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The causal role of interpretive bias in anxiety reactivity
Abstract
Elevated anxiety vulnerability is associated with a tendency to interpret ambiguous stimuli as threatening, but the causal basis of this relationship has not been established. Recently, procedures have been developed to systematically manipulate interpretive bias, but the impact of such manipulation on anxiety reactivity to a subsequent stressor has not yet been examined. In the present study, training procedures were used to induce interpretive biases favoring the threatening or nonthreatening meanings of ambiguous information in a sample of 48 undergraduate students. Following this interpretive training, participants' emotional reactions to a stressful video were assessed. The finding that the manipulation of interpretive bias modified emotional reactivity supports the hypothesis that interpretive bias can indeed play a causal role in anxiety vulnerability.
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“Furthermore, contrary to predictions that the tendency to benignly interpret ambiguous situations should decrease the negative mood response particularly under conditions of emotional provocation [63], we did not find this in the present data.”
From How to boost positive interpretations? A Meta-Analysis of the effectiveness of cognitive bias modification for interpretation (2014) · cites this paper as [63]
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“…training selective attention or interpretation using simple word stimuli can influence later emotional reaction to apparently very different experiences, such as failing to solve difficult anagrams or viewing accident videos (Mackintosh et al., 2006; MacLeod et al., 2002; Wilson et al., 2006).”
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“Additionally, studies that have manipulated interpretation and not informed participants of the purpose of the task have also found effects on anxiety (e.g., Wilson et al., 2006).”
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Joormann, J., & Quinn, M. E. (2014) · Depression and Anxiety · doi:10.1002/da.22264 · Cited by 286
“[65] Participants who were trained to interpret ambiguity in a nonthreatening manner had an attenuated anxiety reaction to the subsequent video stressor.[65, 66] Beard and Amir[67] reported that changes in negative emotion were mediated by traininginduced changes in negative interpretive style.”
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“Variations in emotional reactivity were revealed by variations in the degree to which the stress task altered selfreported mood (Wilson et al., 2006).”
BackgroundIntroduction to the special section on cognitive bias modification in emotional disorders
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Emotional reactivity and cognitive regulation in anxious children
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“As anxious individuals display biases towards threatening interpretations, a tendency believed to lead to negative emotional hyper-reactivity (Wilson et al., 2006), reappraisal is expected to be a relatively difficult but especially important emotion regulation strategy for anxious individuals.”
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Joormann, J., & D’Avanzato, C. (2010) · Cognition & Emotion · doi:10.1080/02699931003784939 · Cited by 288
“In a related study, participants who received interpretive training using ambiguous homophones were subsequently presented four distressing television clips of real-life emergency rescue situations (Wilson, MacLeod, Mathews, & Rutherford, 2006 ).”
BackgroundMenne-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
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BackgroundResultPatterns of Emotional Reactivity and Regulation in Children with Anxiety Disorders
Carthy, T., Horesh, N., Apter, A., & Gross, J. J. (2010) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-009-9167-8 · Cited by 230
“The anxious' emotional hyper-reactivity is thought to emerge from a biased processing of threat-related information (Beck et al. 1985; Wilson et al. 2006).”
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Testing the efficacy of theoretically derived improvements in the treatment of social phobia.
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Challenges in Developing Novel Treatments for Childhood Disorders: Lessons from Research on Anxiety
Pine, D. S., Helfinstein, S. M., Bar-Haim, Y., Nelson, E., & Fox, N. A. (2009) · Neuropsychopharmacology · doi:10.1038/npp.2008.113 · Cited by 194
“A growing number of experiments document reliable effects of training on attention bias (Clarke, 2008; Dandeneau et al, 2007; Eldar et al, 2008; Wilson et al, 2006).”
Crocker, L. D., Heller, W., Warren, S. L., O'Hare, A. J., Infantolino, Z. P., & Miller, G. A. (2013) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2013.00261 · Cited by 193
“Growing sophistication in theory and methodological approaches has led to empirical evidence suggesting that these processes are not only interdependent but effectively integrated in at least some areas of the brain (e.g., Gray, 2004; Pessoa, 2008, 2009; Miller, 2010).”
