Examining Cognitive Bias Modification interventions for reducing food value and choice: Two pre-registered, online studies.

Future Research ◽

Control Group ◽

Unhealthy Food ◽

Weak Evidence ◽

There is considerable interest in Cognitive Bias Modification (CBM) as a potential treatment for overweight / obesity. Inhibitory Control Training (ICT) and Evaluative Conditioning (EC) are two popular paradigms which rely on associatively learned responses (unhealthy food -> inhibition, or unhealthy food-> negative stimulus, respectively) through repeated cue-response contingencies. Both ICT and EC have demonstrated some effectiveness for reducing food intake, value and / or choice, when administered in the laboratory and online. However, studies have been criticised for inconsistencies in design (e.g. use of inadequate control groups) which makes it difficult to draw robust conclusions. In two pre-registered, online studies our aim was to examine active ICT (study 1) and EC (study 2) in multiple groups where the cue->response contingencies were systematically varied (100%, 75%, 50%, 25%), before examining food-cue valuations and hypothetical food choice. In both studies varying the cue-> response contingencies did not lead to significant changes in food-cue devaluation following training. ICT did not substantially influence hypothetical food choice, whereas there was weak evidence that EC reduced choice for unhealthy foods, compared to a control group with 50% cue-response contingencies. Taken together both studies provide limited evidence for online CBM as a viable psychological treatment – at least through the mechanism of food-cue devaluation or changes in healthy and unhealthy food choice. Future research is needed to investigate the factors that contribute towards successful CBM training to critically evaluate the potential for these strategies within health interventions.

Cognitive bias modification for interpretation training via smartphones for social anxiety in Chinese undergraduates

Journal of Experimental Psychopathology ◽

10.1177/2043808719875274 ◽

2019 ◽

Vol 10 (3) ◽

pp. 204380871987527 ◽

Cited By ~ 1

Author(s):

Xiran Sun ◽

Ranming Yang ◽

Qin Zhang ◽

Jing Xiao ◽

Chieh Li ◽

...

Keyword(s):

Social Anxiety ◽

Cognitive Bias ◽

Unmet Need ◽

Training Group ◽

Control Group ◽

High Social Anxiety ◽

Bias Modification ◽

Chinese Undergraduates ◽

Ambiguous Situations

To address the unmet need for treatment of social anxiety disorder in China, it is timely and relevant to identify more effective, accessible, economic, and easily disseminated interventions. The present study examined the effect of an eight-session program for cognitive bias modification for interpretation (CBM-I). Smartphones were used in the training of reducing interpretation bias and social anxiety of Chinese undergraduates with high social anxiety. In total, 38 participants were randomly assigned to either a CBM-I training group ( n = 19) or a control group ( n = 19). As a result, the CBM-I training group provided more positive interpretations in ambiguous situations and less social anxiety than the control group. Results indicate that CBM-I training via smartphones can effectively promote positive interpretations of ambiguous situations and relieve social anxiety. CBM-I via smartphones may have clinical utility when applied as a multisession intervention of social anxiety for Chinese undergraduates.

Emotional Bias Modification in Youths with Attention Deficit Hyperactivity Disorder (ADHD): New Research Vista

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17114028 ◽

2020 ◽

Vol 17 (11) ◽

pp. 4028

Author(s):

Zhang Melvyn ◽

Aloysius Chow ◽

Ranganath Vallabhajosyula ◽

Daniel SS Fung

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Cognitive Bias ◽

Attention Deficit ◽

Cognitive Biases ◽

Preliminary Evidence ◽

Emotional Dysregulation ◽

Future Research ◽

Hyperactivity Disorder ◽

Whilst cognitive bias modification was initially used in the treatment of anxiety disorders, it is also currently being used for the treatment of other psychopathologies. In fact, cognitive bias modification has been especially well-investigated amongst children and adolescents. A recent review suggests some evidence for the modification of interpretative biases amongst children with neurodevelopment disorders. There have since been other studies reporting of the existence of other cognitive biases, such as emotional biases, amongst individuals with attention deficit hyperactivity disorder (ADHD). This perspective article will discuss the epidemiology of ADHD and the nature of emotional biases that are present amongst individuals with ADHD. This perspective article also reviewed some of the studies that have assessed and modified emotional biases in individuals with ADHD. A total of three studies have been identified from the published literature that provide evidence for targeting emotional biases amongst individuals with ADHD. These studies provide us with preliminary evidence for the effectiveness of modifying emotional biases and how it could help in ameliorating symptoms related to emotional dysregulation. There needs to be future research in this area with further evidence supporting the effectiveness of modifying emotional biases. It is also crucial for future research to determine which of these tools is best at detecting such biases, and which of these tools are versatile enough and non-invasive that they could safely be implemented for both research and clinical needs.

