Role of Fear Domain Match and Baseline Bias in Interpretation Training for Contamination Fear

Abstract

Cognitive Bias Modification for anxious interpretations (CBM-I) is a computerized training program designed to reduce threatening interpretations of ambiguous information. In addition to testing the efficacy of CBM-I for contamination fear on various cognitive outcomes and emotional vulnerability, the current study examined whether the content of CBM-I must match a person's fear domain to be efficacious, and examined the moderating role of preexisting interpretation bias on CBM-I's efficacy. Participants (n = 121) high in contamination fear were assigned to one session of either CBM-I focused on contamination fear content, CBM-I focused on height fear content, or a sham control condition. Planned contrasts indicated that fear domain match does tend to enhance CBM-I's effects: compared to the heights condition, those in the contamination training condition improved on five of the eight cognitive bias-related variables, though there was no change on measures of emotional vulnerability. In contrast, there was little difference between the heights training and sham conditions. Minimal evidence was found for baseline interpretation bias as a moderator. Results support the use of CBM-I that matches the fear domain of the participant, regardless of baseline bias level.

Keywords

cognitive bias modification interpretation bias anxiety controllability contamination fear

References

Bar-Haim

, Morag

, & Glickman

(2011). Training anxious children to disengage from threat: A randomized controlled trial. Journal of Child Psychology and Psychiatry, 52, 861–869. https://dx-doi-org.web.bisu.edu.cn/10.1111/j.1469-7610.2011.02368.x

Barlow

D. H.

(1991). Disorders of emotion. Psychological Inquiry, 2(1), 58–71. https://dx-doi-org.web.bisu.edu.cn/10.1207/s15327965pli0201_15

Barlow

D. H.

(2002). Anxiety and its disorders: The nature and treatment of anxiety and panic (2nd ed.): Guilford Press, New York, NY.

Beadel

J. R.

, Smyth

F. L.

, & Teachman

B. A.

(2014). Change processes during cognitive bias modification for obsessive compulsive beliefs. Cognitive Therapy and Research, 38(2), 103–119. https://dx-doi-org.web.bisu.edu.cn/10.1007/s10608-013-9576-6

Brown

T. A.

, Campbell

L. A.

, Lehman

C. L.

, Grisham

J. R.

, & Mancill

R. B.

(2001). Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample. Journal of Abnormal Psychology, 110(4), 585–599. https://dx-doi-org.web.bisu.edu.cn/10.1037/0021-843X.110.4.585

Brown

T. A.

, White

K. S.

, Forsyth

J. P.

, & Barlow

D. H.

(2004). The structure of perceived emotional control: Psychometric properties of a revised Anxiety Control Questionnaire. Behavior Therapy, 35(1), 75–99. https://dx-doi-org.web.bisu.edu.cn/10.1016/S0005-7894(04)80005-4

Burns

G. L.

, Keortge

S. G.

, Formea

G. M.

, & Sternberger

L. G.

(1996). Revision of the Padua Inventory of obsessive compulsive disorder symptoms: Distinctions between worry, obsessions, and compulsions. Behaviour Research and Therapy, 34(2), 163–173. https://dx-doi-org.web.bisu.edu.cn/10.1016/0005-7967(95)00035-6

Clerkin

E. M.

, & Teachman

B. A.

(2011). Training interpretation biases among individuals with symptoms of obsessive compulsive disorder. Journal of Behavior Therapy and Experimental Psychiatry, 42, 337–343. https://dx-doi-org.web.bisu.edu.cn/10.1016/j.jbtep.2011.01.003

Deacon

, & Olatunji

B. O.

(2007). Specificity of disgust sensitivity in the prediction of behavioral avoidance in contamination fear. Behaviour Research and Therapy, 45(9), 2110–2120. https://dx-doi-org.web.bisu.edu.cn/10.1016/j.brat.2007.03.008

10.

Flatt

, & King

(2009). The Self-Efficacy Questionnaire for Phobic Situations (SEQ-SP): Development and psychometric evaluation. Behaviour Change, 26(2), 141–152. https://dx-doi-org.web.bisu.edu.cn/10.1375/bech.26.2.141

11.

Gallagher

M. W.

, Naragon-Gainey

, & Brown

T. A.

(2014). Perceived control is a transdiagnostic predictor of cognitive–behavior therapy outcome for anxiety disorders. Cognitive Therapy and Research, 38(1), 10–22. https://dx-doi-org.web.bisu.edu.cn/10.1007/s10608-013-9587-3

12.

Garcia-Palacios

, Botella

, Hoffman

, & Fabregat

(2007). Comparing acceptance and refusal rates of virtual reality exposure vs. in vivo exposure by patients with specific phobias. Cyberpsychology & Behavior, 10, 722–724. https://dx-doi-org.web.bisu.edu.cn/10.1089/cpb.2007.9962

13.