BackgroundField, A. P., & Lester, K. J. (2010) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-010-0078-8 · Cited by 205
Interpretation in Social Anxiety: When Meaning Precedes Ambiguity
Beard, C., & Amir, N. (2009) · Cognitive Therapy and Research · doi:10.1007/s10608-009-9235-0 · Cited by 165
“Only studies that directly modify interpretation and examine the effect on anxiety allow causal conclusions to be made (e.g., Wilson et al. 2006 ).”
Looking on the bright side: Accessing benign meanings reduces worry
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“In keeping with Wilson et al. (2006) and Murphy et al. (2007), the lack of group differences in anxiety immediately following completion of both of the ambiguity tasks did not preclude significant group differences in anxiety reactivity during the breathing focus task.”
ResultThe effects of modifying interpretation bias on worry in generalized anxiety disorder
Hayes, S., Hirsch, C. R., Krebs, G., & Mathews, A. (2010) · Behaviour Research and Therapy · doi:10.1016/j.brat.2009.10.006 · Cited by 167
Training forgetting of negative material in depression.
Joormann, J., Hertel, P. T., LeMoult, J., & Gotlib, I. H. (2009) · Journal of Abnormal Psychology · doi:10.1037/a0013794 · Cited by 165
“Similar results have been reported in a number of follow-up studies, all conducted under the umbrella of cognitivebias modification (Hirsch, Mathews, & Clark, 2007; Wilson, MacLeod, Mathews, & Rutherford, 2006; Yiend, Mackintosh, & Mathews, 2005).”
ResultBowler, 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
Grafton, B., MacLeod, C., Rudaizky, D., Holmes, E. A., Salemink, E., Fox, E., & Notebaert, L. (2017) · British Journal of Psychiatry · doi:10.1192/bjp.bp.115.176123 · Cited by 160
Self-citationBethell, E., Holmes, A., MacLarnon, A. M., & Semple, S. (2012) · Animal Welfare · doi:10.7120/09627286.21.2.185 · Cited by 152
“They are also reliable predictors of self-reported distress 59 experienced during stressful life events, and considered to be important markers of human 60 psychological wellbeing (Mathews & MacLeod 2002; Pury 2002; Wilson et al 2006).”
BackgroundFacilitating a benign interpretation bias in a high socially anxious population
Murphy, R., Hirsch, C. R., Mathews, A., Smith, K., & Clark, D. M. (2007) · Behaviour Research and Therapy · doi:10.1016/j.brat.2007.01.007 · Cited by 198
“Participants were given an unrelated set of filler tasks to complete for the duration of 10 minutes after the training task: the Wechsler Symbol Search subtest (Wechsler, 1997) and Wechsler Digit Symbol - Symbol Copy subtest (Wechsler, 1997), both subsets of the Wechsler Adult Intelligence Scale, and a letter cancella…”
MethodBrosan, 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
Amir, N., & Taylor, C. T. (2012) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0026928 · Cited by 136
“Previous studies have demonstrated that computerized CBM paradigms can induce selective interpretive biases of ambiguous material in non-clinical and analogue samples (e.g., Grey & Mathews, 2000; Mathews & Mackintosh, 2000; Murphy et al., 2007; Wilson et al., 2006).”
BackgroundEnduring consequences of experimentally induced biases in interpretation
Yiend, J., Mackintosh, B., & Mathews, A. (2005) · Behaviour Research and Therapy · doi:10.1016/j.brat.2004.06.007 · Cited by 135
Self-citationA three-phase model of the social emotional functioning in eating disorders
Treasure, J., Corfield, F., & Cardi, V. (2012) · European Eating Disorders Review · doi:10.1002/erv.2181 · Cited by 128
Inducing a benign interpretational bias reduces trait anxiety
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“To further illustrate this point, consider the results reported by Wilson et al. (2006).”
ResultCognitive bias modification training in adolescents: effects on interpretation biases and mood
Menne‐Lothmann, C., Holmes, E. A., Chan, S. W. Y., & Lau, J. Y. F. (2010) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2010.02286.x · Cited by 125
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Cognitive bias modification procedures in the management of mental disorders
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“attenuates negative emotional reactions to a subsequent stressor [33], has been upheld by recent research.”
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“( Wilson, MacLeod, Rutherford, & Mathews, 2006 ), indicating a causal role for such biases in”
BackgroundModifying interpretations among individuals high in anxiety sensitivity
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Attentional biases and the persistence of sad mood in major depressive disorder.
