Category: Adult Anxiety - GAD
Background: Generalized Anxiety Disorder (GAD) is associated with negative interpretation bias, or the tendency to interpret ambiguous situations in a threatening manner, and this tendency may lead to excessive worry and anxiety. Cognitive bias modification for interpretation bias (CBM-I) has received empirical support. However, few CBM-I programs target this bias in the broad range of GAD worry domains. Targeting negative interpretation bias in these domains may have a beneficial effect on interpretation bias, as well as on GAD symptoms and other cognitive phenomena associated with GAD (i.e., intolerance of uncertainty).
Goals & Hypotheses: To validate a new CBM-I program designed to target negative interpretation bias in a range of worry domains and to assess the impact of training on intolerance of uncertainty and GAD symptoms. We hypothesized that, compared to an interpretation control condition (ICC), CBM-I would be associated with greater reductions in (1) negative interpretation bias, (2) intolerance of uncertainty, and (3) GAD symptoms at post-training and 1-week follow-up.
Method: N = 30 adults (76.67% women; mean age = 26.90, SD = 9.72) with elevated worry and anxiety received four sessions of CBM-I or ICC. Both conditions involved four sessions of a computerized task using a Word and Sentence Association paradigm, designed to reduce negative interpretation bias (CBM-I) or to have no effect on interpretation bias (ICC). Measures of interpretation bias, intolerance of uncertainty and GAD symptoms were administered pre and post-training and 1-week follow-up.
Results: Compared to the control condition, CBM-I was associated with greater reductions in interpretation bias during training, F(1, 27) = 8.40, p = .007, η2p = .22, and lower levels of interpretation bias at post-training (g = 0.80) and 1-week follow-up (g = 0.42). Although a significant within-group reduction in intolerance of uncertainty was observed in CBM-I during training (g = 0.77), the Group x Time interaction was not significant, F(1, 27) = 2.04, p = .163, η2p = .06. No effect of training was observed on GAD symptoms.
Discussion: This study provides validation for a CBM-I training program designed to reduce negative interpretation bias in a range of worry domains. However, this CBM-I training cannot be used as a stand-alone intervention for GAD symptoms at present. Implications for both theory and clinical practice are discussed.
St. Joseph's Healthcare Hamilton
Hamilton, Ontario, Canada