated preliminary efficacy of CBM targeting attention bias (CBM-A) in individuals with Social Anxiety Disorder (SAD).[6,7] Both trials utilized the same protocol, which comprised a dot probe task completed in eight, twice weekly computer sessions.”
BackgroundMethodSelf-citationRytwinski, N. K., Fresco, D. M., Heimberg, R. G., Coles, M. E., Liebowitz, M. R., Cissell, S., Stein, M. B., & Hofmann, S. G. (2009) · Depression and Anxiety · doi:10.1002/da.20503 · Cited by 432 · see citing works
Amir, N., Weber, G., Beard, C., Bomyea, J., & Taylor, C. T. (2008) · Journal of Abnormal Psychology · doi:10.1037/a0013445 · Cited by 356 · cited 1× · see citing works
“Participants were asked to complete a 5 min impromptu speech, following the same procedure as in previous studies.[18,19] Participants were presented with a list of five topics: three topics were from previous studies (abortion, nuclear power, the American Health System; Hofmann, Newman, Ehlers, & Roth, 1995) and two…”
MethodSelf-citationDandeneau, S. D., Baldwin, M. W., Baccus, J. R., Sakellaropoulo, M., & Pruessner, J. C. (2007) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.93.4.651 · Cited by 341 · see citing works
Beard, C., & Amir, N. (2008) · Behaviour Research and Therapy · doi:10.1016/j.brat.2008.05.012 · Cited by 319 · cited 5× · see citing works
“Only 6% of participants correctly guessed that they received a treatment following CBM-A[7] compared to 46% following CBM-I.[8] Although such findings quell any concerns about demand effects, they suggest that CBM may not be a very credible treatment, particularly CBM-A.”
BackgroundMethodResultInfluentialSelf-citationIntroduction to the special section on cognitive bias modification in emotional disorders
Koster, E. H. W., Fox, E., & MacLeod, C. (2009) · Journal of Abnormal Psychology · doi:10.1037/a0014379 · Cited by 272 · cited 1× · see citing works
“INTRODUCTION Cognitive Bias Modification (CBM) interventions directly target cognitive mechanisms associated with vulnerability to anxiety disorders, such as attention and interpretation biases (see[1,2]).”
BackgroundPredictors of Response to Cognitive-Behavioral Group Therapy for Social Phobia
Chambless, D. L., Tran, G. Q., & Glass, C. R. (1997) · Journal of Anxiety Disorders · doi:10.1016/s0887-6185(97)00008-x · Cited by 228 · cited 7× · see citing works
“Should these findings be replicated in larger samples, AIM has the potential to be a widely accessible and efficacious treatment for SAD.”
BackgroundInfluentialCognitive bias modification for anxiety: current evidence and future directions
Beard, C. (2011) · Expert Review of Neurotherapeutics · doi:10.1586/ern.10.194 · Cited by 222 · see citing works
Self-citationSee, J., MacLeod, C., & Bridle, R. (2009) · Journal of Abnormal Psychology · doi:10.1037/a0014377 · Cited by 215 · cited 1× · see citing works
“Because it is feasible to deliver CBM-A at home,[29] an ideal protocol may be to provide patients with both options when delivering CBM.”
BackgroundBorkovec, T. D., & Mathews, A. (1988) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.56.6.877 · Cited by 172 · cited 1× · see citing works
“Previous studies of psychosocial treatment for anxiety disorders have reported mean credibility ratings of seven and expectancy ratings of around 70%.[21,25] We chose modest benchmarks of five or above for credibility and 50% or above for expectancy.”
BackgroundBrosan, L., Hoppitt, L., Shelfer, L., Sillence, A., & Mackintosh, B. (2011) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2010.12.006 · Cited by 139 · cited 6× · see citing works
“CBM-I seems to be more face valid, and indeed, Brosan et al.’”