Green

J. S.

, & Teachman

B. A.

(2012). Is “cootie” in the eye of the beholder? An experimental attempt to modify implicit associations tied to contamination fears. Journal of Experimental Psychopathology, 3(3), 479–495. https://dx-doi-org.web.bisu.edu.cn/10.5127/jep.026111

14.

Hauptmann

, & Karni

(2002). From primed to learn: The saturation of repetition priming and the induction of long-term memory. Cognitive Brain Research, 13(3), 313–322. https://dx-doi-org.web.bisu.edu.cn/10.1016/S0926-6410(01)00124-0

15.

Hallion

L. S.

, & Ruscio

A. M.

(2011). A meta-analysis of the effect of cognitive bias modification on anxiety and depression. Psychological Bulletin, 137(6), 940–958. https://dx-doi-org.web.bisu.edu.cn/10.1037/a0024355

16.

Jones

M. K.

, & Menzies

R. G.

(1997). The cognitive mediation of obsessive-compulsive handwashing. Behaviour Research and Therapy, 35(9), 843–850. https://dx-doi-org.web.bisu.edu.cn/10.1016/S0005-7967(97)00035-1

17.

Keough

M. E.

, Riccardi

C. J.

, Timpano

K. R.

, Mitchell

M. A.

, & Schmidt

N. B.

(2010). Anxiety symptomatology: The association with distress tolerance and anxiety sensitivity. Behavior Therapy, 41(4), 567–574. https://dx-doi-org.web.bisu.edu.cn/10.1016/j.beth.2010.04.002

18.

Kohn

, Saxena

, Levav

, & Saraceno

(2004). The treatment gap in mental health care. Bulletin of the World Health Organization, 82, 858–866.

19.

Koster

E. H.

, Fox

, & MacLeod

(2009). Introduction to the special section on cognitive bias modification in emotional disorders. Journal of Abnormal Psychology, 118(1), 1–4. https://dx-doi-org.web.bisu.edu.cn/10.1037/a0014379

20.

Mathews

, & Mackintosh

(2000). Induced emotional interpretation bias and anxiety. Journal of Abnormal Psychology, 109(4), 602–615. https://dx-doi-org.web.bisu.edu.cn/10.1037/0021-843X.109.4.602

21.

Mathews

, & MacLeod

(2002). Induced processing biases have causal effects on anxiety. Cognition and Emotion, 16(3), 331–354. https://dx-doi-org.web.bisu.edu.cn/10.1080/02699930143000518

22.

Menne-Lothmann

, Viechtbauer

, Höhn

, Kasanova

, Haller

S. P.

, Drukker

, … & Lau

J. Y.

(2014). How to boost positive interpretations? A meta-analysis of the effectiveness of cognitive bias modification for interpretation. PloS one, 9(6), e100925. https://dx-doi-org.web.bisu.edu.cn/10.1371/journal.pone.0100925

23.

Micco

J. A.

, Hirshfeld-Becker

D. R.

, Henin

, & Ehrenreich-May

(2014). Content specificity of threat interpretation in anxious and non-clinical children. Cognitive Therapy and Research, 37(1), 78–88. https://dx-doi-org.web.bisu.edu.cn/10.1007/s10608-012-9438-7

24.

Mobini

, Mackintosh

, Illingworth

, Gega

, Langdon

, & Hoppitt

(2014). Effects of standard and explicit cognitive bias modification and computer-administered cognitive-behaviour therapy on cognitive biases and social anxiety. Journal of Behavior Therapy and Experimental Psychiatry, 45(2), 272–279. https://dx-doi-org.web.bisu.edu.cn/10.1016/j.jbtep.2013.12.002

25.

Muris

(2002). Relationships between self-efficacy and symptoms of anxiety disorders and depression in a normal adolescent sample. Personality and individual differences, 32(2), 337–348. https://dx-doi-org.web.bisu.edu.cn/10.1016/S0191-8869(01)00027-7

26.

Muris

, Huijding

, Mayer

, Remmerswaal

, & Vreden

(2009). Ground control to Major Tom: Experimental manipulation of anxiety-related interpretation bias by means of the “space odyssey” paradigm and effects on avoidance tendencies in children. Journal of Anxiety Disorders, 23(3), 333–340. https://dx-doi-org.web.bisu.edu.cn/10.1016/j.janxdis.2009.01.004

27.

Obsessive Compulsive Cognitions Working Group. (2005). Psychometric validation of the Obsessive Beliefs Questionnaire and the Interpretation of Intrusions Inventory: Part 2, factor analyses and testing of a brief version. Behaviour Research and Therapy, 43, 1527–1542. https://dx-doi-org.web.bisu.edu.cn/10.1016/j.brat.2004.07.010

28.

Rachman

(2004). Fear of contamination. Behaviour Therapy and Research, 42, 1227–1255. https://dx-doi-org.web.bisu.edu.cn/10.1016/j.brat.2003.10.009

29.

