Social anxiety disorder affects approximately 7% of the adult population in the U.S., though a vast majority of these individuals do not seek treatment, so it is critical to bring treatment to them. Computerized Cognitive Bias Modification (CBM) training programs are effective in targeting interpretation bias, a key cognitive mechanism underlying social anxiety, and have potential for widespread dissemination, especially if they can be delivered via smart phones, which are becoming ubiquitous. However, the efficacy of CBM paradigms that are adapted to and delivered via smart phones remains unknown. To the best of our knowledge, the present pilot study is the first study of the effectiveness of delivering CBM-Interpretation training via smart phones.
High socially anxious participants (N=20 college students) were selected based on their response on the Social Interaction Anxiety Scale (SIAS). Each participant attended 2 lab sessions (3 weeks apart). In both sessions, participants completed measures of social anxiety, interpretation bias, trait affect, and cognitive flexibility. Participants completed 6 CBM online training sessions (~10 min each; 1 session per day) on their mobile phones in the second week of the study. In each session, participants were shown scenarios in which one or more of the letters in the last word are missing. After filling in the correct missing letter(s), the participant was asked a yes/no question about the scenario to ensure it was read and understood, and were then asked to imagine the scenario depicted in the final sentence as vividly as possible. Self-report affect ratings and passive data (e.g., movement patterns and heart rate) were also collected multiple times daily using a custom smartphone app and Microsoft Band, issued to participants as part of a larger study.
Findings indicated that negative interpretations related to ambiguous social situations were significantly lower (p < .05), and positive interpretations of ambiguous social situations were significantly higher (p < .01), on multiple measures after the intervention. Further, there were no changes to positive or negative ‘foil’ interpretations (p > .05), indicating specificity of the effects. However, there were no significant changes on measures of trait and state social anxiety and general cognitive flexibility (all p > .05), contrary to predictions. Overall, results provide preliminary evidence for the efficacy and viability of delivering CBM-training via smart phones, and demonstrate its effectiveness at reducing negative interpretation bias, but not associated symptoms. Future work will investigate the conditions under which mobile delivery of CBM-training can improve social anxiety symptoms to enhance the clinical utility of training.
Karl Fua– Doctoral Student, University of Virginia, Charlottesville, Virginia
Zara Siddiqui– University of Virginia
Emily Geyer– University of Virginia
Virginia Clemo– University of Virginia
Philip Chow– University of Virginia
Wes Bonelli– University of Virginia
Yu Huang– University of Virginia
Jiaqi Gong– University of Virginia
Laura Barnes– University of Virginia
Bethany Teachman– Professor, University of Virginia, Charlottesville, Virginia