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Cognitive Bias Modification for Interpretation in Major Depression
Joormann, J., Waugh, C. E., & Gotlib, I. H. (2015) · Clinical Psychological Science · doi:10.1177/2167702614560748 · Cited by 100
“…who were trained to interpret ambiguity in a non-anxious manner had an attenuated self-reported anxious reaction to a subsequent stressor (e.g., Wilson, MacLeod, Mathews, & Rutherford, 2006; see also Mackintosh, Mathews, Yiend, Ridgeway, & Cook, 2006) and showed improvements in a subsequently…”
Mobini, S., Reynolds, S. A., & Mackintosh, B. (2012) · Cognitive Therapy and Research · doi:10.1007/s10608-012-9445-8 · Cited by 99
“Wilson et al. (2006) found that participants who were exposed to training in a benign interpretation bias experienced less anxiety in response to a video stressor as compared to participants who were exposed to training designed to induce threat congruent interpretations.”
BackgroundConcreteness training reduces dysphoria: A pilot proof-of-principle study
Watkins, E. R., & Moberly, N. J. (2008) · Behaviour Research and Therapy · doi:10.1016/j.brat.2008.10.014 · Cited by 96
Magnitude of negative interpretation bias depends on severity of depression.
Lee, J.-S., Mathews, A., Shergill, S., & Yiend, J. (2016) · Behaviour Research and Therapy · doi:10.1016/j.brat.2016.05.007 · Cited by 81
Inducing an interpretation bias changes self-imagery: A preliminary investigation
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Pérez‐Edgar, K. E., McDermott, J. M., Korelitz, K. E., Degnan, K. A., Curby, T. W., Pine, D. S., & Fox, N. A. (2010) · Developmental Psychology · doi:10.1037/a0021064 · Cited by 86
Modifying Threat-related Interpretive Bias in Adolescents
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“Support for this hypothesis has been observed in adults (Mackintosh et al. 2006; Wilson et al. 2006).”
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“Although previous research has shown that this seems to be the case in adults (e.g., Mathews & Mackintosh, 2000; Salemink et al., 2007a,b; Wilson et al., 2006), it remains to be seen whether such effects can also be demonstrated in child populations.”
BackgroundResultCognitive bias modification of interpretations: A viable treatment for child and adolescent anxiety?
Lau, J. Y. F. (2013) · Behaviour Research and Therapy · doi:10.1016/j.brat.2013.07.001 · Cited by 71
Angry-happy interpretations of ambiguous faces in social anxiety disorder
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“Experimental studies have also demonstrated a causal association between negative interpretation bias and anxiety reactivity (Mathews and Mackintosh, 2000; Wilson et al., 2006).”
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“Studies using similar stress tasks report that participants trained to make threatening interpretations display significant elevations of state anxiety following a stressor, whereas those in benign conditions do not show pronounced changes (Wilson et al. 2006; Lester et al. 2011).”
BackgroundResultCognitive mechanisms underlying the emotional effects of bias modification
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Self-citationEmerging interventions for PTSD: Future directions for clinical care and research
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“In support of this proposition, a number of studies indicate that information processing characteristics, such as attention and interpretation bias, may be causally implicated in anxiety (e.g., Mathews and MacLeod, 2002; Wilson et al., 2006).”
Kitayama, S., Park, J., Miyamoto, Y., Date, H., Boylan, J. M., Markus, H. R., Karasawa, M., Kawakami, N., Coe, C. L., Love, G. D., et al. (2018) · Personality and Social Psychology Bulletin · doi:10.1177/0146167217748603 · Cited by 59
“In addition, high neuroticism is linked to attentional vigilance to threats including illness symptoms (Derryberry & Reed, 1994; Wilson et al., 2006).”
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Biased interpretation in perfectionism and its modification
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Neuroticism and Interpretive Bias as Risk Factors for Anxiety and Depression
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“Based on such findings, iased processing of ambiguously threatening facial cues has been mplicated as an etiologic and maintaining factor in anxiety (e.g., athews and Mackintosh, 2000; Mathews and MacLeod, 2002; athews et al., 2007; Wilson et al., 2006).”
BackgroundMethodHoppitt, L., Illingworth, J. L., MacLeod, C., Hampshire, A., Dunn, B. D., & Mackintosh, B. (2013) · Behaviour Research and Therapy · doi:10.1016/j.brat.2013.10.008 · Cited by 61
Selective Mutism: An Update and Suggestions for Future Research
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“It is suggested that children with anxiety may be hypersensitive to perceived threat [ 38 ], resulting in a vulnerability to intense emotional experiences and reactions [39, 40].”