BackgroundResultInfluentialNegative Interpretation Bias Mediates the Effect of Social Anxiety on State Anxiety
Beard, C., & Amir, N. (2010) · Cognitive Therapy and Research · doi:10.1007/s10608-009-9258-6 · Cited by 64 · cited 1× · see citing works
“Participants were asked to complete a 5 min impromptu speech, following the same procedure as in previous studies.[18,19] Participants were presented with a list of five topics: three topics were from previous studies (abortion, nuclear power, the American Health System; Hofmann, Newman, Ehlers, & Roth, 1995) and two…”
MethodSelf-citationA case series of attention modification in clinically anxious youths
Rozenman, M., Weersing, V. R., & Amir, N. (2011) · Behaviour Research and Therapy · doi:10.1016/j.brat.2011.02.007 · Cited by 62 · cited 1× · see citing works
“Regarding acceptability, a recent open trial of CBMA suggests that this type of treatment is acceptable to anxious children and their parents based on a participant acceptability questionnaire.[10] However, acceptability has yet to be systematically examined in adults with SAD, which is crucial for eventual update of…”
BackgroundSelf-citation
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Research works printed but not linked: 3
- [5]Beard C Cognitive Bias Modification (CBM) for Anxiety: Current Evidence and Future Directions. Expert Review of Neurotherapeutics in press PMC3092585 21306216
- [14]First MB Spitzer RL Gibbon M Williams JBW Structured clinical interview for DSM-IV axis I disorders - patient edition (SCID-I/PI, version 2.0) 1996 Biometrics Research Department New York
- [16]Heimberg RG Liebowitz MR Hope DA Schneier FR Holt CS Welkowitz LA Cognitive Behavioral Group Therapy vs Phenelzine Therapy for Social Phobia. Archives of General Psychiatry 1998 55 1133 41 9862558
Cited by
Sorted by citations
Social Anxiety and Social Anxiety Disorder
Morrison, A. S., & Heimberg, R. G. (2013) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-050212-185631 · Cited by 480 · see citing works
Menne-Lothmann, C., Viechtbauer, W., Höhn, P., Kasanova, Z., Haller, S. P., Drukker, M., van Os, J., Wichers, M., & Lau, J. Y. F. (2014) · PLoS ONE · doi:10.1371/journal.pone.0100925 · Cited by 235 · see citing works
“, interpretation and attention bias) [68,69] and repeated training sessions of CBM-I [20,34] result in clinical relevant improvements.”
BackgroundMeta-analysis of technology-assisted interventions for social anxiety disorder
Kampmann, I. L., Emmelkamp, P. M. G., & Morina, N. (2016) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2016.06.007 · Cited by 180 · see citing works
Bowler, J. O., Mackintosh, B., Dunn, B. D., Mathews, A., Dalgleish, T., & Hoppitt, L. (2012) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0029932 · Cited by 164 · see citing works
“Beard, Weisberg, and Amir (2011) provided preliminary indication that combined training can reduce self-reported symptoms of social anxiety in a highly socially anxious population compared with a control group.”
BackgroundPotential Applications of Social Robots in Robot-Assisted Interventions for Social Anxiety
Rasouli, S., Gupta, G., Nilsen, E. S., & Dautenhahn, K. (2022) · International Journal of Social Robotics · doi:10.1007/s12369-021-00851-0 · Cited by 151 · see citing works
“A growing body of research suggests that social anxiety can be reduced using CBM [61–63].”
BackgroundPrice, R. B., Wallace, M., Kuckertz, J. M., Amir, N., Graur, S., Cummings, L., Popa, P., Carlbring, P., & Bar-Haim, Y. (2016) · Clinical Psychology Review · doi:10.1016/j.cpr.2016.09.009 · Cited by 144 · see citing works
Self-citationAmir, N., & Taylor, C. T. (2012) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0026928 · Cited by 136 · see citing works
Self-citationBeard, C., Weisberg, R. B., & Primack, J. (2012) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465811000671 · Cited by 124 · see citing works
Self-citationCognitive bias modification procedures in the management of mental disorders
MacLeod, C. (2012) · Current Opinion in Psychiatry · doi:10.1097/yco.0b013e32834fda4a · Cited by 104 · see citing works
Effects of cognitive bias modification on social anxiety: A meta-analysis
Liu, H.-N., Li, X.-W., Han, B.-X., & Liu, X. (2017) · PLoS ONE · doi:10.1371/journal.pone.0175107 · Cited by 79 · see citing works
“In this way, participants might receive greater assistance in decreasing the negative CB compared with the sham condition [25,95].”
BackgroundMobini, S., Reynolds, S., & Mackintosh, B. (2013) · Cognitive Therapy and Research · doi:10.1007/s10608-012-9445-8 · Cited by 105 · see citing works
“In another qualitative study, Beard et al. (2011) examined 10 socially-anxious patients’ attitudes toward and initial impressions of CBM.”
BackgroundRoberts-Wolfe, D., Sacchet, M., Hastings, E., Roth, H., & Britton, W. (2012) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2012.00015 · Cited by 79 · see citing works
“Thus, classic CBT may be moving toward the incorporation of “procedures [that] may alter cognitive biases through a more implicit, experiential process” (Beard et al., 2011).”
