Confusing procedures with process when appraising the impact of cognitive bias modification on emotional vulnerability

Grafton, Ben; MacLeod, Colin; Rudaizky, Daniel; Holmes, Emily A.; Salemink, Elske; Fox, Elaine; Notebaert, Lies

doi:10.1192/bjp.bp.115.176123

Cited by 162Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychological Treatments and AssessmentsPsychotherapy Techniques and Applications

Confusing procedures with process when appraising the impact of cognitive bias modification on emotional vulnerability

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Grafton, Ben, MacLeod, Colin, Rudaizky, Daniel, Holmes, Emily A., Salemink, Elske, Fox, Elaine, Notebaert, Lies·2017·British Journal of Psychiatry

DOI 10.1192/bjp.bp.115.176123

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Abstract

Summary If meta-analysis is to provide valuable answers, then it is critical to ensure clarity about the questions being asked. Here, we distinguish two important questions concerning cognitive bias modification research that are not differentiated in the meta-analysis recently published by Cristea et al (2015) in this journal: (1) do the varying procedures that investigators have employed with the intention of modifying cognitive bias, on average, significantly impact emotional vulnerability?; and (2) does the process of successfully modifying cognitive bias, on average, significantly impact emotional vulnerability? We reanalyse the data from Cristea et al to address this latter question. Our new analyses demonstrate that successfully modifying cognitive bias does significantly alter emotional vulnerability. We revisit Cristea et al's conclusions in light of these findings.

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Some attention bias modification projects have been limited by small sample sizes and poor trial methodology.
“Unfortunately, some projects have been limited by small sample sizes and poor trial methodology [20–23].”
From Acceptance and Commitment Therapy preceded by an experimental Attention Bias Modification procedure in recurrent depression: Study protocol for a randomized controlled trial (2018) · cites this paper as [20]
In “Implications and future directions” (page not provided), the paper says some attention-bias modification procedures were delivered through less rigorous approaches, particularly in uncontrolled home environments. It does not identify small sample sizes as a limitation, so that part of the claim is unsupported by our copy. (LLM, conf=0.84)
Experimental — accuracy not yet measured
Poor outcomes of conventional ABM may be explained by deficient training procedures, such as failure to modify the target process of reducing pre-existing AB in orienting towards threat.
“Poor outcomes may be explained by deficient training procedures: if ABM threat-avoidance training fails to modify its target process (i.e., reduce pre-existing AB in orienting towards threat), this could explain its failure to reduce anxiety [5,8,16,17].”
From Anxiety and Threat-Related Attention: Cognitive-Motivational Framework and Treatment (2018) · cites this paper as [17]
The co-occurrence of reductions in anxiety and AB measures during ABM training is compatible with a causal role of AB in anxiety.
“Several studies have found that reductions in anxiety and AB measures co-occurred during ABM training, which is compatible with a causal role of AB in anxiety [5,8,17].”
From Anxiety and Threat-Related Attention: Cognitive-Motivational Framework and Treatment (2018) · cites this paper as [17]
Several studies have found that reductions in anxiety and AB measures co-occurred during ABM training.
“Several studies have found that reductions in anxiety and AB measures co-occurred during ABM training, which is compatible with a causal role of AB in anxiety [5,8,17].”
From Anxiety and Threat-Related Attention: Cognitive-Motivational Framework and Treatment (2018) · cites this paper as [17]

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Authors: Grafton, B., MacLeod, C., Rudaizky, D., Holmes, E. A., Salemink, E., Fox, E., & Notebaert, L.
Affiliations: The University of Western Australia (AU)
Corresponding author: Grafton, Ben
ORCID: Grafton, Ben
MacLeod, Colin
Rudaizky, Daniel
Holmes, Emily A.
Salemink, Elske
Fox, Elaine
Notebaert, Lies
Venue: British Journal of Psychiatry
Publisher: Royal College of Psychiatrists
Published: 2017-11
Volume: 211
Issue: 5
Pages: 266-271
ISSN: 0007-1250 (ISSN-L)
1472-1465
DOI: 10.1192/bjp.bp.115.176123
OpenAlex: W2765605003
Cited by: 160
References: 40
Citations by year: 2026: 4 · 2025: 6 · 2024: 12 · 2023: 15 · 2022: 2 · 2021: 17 · 2020: 55 · 2019: 23 · 2018: 25 · 2017: 1
FWCI: 4.53
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.cambridge.org/core/terms (unspecified, 62 d)
Locations: The British Journal of Psychiatry (publishedVersion)
PubMed (publishedVersion)
UWA Profiles and Research Repository (University of Western Australia) (submittedVersion, other-oa)
UWA Profiles and Research Repository (UWA) (submittedVersion, other-oa)
UvA-DARE (University of Amsterdam) (submittedVersion)
Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
Utrecht University Repository (Utrecht University) (submittedVersion)
University of Birmingham Research Portal (University of Birmingham) (submittedVersion, other-oa)
Data Archiving and Networked Services (DANS) (submittedVersion)
Funders: Autoritatea Natională pentru Cercetare Stiintifică (DP140103713, DP140104448)
Unitatea Executiva pentru Finantarea Invatamantului Superior, a Cercetarii, Dezvoltarii si Inovarii (DP140104448, DP140103713)
Medical Research Council (MRC-A060-5PR50)
Australian Research Council (DP170104533)
FP7 Ideas: European Research Council (324176)
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 › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords: cognitive bias modification, emotional vulnerability, meta-analysis reanalysis, reanalysis critique
MeSH terms: Affective Symptoms, Humans, Psychotherapeutic Processes, Meta-Analysis as Topic, Cognitive Behavioral Therapy

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Confusing procedures with process when appraising the impact of cognitive bias modification on emotional vulnerability

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