BackgroundPark, G., Vasey, M. W., Kim, G., Hu, D. D., & Thayer, J. F. (2016) · Frontiers in Psychology · doi:10.3389/fpsyg.2016.01164 · Cited by 54
“In contrast, people who made more positive interpretations of surprised faces showed reduced activity in the amygdala as well as increased activity in the ventromedial prefrontal cortex (vmPFC), which has been typically linked with regulatory function (Kim et al., 2003, 2004).”
BackgroundInterpretation Biases in Paranoia
Savulich, G., Freeman, D., Shergill, S., & Yiend, J. (2015) · Behavior Therapy · doi:10.1016/j.beth.2014.08.002 · Cited by 53
Is manipulation of mood a critical component of cognitive bias modification procedures?
Standage, H., Ashwin, C., & Fox, E. (2009) · Behaviour Research and Therapy · doi:10.1016/j.brat.2009.08.005 · Cited by 60
Training Ruminators to Inhibit Negative Information: A Preliminary Report
Daches, S., & Mor, N. (2013) · Cognitive Therapy and Research · doi:10.1007/s10608-013-9585-5 · Cited by 55
“Because CBM procedures initially targeted anxiety, they have typically focused on modifying biases in selective attention (Hakamata et al. 2010) or interpretation (e.g., Mathews and Mackintosh 2000; Wilson et al. 2006).”
Dual Cognitive and Biological Correlates of Anxiety in Autism Spectrum Disorders
Hollocks, M. J., Pickles, A. R., Howlin, P., & Simonoff, E. A. (2016) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-016-2878-2 · Cited by 53
“Some evidence suggests that cognitive biases precede the onset of an anxiety disorder, and that manipulating these biases can induce a positive or negative mood (Lothmann et al. 2011; Wilson et al. 2006).”
BackgroundValidation of a novel attentional bias modification task: the future may be in the cards
Notebaert, L., Clarke, P. J. F., Grafton, B., & MacLeod, C. (2015) · Behaviour Research and Therapy · doi:10.1016/j.brat.2014.12.007 · Cited by 48
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Golombek, K., Lidle, L. R., Tuschen‐Caffier, B., Schmitz, J., & Vierrath, V. (2019) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-019-01359-9 · Cited by 59
How Does Cognitive Bias Modification Affect Anxiety? Mediation Analyses and Experimental Data
Salemink, E., van den Hout, M., & Kindt, M. (2009) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465809990543 · Cited by 48
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 47
“While several psychotherapeutic procedures have been used to treat these biases (Tobon et al., 2011), recently, an increasing amount of research has focused on the use of Cognitive Bias Modification (CBM) procedures (Mackintosh et al., 2006; Wilson et al., 2006).”
BackgroundMethodSavulich, G., Shergill, S. S., & Yiend, J. (2012) · Journal of Experimental Psychopathology · doi:10.5127/jep.016711 · Cited by 47
Cognitive bias modification training in adolescents reduces anxiety to a psychological challenge
Lau, J. Y. F., Belli, S. R., & Chopra, R. B. (2012) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104512455183 · Cited by 50
Implicit interpretation biases affect emotional vulnerability: A training study
Tran, T. B., Siemer, M., & Joormann, J. (2011) · Cognition & Emotion · doi:10.1080/02699931.2010.532393 · Cited by 42
“These findings are similar to prior studies in which participants in the negative compared to the positive training group demonstrated worse outcomes on anxiety following a stressor (Mackintosh et al., 2006; Wilson et al., 2006).”
ResultLester, K., Seal, K., Nightingale, Z. C., & Field, A. (2010) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2009.09.004 · Cited by 46
Experimental modification of interpretation bias regarding social and animal fear in children.
Lester, K. J., Field, A. P., & Muris, P. (2011) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2011.03.006 · Cited by 45
Telman, M. D., Holmes, E. A., & Lau, J. Y. F. (2013) · Child Psychiatry & Human Development · doi:10.1007/s10578-013-0386-6 · Cited by 44
“A wide range of stressors has been used, from insolvable anagrams [36], emotional videos [30], imagined feared situations [38, 39] and negative mood inductions [40].”