BackgroundInfluentialSalemink, E., Kindt, M., Rienties, H., & van den Hout, M. (2013) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2013.10.005 · Cited by 71 · see citing works
Lichtenthal, W. G., Corner, G. W., Slivjak, E. T., Roberts, K. E., Li, Y., Breitbart, W., Lacey, S., Tuman, M., DuHamel, K. N., Blinder, V. S., et al. (2017) · Cancer · doi:10.1002/cncr.30478 · Cited by 70 · see citing works
“We developed a CBM intervention to target FCR in BCS, adapting a program originally developed for anxiety disorders.(21) This intervention, Attention and Interpretation Modification (AIM) for Fear of Breast Cancer Recurrence (AIM-FBCR), attempts to maximize efficacy by targeting both attention and interpretation biase…”
MethodSelf-citationEfficacy of Interpretation Bias Modification in Depressed Adolescents and Young Adults
Micco, J. A., Henin, A., & Hirshfeld‐Becker, D. R. (2013) · Cognitive Therapy and Research · doi:10.1007/s10608-013-9578-4 · Cited by 67 · see citing works
“2010) to eight (Beard et al. 2011) to 12 (Amir and Taylor 2012).”
Klumpp, H., Fitzgerald, J. M., Kinney, K. L., Kennedy, A. E., Shankman, S. A., Langenecker, S. A., & Phan, K. L. (2017) · NeuroImage: Clinical · doi:10.1016/j.nicl.2017.04.006 · Cited by 59 · see citing works
“Similarly, there is evidence cognitive bias modification, which is intended to reduce negative appraisals, decreases threat interpretation bias and anxiety symptoms (Beard and Amir, 2008; Beard et al., 2011).”
Hostile interpretation bias in depression
Smith, H. L., Summers, B. J., Dillon, K. H., Macatee, R. J., & Cougle, J. R. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.05.070 · Cited by 57 · see citing works
Summers, B. J., & Cougle, J. (2016) · Behaviour Research and Therapy · doi:10.1016/j.brat.2016.09.005 · Cited by 50 · see citing works
Cougle, J., Summers, B. J., Allan, N. P., Dillon, K. H., Smith, H. L., Okey, S. A., & Harvey, A. M. (2017) · Behaviour Research and Therapy · doi:10.1016/j.brat.2017.09.004 · Cited by 49 · see citing works
Cardi, V., Esposito, M., Bird, G., Rhind, C., Yiend, J., Schifano, S., Hirsch, C. R., & Treasure, J. L. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.08.019 · Cited by 55 · see citing works
Hoppitt, L., Illingworth, J. L., MacLeod, C., Hampshire, A., Dunn, B., & Mackintosh, B. (2014) · Behaviour Research and Therapy · doi:10.1016/j.brat.2013.10.008 · Cited by 48 · see citing works
Cougle, J., Wilver, N. L., Day, T. N., Summers, B. J., Okey, S. A., & Carlton, C. N. (2020) · The Behavior Therapist · doi:10.1016/j.beth.2019.05.009 · Cited by 42 · see citing works
Effects of Cognitive Bias Modification Training via Smartphones
Yang, R., Cui, L., Feng, L., Xiao, J., Zhang, Q., & Oei, T. P. S. (2017) · Frontiers in Psychology · doi:10.3389/fpsyg.2017.01370 · Cited by 44 · see citing works
“Furthermore, these modifications were accompanied by a decline in the level of anxiety (Beard et al., 2011; Brosan et al., 2011).”
BackgroundNaim, R., Kivity, Y., Bar-Haim, Y., & Huppert, J. (2018) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2017.10.006 · Cited by 43 · see citing works
A systematic review of the word sentence association paradigm (WSAP)
Gonsalves, M. A., Whittles, R. L., Weisberg, R. B., & Beard, C. (2019) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2019.04.003 · Cited by 41 · see citing works
Self-citationBeard, C., Rifkin, L. S., & Björgvinsson, Þ. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.09.021 · Cited by 38 · see citing works
Self-citationPositivity impairment as a broad-based feature of social anxiety.