Smartphone-based cognitive bias modification training improves healthy food choice in obesity: A pilot study

European Eating Disorders Review ◽

10.1002/erv.2622 ◽

2018 ◽

Vol 26 (5) ◽

pp. 526-532 ◽

Cited By ~ 11

Author(s):

Naomi Kakoschke ◽

Chloe Hawker ◽

Ben Castine ◽

Barbora de Courten ◽

Antonio Verdejo-Garcia

Keyword(s):

Pilot Study ◽

Cognitive Bias ◽

Food Choice ◽

Healthy Food ◽

Healthy Food Choice ◽

Unhealthy yet Avoidable—How Cognitive Bias Modification Alters Behavioral and Brain Responses to Food Cues in Individuals with Obesity

Nutrients ◽

10.3390/nu11040874 ◽

2019 ◽

Vol 11 (4) ◽

pp. 874 ◽

Cited By ~ 10

Author(s):

Nora Mehl ◽

Filip Morys ◽

Arno Villringer ◽

Annette Horstmann

Keyword(s):

Cognitive Bias ◽

Brain Connectivity ◽

Inferior Frontal Gyrus ◽

Brain Regions ◽

Anterior Cingulate ◽

Angular Gyrus ◽

Unhealthy Food ◽

Food Cues ◽

Obesity is associated with automatically approaching problematic stimuli, such as unhealthy food. Cognitive bias modification (CBM) could beneficially impact problematic approach behavior. However, it is unclear which mechanisms are targeted by CBM in obesity. Candidate mechanisms include: (1) altering reward value of food stimuli; and (2) strengthening inhibitory abilities. Thirty-three obese adults completed either CBM or sham training during functional magnetic resonance imaging (fMRI) scanning. CBM consisted of implicit training to approach healthy and avoid unhealthy foods. At baseline, approach tendencies towards food were present in all participants. Avoiding vs. approaching food was associated with higher activity in the right angular gyrus (rAG). CBM resulted in a diminished approach bias towards unhealthy food, decreased activation in the rAG, and increased activation in the anterior cingulate cortex. Relatedly, functional connectivity between the rAG and right superior frontal gyrus increased. Analysis of brain connectivity during rest revealed training-related connectivity changes of the inferior frontal gyrus and bilateral middle frontal gyri. Taken together, CBM strengthens avoidance tendencies when faced with unhealthy foods and alters activity in brain regions underpinning behavioral inhibition.

Online Cognitive Bias Modification of Interpretation for Children With Obsessive-Compulsive Disorder

Practice in Clinical Psychology ◽

10.32598/jpcp.8.4.739.1 ◽

2020 ◽

Vol 8 (4) ◽

pp. 325-334

Author(s):

Saeed Nasiry ◽

◽

Zahra Ameli ◽

Pegah Pezeshki ◽

◽

...

Keyword(s):

Obsessive Compulsive Disorder ◽

Cognitive Bias ◽

Interpretation Bias ◽

Control Group ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Study Results ◽

Objective: Numerous children with Obsessive-Compulsive Disorder (OCD) either have no access to its main treatment, i.e. Cognitive Behavioral Therapy (CBT), or fail to respond to it. Cognitive Bias Modification of Interpretation (CBMI) is a novel and promising intervention that targets the incorrect interpretation of intrusive thoughts and impulses, i.e. the characteristics of OCD. The present study aimed to determine the effects of CBMI in children with OCD for the first time. Besides, we evaluated the possibility of online implementation of this intervention. Methods: A sample of 35 children with OCD (aged 7-12 years) were randomly assigned to two study groups. The experimental group (n=18) received CBMI and the controls (n=17) received placebo treatment. Interpretation bias and OCD severity were assessed at pre-test, post-test, and 2-month follow-up stages, using the Obsessive Compulsive Inventory-Child Version (OCICV), Obsessive Beliefs Questionnaire-Child Version (OBQCV), and Ambiguous Scenarios Task (AST). The present study results were analyzed using two-way repeated-measures Analysis of Variance (ANOVA) and Paired Samples t-test. Results: The collected findings demonstrated that after receiving CBMI, children’s propensity to positively interpret ambiguous situations was increased, their tendency towards negative interpretation and OCD severity was also decreased. There was no such significant change in the control group. Furthermore, the effects of CBMI was sustained at the 2-month follow-up step. Conclusion: This study provided preliminary evidence that suggests CBMI is capable of modifying interpretation bias in children with OCD, can reduce the severity of their disorder, and works as an online intervention. This brief and inexpensive intervention could be considered as an auxiliary or standalone treatment for OCD in children.

Incorporating Participatory Action Research in Attention Bias Modification Interventions for Addictive Disorders: Perspectives

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16050822 ◽

2019 ◽

Vol 16 (5) ◽

pp. 822 ◽

Cited By ~ 9

Author(s):

Melvyn Zhang ◽

Jiangbo Ying

Keyword(s):

Action Research ◽

Participatory Action Research ◽

Research Methods ◽

Cognitive Bias ◽

Participatory Design ◽

Future Research ◽

Participatory Action ◽

Addictive Disorders ◽

Participatory action research was introduced in the 1960s and early 1970s, but it has only been more widely adopted in the recent years. Such methodologies have since been applied to several web & mobile-based interventions in psychiatry. To date no prior review has scoped the extent of the application of such methodologies for web & mobile-based interventions in psychiatry. In this article, a scoping literature review was performed, and seven articles have been identified. The most common methodologies are that of co-design workshops; and increasingly service users and participants are included in these workshops. There remains a lack of application of such methodologies for addiction research. Increasingly, attention and cognitive bias modification interventions are more commonplace, given that they have been found to be effective in modifying underlying biases amongst individuals with addictive disorders. Unfortunately, there remains to be inherent limitations with web and mobile versions of attention and cognitive bias modification interventions. Participatory design research methods could help address these limitations and future research involving the conceptualization of new attention or cognitive bias modification applications ought to consider the incorporation of these research methods.