BackgroundResultEffects of modifying the interpretation of emotional ambiguity
Mathews, A. (2012) · Journal of Cognitive Psychology · doi:10.1080/20445911.2011.584527 · Cited by 43
“However, even when no mood change was observed during training (as is typical with methods involving single ambiguous words), differential emotional reactivity has been revealed via responses to a subsequent stress task (e.g., Hoppitt, Mathews, Yiend, & Mackintosh, 2010b; Wilson et al., 2006).”
BackgroundInfluentialLester, K., Field, A., & Muris, P. (2011) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2011.618449 · Cited by 39
“Several studies have shown that anxiety vulnerability effects can occur irrespective of whether mood changes occur during CBM-I (Hirsch et al., 2007; Hoppitt et al., 2010; Wilson et al., 2006).”
BackgroundResultGeneralisation of modified interpretive bias across tasks and domains
Salemink, E., van den Hout, M., & Kindt, M. (2010) · Cognition & Emotion · doi:10.1080/02699930802692053 · Cited by 47
“Generalisability to other tasks might be limited, however this conclusion is not corroborated by other findings of CBM-I effects on video fragments and imagery tasks (Hertel et al., 2003; Mackintosh et al., 2006; Murphy et al., 2007; Wilson et al., 2006).”
BackgroundResultInfluentialBeard, C., Rifkin, L. S., & Björgvinsson, Þ. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.09.021 · Cited by 38
Neurocognition in PTSD: Treatment Insights and Implications
Jak, A. J., Crocker, L. D., Aupperle, R. L., Clausen, A. N., & Bomyea, J. A. (2016) · Current topics in behavioral neurosciences · doi:10.1007/7854_2016_62 · Cited by 39
The Plasticity of Adolescent Cognitions: Data from a Novel Cognitive Bias Modification Training Task
Lau, J. Y. F., Molyneaux, E., Telman, M. D., & Belli, S. R. (2011) · Child Psychiatry & Human Development · doi:10.1007/s10578-011-0244-3 · Cited by 44
“This is not particularly surprising taken in context of adult data: although instances of training effects on mood change have been found [56, 57], others have reported no effects on mood [14, 16, 58, 59] or mixed results [17, 21, 60].”
ResultDavey, G. C. L., & Meeten, F. (2016) · Biological Psychology · doi:10.1016/j.biopsycho.2016.04.003 · Cited by 34
Looming Maladaptive Style as a Moderator of Risk Factors for Anxiety
Adler, A., & Strunk, D. R. (2009) · Cognitive Therapy and Research · doi:10.1007/s10608-008-9221-y · Cited by 36
“Evidence for a causal relationship has also been shown with experimental manipulations of information processing biases leading to change in anxiety (Wilson et al. 2006).”
BackgroundThe Sex Differences in Regulating Unpleasant Emotion by Expressive Suppression: Extraversion Matters
Ayan, C. A. I., Lou, Y., Long, Q., & Yuan, J. (2016) · Frontiers in Psychology · doi:10.3389/fpsyg.2016.01011 · Cited by 42
Metadata
- Authors
- Wilson, E. J., MacLeod, C., Mathews, A., & Rutherford, E. M.
- Affiliations
- The University of Western Australia (AU)
- MRC Cognition and Brain Sciences Unit (GB)
- ORCID
- MacLeod, Colin
- Venue
- Journal of Abnormal Psychology
- Published
- 2006-02
- Volume
- 115
- Issue
- 1
- Pages
- 103-111
- ISSN
- 0021-843X (ISSN-L)
- 1939-1846
- OpenAlex
- W2043978415
- Cited by
- 262
- References
- 29
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 7 · 2023: 15 · 2022: 3 · 2021: 7 · 2020: 11 · 2019: 10 · 2018: 5 · 2017: 9 · 2016: 21 · 2015: 11 · 2014: 22 · 2013: 20 · 2012: 24
- FWCI
- 20.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Abnormal Psychology (publishedVersion)
- PubMed (publishedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion)
- UEA Digital Repository (University of East Anglia) (submittedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- interpretation bias, threat interpretation, ambiguous stimuli, emotional reactivity, stress response, anxiety vulnerability, causal manipulation
- MeSH terms
- Anxiety Disorders, Cognition, Data Interpretation, Statistical, Humans, Teaching, Observer Variation, Bias
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