Gilboa‐Schechtman, E., Shachar, I., & Sahar, Y. (2014) · The Wiley Blackwell Handbook of Social Anxiety Disorder · doi:10.1002/9781118653920.ch19 · Cited by 36 · see citing works
Viana, A. G., & Gratz, K. L. (2012) · Journal of Clinical Psychology · doi:10.1002/jclp.21890 · Cited by 36 · see citing works
Macdonald, E. M., Koerner, N., & Antony, M. (2013) · Cognitive Therapy and Research · doi:10.1007/s10608-012-9519-7 · Cited by 37 · see citing works
“…association paradigm, Beard et al. (2011)’s placebo training condition had the same structure as the CBM training but required participants to make judgments about the relatedness of words to non-valenced ambiguous statements (e.g., ‘‘sand’’ and ‘‘you play at the beach’’; Beard et al. 2011).”
BackgroundInfluentialCognitive Biases in Social Anxiety Disorder
Amir, N., & Bomyea, J. (2010) · Elsevier eBooks · doi:10.1016/b978-0-12-375096-9.00014-6 · Cited by 51 · see citing works
Self-citationAn Attempt to Target Anxiety Sensitivity via Cognitive Bias Modification
Clerkin, E. M., Beard, C., Fisher, C. R., & Schofield, C. A. (2015) · PLoS ONE · doi:10.1371/journal.pone.0114578 · Cited by 34 · see citing works
“, a modified Word-Sentence Association Paradigm (WSAP; [23], [24], [25], [26]) to test the impact of interpretation training on AS and emotional vulnerability [27].”
BackgroundMethodSelf-citationHeeren, A., Ceschi, Dethier, Philippot, & Valentiner (2013) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s43097 · Cited by 35 · see citing works
“7,8 14–16 Recent findings also pointed out that there are additional treatment modalities, such as the administration of cannabidiol or D-cycloserine prior to exposure, which might enhance the efficacy of currently available cognitive– behavioral therapy programs.”
BackgroundTranslating CBM-I Into Real-World Settings: Augmenting a CBT-Based Psychiatric Hospital Program
Beard, C., Rifkin, L. S., Silverman, A. L., & Björgvinsson, Þ. (2018) · Behavior Therapy · doi:10.1016/j.beth.2018.09.002 · Cited by 33 · see citing works
Self-citationModification of Hostile Interpretation Bias in Depression: A Randomized Controlled Trial
Smith, H. L., Dillon, K. H., & Cougle, J. R. (2017) · Behavior Therapy · doi:10.1016/j.beth.2017.08.001 · Cited by 31 · see citing works
Yeung, E. S., & Sharpe, L. (2019) · Cognitive Therapy and Research · doi:10.1007/s10608-019-10012-3 · Cited by 31 · see citing works
Cognitive bias modification of interpretation in children with social anxiety disorder
Orchard, F., Apetroaia, A., Clarke, K., & Creswell, C. (2017) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2016.10.012 · Cited by 32 · see citing works
Kuckertz, J. M., Schofield, C. A., Clerkin, E. M., Primack, J., Boettcher, H., Weisberg, R. B., Amir, N., & Beard, C. (2019) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465818000231 · Cited by 30 · see citing works
“However, data from both Studies 1 and 2 suggest that it may be important to do so, given that baseline credibility and patient perceptions predicted better treatment outcomes (see also Beard et al., 2011).”
BackgroundMethodResultInfluentialSelf-citationHabitWorks: Development of a CBM-I Smartphone App to Augment and Extend Acute Treatment
Beard, C., Ramadurai, R., McHugh, R. K., Pollak, J. P., & Björgvinsson, T. (2021) · Behavior Therapy · doi:10.1016/j.beth.2020.04.013 · Cited by 29 · see citing works
Self-citationThe influences of virtual social feedback on social anxiety disorders
Kishimoto, T., & Ding, X.-F. (2019) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465819000377 · Cited by 23 · see citing works
“Studies showed that targeting cognitive bias can facilitate and enhance the treatment of SAD (Beard et al., 2011).”
BackgroundSelective Attention and Fear of Cancer Recurrence in Breast Cancer Survivors
Custers, J. A. E., Becker, E. S., Gielissen, M. F. M., van Laarhoven, H. W. M., Rinck, M., & Prins, J. B. (2014) · Annals of Behavioral Medicine · doi:10.1007/s12160-014-9632-9 · Cited by 26 · see citing works
“Studies on interventions in which implicit cognitive processes related to anxiety are influenced by cognitive bias modification reported positive findings [11–13].”