Rapee

R. M.

, Craske

M. G.

, Brown

T. A.

, & Barlow

D. H.

(1996). Measurement of perceived control over anxiety-related events. Behavior Therapy, 27(2), 279–293. https://dx-doi-org.web.bisu.edu.cn/10.1016/S0005-7894(96)80018-9

30.

Salemink

, Kindt

, Rienties

, & Van Den Hout

(2014). Internet-based Cognitive Bias Modification of Interpretations in patients with anxiety disorders: A randomised controlled trial. Journal of Behavior Therapy and Experimental Psychiatry, 45(1), 186–195. https://dx-doi-org.web.bisu.edu.cn/10.1016/j.jbtep.2013.10.005

31.

Salemink

, van den Hout

, & Kindt

(2010). Generalisation of modified interpretive bias across tasks and domains. Cognition and Emotion, 24(3), 453–464. https://dx-doi-org.web.bisu.edu.cn/10.1080/02699930802692053

32.

Salemink

, van den Hout

, & Kindt

(2007). Trained interpretive bias: validity and effects on anxiety. Journal of Behavior Therapy and Experimental Psychiatry, 38(2), 212–224. https://dx-doi-org.web.bisu.edu.cn/10.1016/j.jbtep.2006.10.010

33.

Salemink

, & Wiers

R. W.

(2011). Modifying threat-related interpretive bias in adolescents. Journal of Abnormal Child Psychology, 39(7), 967–976. https://dx-doi-org.web.bisu.edu.cn/10.1007/s10802-011-9523-5

34.

See

, MacLeod

, Bridle

(2009). The reduction of anxiety vulnerability through the modification of attentional bias: A real-world study using a home-based cognitive bias modification procedure. Journal of Abnormal Psychology, 11 8, 65–75. https://dx-doi-org.web.bisu.edu.cn/10.1037/a0014377

35.

Simons

J. S.

, & Gaher

R. M.

(2005). The Distress Tolerance Scale: Development and validation of a self-report measure. Motivation and Emotion, 29(2), 83–102. https://dx-doi-org.web.bisu.edu.cn/10.1007/s11031-005-7955-3

36.

Steinman

S. A.

(2010). Modifying interpretations among individuals high in anxiety sensitivity. (Master's), University of Virginia, Charlottesville, VA. https://dx-doi-org.web.bisu.edu.cn/10.1016/j.janxdis.2009.08.008

37.

Steinman

S. A.

, & Teachman

B. A.

(2014). Reaching new heights: Comparing interpretation bias modification to exposure therapy for extreme height fear. Journal of Consulting and Clinical Psychology, 82, 404–417. https://dx-doi-org.web.bisu.edu.cn/10.1037/a0036023

38.

Tran

T. B.

, Hertel

P. T.

, & Joormann

(2011). Cognitive bias modification: Induced interpretive biases affect memory. Emotion, 11(1), 145. https://dx-doi-org.web.bisu.edu.cn/10.1037/a0021754

39.

van Peski-Oosterbaan

A. S.

, Spinhoven

, van der Does

A. J. W.

, Bruschke

A. V. G.

, & Rooijmans

H. G. M.

(1999). Cognitive change following cognitive behavioural therapy for non-cardiac chest pain. Psychotherapy and Psychosomatics, 68, 214–220. https://dx-doi-org.web.bisu.edu.cn/10.1159/000012335

40.

Washington

C. S.

, Norton

P. J.

, & Temple

(2008). Obsessive-compulsive symptoms and obsessive-compulsive disorder: A multiracial/ethnic analysis of a student population. Journal of Nervous and Mental Disease, 196(6), 456–461. https://dx-doi-org.web.bisu.edu.cn/10.1097/NMD.0b013e3181775a62

41.

Wheaton

M. G.

, Abramowitz

J. S.

, Berman

N. C.

, Riemann

B. C.

, & Hale

L. R.

(2010). The relationship between obsessive beliefs and symptom dimensions in obsessive-compulsive disorder. Behaviour Research and Therapy, 48, 949–954. https://dx-doi-org.web.bisu.edu.cn/10.1016/j.brat.2010.05.027

42.

Williams

S. L.

, Kinney

P. J.

, & Falbo

(1989). Generalization of therapeutic changes in agoraphobia: The role of perceived self-efficacy. Journal of Consulting and Clinical Psychology, 57(3), 436–442. https://dx-doi-org.web.bisu.edu.cn/10.1037/0022-006X.57.3.436

43.

Wolpe

(1990). The practice of behavior therapy (4th ed.): Pergamon Press, Elmsford, NY.

44.

Woud

M. L.

, & Becker

E. S.

(2014). Editorial for the special issue on cognitive bias modification techniques: An introduction to a time traveller's tale. Cognitive Therapy and Research, 38(2), 83–88. https://dx-doi-org.web.bisu.edu.cn/10.1007/s10608-014-9605-0