Modifying interpretation biases in body dysmorphic disorder: Evaluation of a brief computerized treatment

Background:Cognitive bias modification (CBM) is a novel treatment for anxiety disorders that utilizes computerized tasks to train attention and interpretation biases away from threat. To date, attitudes toward and acceptability of CBM have not been systematically examined.Method:We conducted qualitative interviews with 10 anxious primary care patients to examine attitudes toward and initial impressions of CBM. Interviews explored general impressions, as well as reactions to the treatment rationale and two computer programs, one targeting attention bias and one targeting interpretation bias. Three clinical psychologists independently coded transcripts and collaboratively developed categories and themes guided by grounded theory.Results:A number of facilitators and barriers emerged related to engaging in treatment in general, computerized treatment, and CBM specifically. Participants stated that the written rationale for CBM seemed relevant and helpful. However, after interacting with the attention modification program, participants frequently expressed a lack of understanding about how the program would help with anxiety. Participants reported greater understanding and engagement with the interpretation modification program.Conclusions:Participants reported a number of positive characteristics of CBM, but it may need improvements regarding its treatment rationale and credibility. Future qualitative studies with individuals who complete a CBM treatment are warranted. Implications for future CBM development and dissemination are discussed.

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Interpretation Bias Across Body Dysmorphic, Social Anxiety and Generalized Anxiety Disorder—A Multilevel, Diffusion Model Account

Cognitive Therapy and Research ◽

10.1007/s10608-020-10180-7 ◽

2021 ◽

Author(s):

Fanny Alexandra Dietel ◽

Anne Möllmann ◽

Paul-Christian Bürkner ◽

Sabine Wilhelm ◽

Ulrike Buhlmann

Keyword(s):

Anxiety Disorder ◽

Social Anxiety ◽

Diffusion Model ◽

Generalized Anxiety Disorder ◽

Body Dysmorphic Disorder ◽

Interpretation Bias ◽

Generalized Anxiety ◽

Interpretation Biases ◽

Model Account ◽

Current Concerns

Abstract Background Interpretation biases are suggested to be transdiagnostic phenomena, but have rarely been compared across different disorders and current concerns. Methods We investigated explicit, decision-based, and more implicit, reaction time-based interpretation bias in individuals with body dysmorphic disorder (BDD; N = 29), social anxiety disorder (SAD; N = 36), generalized anxiety disorder (GAD; N = 22), and non-clinical controls (NC; N = 32), using an adapted Word Sentence Association Paradigm (WSAP). Results Results indicated that interpretation bias occurred transdiagnostically, while content-specific bias patterns varied meaningfully across groups. BDD and SAD shared explicit and, more inconsistently, implicit interpretation biases for appearance-related and social situations. The GAD group exhibited an explicit and implicit negative interpretation bias for general situations, and an additional implicit lack of positive bias. Mechanistic Wiener diffusion model analyses revealed that interpretation bias patterns were mainly driven by speeded information uptake, potentially mirroring disorder-specific associative memory organization. Conclusions These findings have important implications for understanding interpretation biases as both etiological and treatment factors.

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Effects of an Appearance-Focused Interpretation Training Intervention on Eating Disorder Symptoms

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465818000164 ◽

2018 ◽

Vol 46 (6) ◽

pp. 676-689 ◽

Cited By ~ 4

Author(s):

Berta J. Summers ◽

Jesse R. Cougle

Keyword(s):

Eating Disorder ◽

Body Dysmorphic Disorder ◽

Post Treatment ◽

Placebo Control ◽

Drive For Thinness ◽

Eating Disorder Symptoms ◽

Related Information ◽

Interpretation Biases ◽

Secondary Analyses ◽

Pre Treatment

Background: Previous research suggests that computerized interpretation bias modification (IBM) techniques may be useful for modifying thoughts and behaviours relevant to eating pathology; however, little is known about the utility of IBM for decreasing specific eating disorder (ED) symptoms (e.g. bulimia, drive for thinness). Aims: The current study sought to further examine the utility of IBM for ED symptoms via secondary analyses of an examination of IBM for individuals with elevated body dysmorphic disorder (BDD) symptoms (see Summers and Cougle, 2016), as these disorders are both characterized by threat interpretation biases of ambiguous appearance-related information. Method: We recruited 41 participants for a randomized trial comparing four sessions of IBM aimed at modifying problematic social and appearance-related threat interpretation biases with a placebo control training (PC). Results: At 1-week post-treatment, and relative to the PC, the IBM group reported greater reductions in negative/threat interpretations of ambiguous information in favour of positive/benign biases. Furthermore, among individuals with high pre-treatment bulimia symptoms, IBM yielded greater reductions in bulimia symptoms compared with PC at post-treatment. No treatment effects were observed on drive for thinness symptoms. Conclusions: The current study suggests that cognitive interventions for individuals with primary BDD symptoms may improve co-occurring ED symptoms such as bulimia.

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Interpretation bias across body dysmorphic, social anxiety and generalized anxiety disorder – a multilevel, diffusion model account

10.31234/osf.io/3hnpu ◽

2019 ◽

Author(s):

Fanny Alexandra Dietel ◽

Anne Möllmann ◽

Paul - Christian Bürkner ◽

Sabine Wilhelm ◽

Ulrike Buhlmann

Keyword(s):

Anxiety Disorder ◽

Social Anxiety ◽

Diffusion Model ◽

Generalized Anxiety Disorder ◽

Body Dysmorphic Disorder ◽

Interpretation Bias ◽

Generalized Anxiety ◽

Interpretation Biases ◽

Model Account ◽

Current Concerns

Interpretation biases are suggested to be transdiagnostic phenomena, but have rarely been compared across disorders and current concerns. We investigated explicit, decision-based and more implicit, reaction time-based interpretation bias in individuals with body dysmorphic disorder (BDD; N = 29), social anxiety disorder (SAD; N = 36), generalized anxiety disorder (GAD; N = 22), and non-clinical controls (NC; N = 32), using an adapted Word Sentence Association Paradigm (WSAP). Results indicated that interpretation bias occurred transdiagnostically, while content-specific bias patterns varied meaningfully across groups. BDD and SAD shared explicit and, more inconsistently, implicit interpretation biases for appearance-related and social situations. The GAD group exhibited a negative interpretation bias for general situations, and an additional implicit lack of positive bias. Mechanistic Wiener diffusion model analyses revealed that interpretation bias was mainly driven by speeded information uptake, potentially mirroring disorder-specific associative memory organization. These findings have important implications for the understanding of interpretation biases as both etiological and treatment factors.

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