BackgroundButler, E., Mobini, S., Rapee, R., Mackintosh, B., & Reynolds, S. (2015) · Cogent Psychology · doi:10.1080/23311908.2015.1011905 · Cited by 21 · see citing works
“…on modifying interpretative biases and reducing anxiety in non-clinical or clinical social anxiety (e.g. Amir & Taylor, 2012; Beard & Amir, 2008; Beard, Weisberg, & Amir, 2011; Bowler et al., 2012; Khalili-Torghabeh, Salehi Fadardi, Mackintosh, Reynolds, & Mobini, 2014; Mobini et al., 2014;…”
BackgroundDalili, M. N., Schofield-Toloza, L., Munafo, M. R., & Penton‐Voak, I. S. (2016) · Cognition & Emotion · doi:10.1080/02699931.2016.1169999 · Cited by 25 · see citing works
“, 2014) and interpretation bias (Beard et al., 2011) should similarly generalise to untrained faces.”
BackgroundStanley, I. H., Hom, M. A., & Joiner, T. E. (2018) · Behaviour Research and Therapy · doi:10.1016/j.brat.2018.01.008 · Cited by 24 · see citing works
Dietel, F. A., Möllmann, A., Bürkner, P., Wilhelm, S., & Buhlmann, U. (2021) · Cognitive Therapy and Research · doi:10.1007/s10608-020-10180-7 · Cited by 27 · see citing works
Leung, C. J., Fosuaah, A., Frerichs, J., Heslin, M., Kabir, T., Lee, T. M. C., McGuire, P., Meek, C., Mouchlianitis, E., Nath, A. S., et al. (2019) · BMC Psychiatry · doi:10.1186/s12888-019-2215-3 · Cited by 20 · see citing works
Khalili-Torghabeh, S., Fadardi, J. S., Mackintosh, B., Reynolds, S., & Mobini, S. (2014) · Journal of Experimental Psychopathology · doi:10.5127/jep.037713 · Cited by 17 · see citing works
Dillon, K. H., Medenblik, A. M., Mosher, T. M., Elbogen, E. B., Morland, L. A., & Beckham, J. C. (2020) · Journal of Traumatic Stress · doi:10.1002/jts.22525 · Cited by 21 · see citing works
Leung, C. J., Yiend, J., & Lee, T. M. C. (2022) · Behavior Therapy · doi:10.1016/j.beth.2022.01.011 · Cited by 21 · see citing works
Sharpe, L., Jones, E. B., Pradhan, P., Todd, J., & Colagiuri, B. (2022) · Pain · doi:10.1097/j.pain.0000000000002784 · Cited by 22 · see citing works
Prior, K., Salemink, E., Wiers, R. W., Teachman, B. A., Piggott, M., Newton, N. C., Teesson, M., Baillie, A. J., Campbell, S., & Stapinski, L. A. (2020) · Alcoholism: Clinical and Experimental Research · doi:10.1111/acer.14452 · Cited by 18 · see citing works
“Trial repetition, boredom, and disengagement are serious concerns for CBM training (Beard et al., 2011).”
BackgroundThe Effect of Confidence on Dropout Rate and Outcomes in Online Cognitive Bias Modification
Hohensee, N., Meyer, M. J., & Teachman, B. A. (2020) · Journal of Technology in Behavioral Science · doi:10.1007/s41347-020-00129-8 · Cited by 18 · see citing works
Patel, T. A., Wilver, N. L., & Cougle, J. R. (2023) · Body Image · doi:10.1016/j.bodyim.2023.05.004 · Cited by 18 · see citing works
Chapter 16 – Cognitive Biases in Social Anxiety Disorder
Kuckertz, J. M., & Amir, N. (2014) · Elsevier eBooks · doi:10.1016/b978-0-12-394427-6.00016-9 · Cited by 3 · see citing works
Self-citationViana, A. G., Dixon, L. J., Stevens, E. N., & Ebesutani, C. K. (2016) · Cognitive Therapy and Research · doi:10.1007/s10608-016-9783-z · Cited by 19 · see citing works
“Computerized Assessment of Interpretation Biases Children completed a modified version of the Word-Sentence Association Paradigm (WSAP; Beard et al. 2011) as a computer-based assessment of interpretation biases.”
MethodDevelopment of a cognitive bias modification intervention for anxiety disorders in primary care
Weisberg, R. B., Gonsalves, M. A., Ramadurai, R., Braham, H., Fuchs, C. H., & Beard, C. (2021) · British Journal of Clinical Psychology · doi:10.1111/bjc.12281 · Cited by 17 · see citing works
Self-citationHenricks, L. A., Lange, W., Luijten, M., van den Berg, Y. H. M., Stoltz, S. E. M. J., Cillessen, A. H. N., & Becker, E. S. (2022) · Cognitive Therapy and Research · doi:10.1007/s10608-022-10304-1 · Cited by 17 · see citing works
“, 2014; Watts & Weems, 2006), and research showing the effectiveness of combined Cognitive Bias Modification (CBM) techniques in reducing social anxiety (Beard et al., 2011; Lisk et al., 2018).”
