Cognitive bias modification for anxiety: current evidence and future directions
Open accessAbstract
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 interpretation biases via repeated practice on cognitive tasks. Analogue studies have demonstrated that CBM affects cognitive biases and anxiety in a number of anxiety conditions. Multisession CBM treatments have shown preliminary efficacy for generalized social phobia and generalized anxiety disorder, with effect sizes comparable to existing treatments. However, with any newly developing field, there are a number of important limitations of the existing data that need to be addressed before making firm conclusions regarding CBM's efficacy for anxiety disorders. This article focuses on the theoretical rationale for CBM and the current evidence from analogue and clinical samples.
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Interpretation biases contribute to the development of anxiety symptoms and disorders, as well as to the maintenance and severity of these conditions.
“Interpretation biases have been shown to contribute to the development of anxiety symptoms and disorders, as well as to the maintenance and severity of these conditions (Beard, 2011; Muris et al., 2008).”
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, 2011
In “Why target cognitive biases?,” the paper describes interpretation bias as part of a cycle that maintains anxiety. Its “Interpretation bias” subsection reports that negative interpretations predict later PTSD and OCD symptom severity and calls interpretation bias a vulnerability factor. It does not show that interpretation bias contributes to the onset of anxiety symptoms or disorders, so the claim’s development component is stronger than the evidence presented. (LLM, conf=0.84)
Experimental — accuracy not yet measuredIBM studies have been reported as acceptable with regard to perceived helpfulness, personal relevance, user-friendliness, credibility, ease of use, simplicity, and esthetic appearance.
“IBM studies in particular have been reported as acceptable with regard to their perceived helpfulness, personal relevance, userfriendliness, credibility, ease of use, simplicity, and esthetic appearance (Beard, 2011; Beard et al., 2020; Beard et al., 2019).”
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, 2011
The “Safety & patient acceptability” section reports preliminary patient satisfaction with CBM and says most participants preferred the interpretation task (CBM-I). It does not report acceptability across the listed attributes, and it identifies credibility as needing improvement. Page numbers are not available in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredIn most CBM approaches, patients in both control and experimental groups think they are in the control group.
“Remarkably, in most CBM approaches, patients both in the control group and in the experimental group think that they are in the control group (Beard, 2011).”
From Addiction, adolescence, and the integration of control and motivation (2011) · cites this paper as Beard, 2011
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- Authors
- Beard, C.
- Affiliations
- Brown University (US)
- Corresponding author
- Beard, Courtney
- ORCID
- Beard, Courtney
- Venue
- Expert Review of Neurotherapeutics
- Publisher
- Informa UK Limited
- Published
- 2011-02
- Volume
- 11
- Issue
- 2
- Pages
- 299-311
- ISSN
- 1473-7175 (ISSN-L)
- 1744-8360
- PMC
- PMC3092585
- OpenAlex
- W2149707348
- Cited by
- 222
- References
- 98
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 10 · 2023: 11 · 2022: 13 · 2021: 14 · 2020: 11 · 2019: 13 · 2018: 16 · 2017: 15 · 2016: 20 · 2015: 30 · 2014: 18 · 2013: 21 · 2012: 15
- FWCI
- 2.36
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Expert Review of Neurotherapeutics (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Boettcher Foundation
- National Institute of Mental Health (F32MH083330, F32 MH08083330)
- 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, anxiety disorders, attentional bias, interpretation bias, generalized social phobia, generalized anxiety disorder, treatment efficacy, theoretical rationale
- MeSH terms
- Anxiety, Anxiety Disorders, Attention, Clinical Trials as Topic, Humans, Phobic Disorders, Cognitive Behavioral Therapy
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