Cited by 124Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesDigital Mental Health InterventionsPsychological Treatments and Assessments

The DOI matches its Crossref record; 35 of the 35 references it cites were found in a registry or an index; none of the 36 sources its claims cite is checked for support yet.

Socially anxious primary care patients' attitudes toward cognitive bias modification (CBM): A qualitative study

Open access
Beard, Courtney, Weisberg, Risa B., Primack, Jennifer·2012·Behavioural and Cognitive Psychotherapy

Abstract

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.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This qualitative study interviewed 10 socially anxious primary care patients about cognitive bias modification (CBM) after a brief rationale and demonstration. Participants saw positives in CBM but often lacked understanding of how the attention-bias task would help anxiety, while they reported greater understanding and engagement with the interpretation-bias task.

Key findings

  • Participants identified facilitators and barriers to engaging in treatment in general, computerized treatment, and CBM specifically; the written CBM rationale seemed relevant and helpful, but after trying the attention modification program, many expressed a lack of understanding about how it would help with anxiety.
  • Participants preferred the interpretation modification program (CBM-I) over the attention modification program (CBM-A), finding CBM-I more intuitive, fun, and engaging; CBM-A was more often called “weird,” “repetitive and boring,” “frustrating,” and “aggravating.”
  • Most participants described the CBM tasks as “easy” and “straightforward,” and most found the commonly used protocol of eight sessions over four weeks acceptable, though some thought more sessions would be needed to reverse longstanding habits.
  • A significant theme was the need to understand CBM: participants asked “what was the point of that?” and stated “people need to know why they’re doing something,” especially regarding the CBM-A task.

Methods

  • Qualitative interview study with 10 anxious primary care patients recruited from one medium-sized family medicine practice; inclusion required age 18+, clinic patient, LSAS total score ≥ 30, no active psychosis or mania, and English literacy. Of 26 screened, 7 were not socially anxious, 9 did not participate, and 10 completed the interview.
  • Semi-structured individual interviews lasted 37 to 57 minutes (M = 46.5, SD = 7.72); participants read a brief CBM rationale, completed brief demonstrations of a CBM-A dot-probe task and a CBM-I task, and discussed impressions.
  • Three clinical psychologists independently coded verbatim transcripts using iterative grounded theory, discussed themes collaboratively, and determined saturation after 10 interviews.

Limitations

  • Stated: the sample was modest and from one location, lacked ethnic diversity, comprised volunteers, and 9 of 10 had received prior mental health treatment; findings may not generalize to anxious primary care patients who avoid such interactions, to other disorders targeted by CBM, or beyond initial impressions after a brief demonstration rather than completed treatment.
  • Stated: participants’ hypothetical beliefs about what they may desire should be interpreted cautiously because attitudes do not always correlate with actual behavior.
  • Evident: the Principal Investigator conducted the interviews and had a priori beliefs that participants would find the tasks boring and unusual, which may have influenced interview dynamics, though independent coding and consensus procedures were used.

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Integrity signals

Registry

Crossref · 10.1017/s1352465811000671

Cites

35 of 35 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

83 Own result · 24 Not checked yet · 16 Own interpretation · 11 Own method · 6 No basis given

Verify all 36 references — free account

Show all 71 claims

  • It may state two separate claims as one. 41
  • Probably not a substantial claim. 43
69 of 69
  • The paper relies on this without support.

    Current CBM protocols are extremely repetitive, requiring patients to complete hundreds of quick trials per session.

    “First, current protocols are extremely repetitive, requiring patients to complete hundreds of quick trials (e.g., lasting less than one second) per session.”
  • The paper relies on this without support.

    CBM protocols have low face validity and thus may be less credible than existing treatments.

    “Additionally, CBM protocols have low face validity and thus may be less credible than existing treatments.”
  • The paper relies on this without support.

    This study is the first to conduct a qualitative analysis of attitudes toward CBM.

    “This study is the first to conduct a qualitative analysis of attitudes toward CBM.”
  • The paper relies on this without support.

    CBM and CCBT have similar dissemination potential, such as stepped care and self-help.

    “Given that CBM and CCBT have similar dissemination potential (e.g., stepped care, self-help)”
  • The paper relies on this without support.

    Beliefs and attitudes do not always correlate with actual behavior.

    “Beliefs and attitudes do not always correlate with actual behavior.”
  • The paper relies on this without support.

    Previous CBM protocols have not informed participants about how CBM is designed to reduce anxiety.

    “previous CBM protocols have not informed participants about how CBM is designed to reduce anxiety.”
6 of 6

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Citations

Cites

Show all 35 references

Research works printed but not linked: 1

  1. First, 1996, Structured Clinical Interview for DSM-IV Axis I Disorders: patient edition (SCID-I/PI, version 2.0)

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Metadata

Authors
Beard, C., Weisberg, R. B., & Primack, J.
Affiliations
Brown University (US)
Corresponding author
Beard, Courtney
Venue
Behavioural and Cognitive Psychotherapy
Published
2011-11-30
Volume
40
Issue
5
Pages
618-633
ISSN
  • 1352-4658 (ISSN-L)
  • 1469-1833
OpenAlex
W2119983695
Cited by
124
References
35
Citations by year
2026: 6 · 2025: 8 · 2024: 9 · 2023: 11 · 2022: 7 · 2021: 13 · 2020: 10 · 2019: 13 · 2018: 9 · 2017: 6 · 2016: 6 · 2015: 7 · 2014: 7 · 2013: 7 · 2012: 4
FWCI
7.39
Type
journal article
Language
en
Open access
Locations
  • Behavioural and Cognitive Psychotherapy (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (F32MH083330, MH69595, K23MH069595, MH083330)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
  • Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
Keywords
cognitive bias modification, social anxiety, primary care patients, treatment acceptability, patient attitudes, computerized cognitive training, attentional bias modification, interpretation bias modification, treatment rationale
MeSH terms
Adult, Aged, Anxiety Disorders, Attention, Attitude, Behavior Therapy, Cooperative Behavior, Culture, Female, Humans, Implosive Therapy, Judgment, Male, Middle Aged, Patient Acceptance of Health Care, Patient Education as Topic, Phobic Disorders, Physician-Patient Relations, Primary Health Care, Therapy, Computer-Assisted, Cognitive Behavioral Therapy, Patient Satisfaction, Interdisciplinary Communication

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