BackgroundParsons, E. M., Luebbe, A. M., & Clerkin, E. M. (2017) · Mindfulness · doi:10.1007/s12671-017-0738-6 · Cited by 17 · see citing works
Pictet, A. (2014) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2014.00043 · Cited by 14 · see citing works
Hahn, A. M., Simons, R. M., Simons, J. S., Wiers, R. W. H. J., & Welker, L. E. (2019) · Clinical Psychological Science · doi:10.1177/2167702619834570 · Cited by 15 · see citing works
Moving towards the benign: automatic interpretation bias modification in dysphoria
Cowden Hindash, A. H., & Rottenberg, J. A. (2017) · Behaviour Research and Therapy · doi:10.1016/j.brat.2017.09.005 · Cited by 15 · see citing works
Lau, J., & Pile, V. (2015) · Clinical Psychological Science · doi:10.1177/2167702614549596 · Cited by 22 · see citing works
The Role of Treatment Perceptions in Intervention Evaluation: A Review
Sidani, S., & Fox, M. T. (2020) · Science of Nursing and Health Practices · doi:10.31770/2561-7516.1079 · Cited by 14 · see citing works
“The relationship between expectancy and outcomes was examined in studies of psychological (Beard et al., 2011; Boettcher et al., 2013; Nock et al., 2007), cognitive, behavioral, cognitivebehavioral (Beasly et al., 2017; El-Alaoui et al., 2015; Goossens et al., 2005; Smeets et al., 2008), surgical…”
BackgroundPredictors of Symptom Outcome in Interpretation Bias Modification for Dysphoria
Smith, H. L., McDermott, K. A., Carlton, C. N., & Cougle, J. R. (2018) · Behavior Therapy · doi:10.1016/j.beth.2018.10.001 · Cited by 13 · see citing works
Cognitive Bias Modification: A New Frontier in Cognition and Emotion Research
MacLeod, C., & Clarke, P. (2013) · UWA Profiles and Research Repository (UWA) · Cited by 13 · see citing works
Klein, K. M., Fitzgerald, E. H., Forney, K. J., Kennedy, G. A., & Keel, P. K. (2022) · International Journal of Eating Disorders · doi:10.1002/eat.23751 · Cited by 12 · see citing works
A Pilot Open Trial of Cognitive Bias Modification for Panic Disorder
Beard, C., Fuchs, C. H., Asnaani, A., Schulson, M., Schofield, C. A., Clerkin, E. M., & Weisberg, R. B. (2016) · Cognitive Therapy and Research · doi:10.1007/s10608-016-9790-0 · Cited by 12 · see citing works
“Similar to prior work (Beard et al. 2011; Brosan et al. 2011), we tested a combined protocol”
MethodResultInfluentialSelf-citationSherman, J. A., & Ehrenreich, J. T. (2017) · Child Psychiatry & Human Development · doi:10.1007/s10578-017-0760-x · Cited by 11 · see citing works
To save or not to save: The use of cognitive bias modification in a high-hoarding sample
David, J., Baldwin, P. A., & Grisham, J. R. (2019) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2019.100457 · Cited by 11 · see citing works
AlMoghrabi, N., Franken, I. H. A., Mayer, B., & Huijding, J. (2021) · Behaviour Change · doi:10.1017/bec.2021.11 · Cited by 10 · see citing works
“Previous combined bias training procedures trained participants using two separate tasks such as dot-probe (i.e. to train attention bias) and vignettes (i.e. to train interpretation bias; e.g. Beard et al., 2011; Brosan et al., 2011; Lisk et al., 2018; Naim et al., 2018).”
BackgroundMethodInfluentialAlmeida, O. P., MacLeod, C., Ford, A. H., Grafton, B., Hirani, V., Glance, D., & Holmes, E. A. (2014) · Trials · doi:10.1186/1745-6215-15-282 · Cited by 10 · see citing works
“The intervention targets both attentional and interpretative biases, as this seems to enhance treatment response [30].”
BackgroundNeural correlates of cognitive bias modification for interpretation
Sakaki, K., Nozawa, T., Ikeda, S., & Kawashima, R. (2020) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsaa026 · Cited by 7 · see citing works
Computerized inhibitory control training reduces anxiety in preadolescent students
Shanok, N. A., Meltzer, K., Frank, C., Lugo, V., & Jones, N. A. (2021) · Applied Neuropsychology Child · doi:10.1080/21622965.2021.1884984 · Cited by 10 · see citing works
“…2015), similar computerized training approaches have shown to successfully reduce attentional or cognitive impairments in a sample of adults with social anxiety disorder (Beard et al., 2011) as well a non-clinical adult sample scoring high on the Penn State Worry Questionnaire (Hayes et al., 2010).”
Background“What I believe is true”: Belief-confirming reasoning bias in social anxiety disorder
Vroling, M. S., Glashouwer, K. A., Lange, W., Dam, E. A., & de Jong, P. J. (2016) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2016.03.013 · Cited by 9 · see citing works
Britton, G., & Bailey, H. J. (2018) · UWL Repository (University of West London) · Cited by 10 · see citing works
Beard, C., Beckham, E. E., Solomon, A., Fenley, A. R., & Pincus, D. B. (2021) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2021.09.005 · Cited by 9 · see citing works
Self-citationMarks, C. P. K., Kraft, J. D., Grant, D. M., & Wells, T. T. (2020) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-020-09839-y · Cited by 9 · see citing works
Effects of an Appearance-Focused Interpretation Training Intervention on Eating Disorder Symptoms
Summers, B. J., & Cougle, J. R. (2018) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465818000164 · Cited by 9 · see citing works
“The words did not have a negative (or positive) appearancerelated interpretation; this was modelled after previous work (Beard and Amir, 2008; Beard et al., 2011).”
ResultVassilopoulos, S., Moberly, N., & Lau, J. Y. F. (2015) · International Journal of Cognitive Therapy · doi:10.1521/ijct.2015.8.4.318 · Cited by 14 · see citing works
Interpretive Bias Modification for Disgust
Whitton, A., Grisham, J., Henry, J., & Palada, H. (2013) · Journal of Experimental Psychopathology · doi:10.5127/jep.030812 · Cited by 8 · see citing works
“…for generalised anxiety disorder (Brosan, Hoppitt, Shelfer, Sillence & Mackintosh, 2011),16 sessions over 8 weeks for social anxiety (Beard, Weisberg & Amir, 2011), 8 daily sessions for high trait anxiety (Salemink, et al., 2009) or even a single session of 288 (Najmi & Amir, 2010) or 160…”
BackgroundParsons, E. M., Straub, K. T., Smith, A. R., & Clerkin, E. M. (2017) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000000656 · Cited by 8 · see citing works
Amir, N., & Conley, S. L. (2013) · doi:10.1002/9781118528563.wbcbt09 · Cited by 8 · see citing works
Self-citationModerators and Mediators of the Interpretation Bias–Emotional Disorders Link
Polack, R. G., Davis, A. L., & Joormann, J. (2023) · CBT: science into practice · doi:10.1007/978-3-031-23650-1_4 · Cited by 7 · see citing works
Chen, R., Zheng, J., Li, T., Zhang, Q., Li, C., & Cui, L. (2020) · Current Psychology · doi:10.1007/s12144-020-01094-4 · Cited by 7 · see citing works
“…conditions are unreliable given that participants in sham condition can hardly believe they were in the equal condition to the training group (Beard et al. 2011; Cristea et al. 2015; Summers and Cougle 2016; Watkins et al. 2009), and control CBM-I may also provide a low-level active training…”
BackgroundThe influence of cognitive biases on psychophysiological vulnerability to stress
Randall, K. D. (2012) · Cited by 7 · see citing works
Investigating the therapeutic potential of cognitive bias modification for high anxiety sensitivity.
Macdonald, E. M., Koerner, N., Antony, M., Vickers, K., Mastorakos, T., & Kuo, J. R. (2019) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2019.101521 · Cited by 3 · see citing works
Beard, C., Peckham, A., Griffin, M. L., Weiss, R. D., Taghian, N. R., & McHugh, R. K. (2019) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2019.107644 · Cited by 6 · see citing works
“WSAP Scores by Primary Substance Type.”
MethodInfluentialSelf-citationJeong, Y., & Kim, S. H. (2020) · Computers in Human Behavior · doi:10.1016/j.chb.2020.106668 · Cited by 7 · see citing works
Halvaiepour, Z., Yazdkhasti, F., Oreyzi, H., & Nosratabadi, M. (2020) · Journal of Sex & Marital Therapy · doi:10.1080/0092623x.2020.1842572 · Cited by 6 · see citing works
Reyes, N., Boulton, K., Han, J., Torok, M. H., & Wong, Q. (2020) · Cognitive Therapy and Research · doi:10.1007/s10608-019-10074-3 · Cited by 7 · see citing works
Wu, Z., Li, S., Chen, Z., & Nie, Y. (2024) · Behaviour Research and Therapy · doi:10.1016/j.brat.2024.104616 · Cited by 5 · see citing works
de Rutte, J. L., Myruski, S., Davis, E. A., Findley, A. M., & Dennis‐Tiwary, T. A. (2025) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2025.103000 · Cited by 5 · see citing works
Social Anxiety Disorder: Assessment and Treatment
Ginzburg, D., Schreiber, F., & Stangier, U. (2014) · Wiley eBooks · doi:10.1002/9781118775349.ch47 · Cited by 13 · see citing works
Cognitive bias modification of interpretation for social anxiety: A “bottom-up” intervention?
Liu, B.-Q., & Li, X. (2018) · Advances in Psychological Science · doi:10.3724/sp.j.1042.2018.00859 · Cited by 1 · see citing works
DERİN, S., & Yorulmaz, O. (2022) · Current Psychology · doi:10.1007/s12144-022-03178-9 · Cited by 4 · see citing works
Obsesif Kompulsif Bozuklukta Bilişsel Yanlılık Değişimi
DERİN, S., & Yorulmaz, O. (2020) · Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry · doi:10.18863/pgy.620707 · Cited by 4 · see citing works
Summers, B. J., & Cougle, J. R. (2017) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2017.06.004 · Cited by 4 · see citing works
Prior, K., Salemink, E., Wiers, R., Teachman, B., Piggott, M., Newton, N., Teesson, M., Baillie, A., Manning, V., McLellan, L. F., et al. (2021) · JMIR Research Protocols · doi:10.2196/28667 · Cited by 3 · see citing works
“Further increasing the risk of attrition, CBM interventions are inherently repetitive and as such are sometimes considered boring because of the monotonous nature of the tasks [28,91].”
BackgroundCognitive Bias Modification Training
Grafton, B., & MacLeod, C. (2014) · doi:10.1002/9781118775349.ch64 · Cited by 7 · see citing works
Predictive roles of cognitive biases in health anxiety: A machine learning approach
Shi, C., Du, X., Chen, W., & Ren, Z. (2024) · Stress and Health · doi:10.1002/smi.3463 · Cited by 3 · see citing works
Prior, K., Salemink, E., Piggott, M., Manning, V., Wiers, R., Teachman, B., Teesson, M., Baillie, A., Mahoney, A. E. J., McLellan, L. F., et al. (2023) · JMIR Formative Research · doi:10.2196/46008 · Cited by 2 · see citing works
“Contrary to previous literature, which suggests that trial repetition, boredom, and disengagement are serious concerns for CBM training [56,57], qualitative feedback on the aspects of the program they found most and least helpful indicated that the reaction time–based nature of ApBM was “fun” and…”
BackgroundResult
- Authors
- Beard, C., Weisberg, R. B., & Amir, N.
- Affiliations
- Brown University (US)
- San Diego State University (US)
- Corresponding author
- Beard, Courtney
- Venue
- Depression and Anxiety
- Publisher
- Hindawi Limited
- Published
- 2011-09-02
- Volume
- 28
- Issue
- 11
- Pages
- 981-988
- ISSN
- 1091-4269 (ISSN-L)
- PMC
- PMC3215809
- OpenAlex
- W2060608730
- Cited by
- 124
- References
- 29
- Citations by year
- 2025: 3 · 2024: 6 · 2023: 6 · 2022: 7 · 2021: 10 · 2020: 14 · 2019: 10 · 2018: 7 · 2017: 12 · 2016: 10 · 2015: 7 · 2014: 11 · 2013: 11 · 2012: 7
- FWCI
- 12.37
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Pfizer
- National Institute of Mental Health (F32MH083330, R01MH087623, R34MH077129, MH083330)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- cognitive bias modification, social anxiety disorder, attentional bias modification, interpretation bias modification, dot-probe task, treatment credibility, treatment acceptability, computerized cognitive training, speech performance
- MeSH terms
- Adult, Attention, Double-Blind Method, Female, Humans, Male, Middle Aged, Phobic Disorders, Pilot Projects, Placebos, Therapy, Computer-Assisted, Cognitive Behavioral Therapy, Treatment Outcome, Patient Satisfaction, Young Adult
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