Neural correlates of cognitive bias modification for interpretation

Social Cognitive and Affective Neuroscience ◽

10.1093/scan/nsaa026 ◽

2020 ◽

Vol 15 (2) ◽

pp. 247-260

Author(s):

Kohei Sakaki ◽

Takayuki Nozawa ◽

Shigeyuki Ikeda ◽

Ryuta Kawashima

Keyword(s):

Cognitive Bias ◽

Occipital Lobe ◽

Neural Correlates ◽

Control Group ◽

Social Situations ◽

Post Intervention ◽

Significant Group ◽

Bias Modification ◽

Somatosensory Areas

Abstract The effectiveness of cognitive bias modification for interpretation (CBM-I), a treatment method employed to reduce social anxiety (SA), has been examined. However, the neural correlates of CBM-I remain unclear, and we aimed to elucidate brain activities during intervention and activity changes associated with CBM-I effectiveness in a pre–post intervention comparison. Healthy participants divided into two groups (CBM, control) were scanned before, during and after intervention using functional magnetic resonance imaging. Ambiguous social situations followed by positive outcomes were repeatedly imagined by the CBM group during intervention, while half of the outcomes in the control group were negative. Whole-brain analysis revealed that activation of the somatomotor and somatosensory areas, occipital lobe, fusiform gyrus and thalamus during intervention was significantly greater in the CBM than in the control group. Furthermore, altered activities in the somatomotor and somatosensory areas, occipital lobe and posterior cingulate gyrus during interpreting ambiguous social situations showed a significant group × change in SA interaction. Our result suggests that when facing ambiguous social situations, positive imagery instilled by CBM-I is recalled, and interpretations are modified to contain social reward. These findings may help to suggest an alternative manner of enhancing CBM-I effectiveness from a cognitive-neuroscience perspective.

Mobile Phone Cognitive Bias Modification Research Platform for Substance Use Disorders: Protocol for a Feasibility Study (Preprint)

10.2196/preprints.9740 ◽

2017 ◽

Author(s):

Melvyn Zhang ◽

JiangBo Ying ◽

Guo Song ◽

Daniel SS Fung ◽

Helen Smith

Keyword(s):

Mobile Phone ◽

Cognitive Bias ◽

Developmental Process ◽

Mobile Technologies ◽

Future Research ◽

Time Data ◽

Addictive Disorders ◽

Research Platform ◽

BACKGROUND Cognitive biases refer to automatic attentional and interpretational tendencies, which could be retained by cognitive bias modification interventions. Cristea et al and Jones et al have published reviews (in 2016 and 2017 respectively) on the effectiveness of such interventions. The advancement of technologies such as electronic health (eHealth) and mobile health (mHealth) has led to them being harnessed for the delivery of cognitive bias modification. To date, at least eight studies have demonstrated the feasibility of mobile technologies for the delivery of cognitive bias modification. Most of the studies are limited to a description of the conventional cognitive bias modification methodology that has been adopted. None of the studies shared the developmental process for the methodology involved, such that future studies could adopt it in the cost-effective replication of such interventions. OBJECTIVE It is important to have a common platform that could facilitate the design and customization of cognitive bias modification interventions for a variety of psychiatric and addictive disorders. It is the aim of the current research protocol to describe the design of a research platform that allows for customization of cognitive bias modification interventions for addictive disorders. METHODS A multidisciplinary team of 2 addiction psychiatrists, a psychologist with expertise in cognitive bias modification, and a computer engineer, were involved in the development of the intervention. The proposed platform would comprise of a mobile phone version of the cognitive bias task which is controlled by a server that could customize the algorithm for the tasks and collate the reaction-time data in realtime. The server would also allow the researcher to program the specific set of images that will be present in the task. The mobile phone app would synchronize with the backend server in real-time. An open-sourced cross-platform gaming software from React Native was used in the current development. RESULTS Multimedia Appendix 1 contains a video demonstrating the operation of the app, as well as a sample dataset of the reaction times (used for the computation of attentional biases) captured by the app. CONCLUSIONS The current design can be utilized for cognitive bias modification across a spectrum of disorders and is not limited to one disorder. It will be of value for future research to utilize the above platform and compare the efficacy of mHealth approaches, such as the one described in this study, with conventional Web-based approaches in the delivery of attentional bias modification interventions. REGISTERED REPORT IDENTIFIER RR1-10.2196/9740

Unhealthy Yet Avoidable – How Cognitive Bias Modification Alters Behavioral And Brain Responses To Food Cues In Obesity

10.1101/475020 ◽

2018 ◽

Author(s):

Mehl Nora ◽

Morys Filip ◽

Villringer Arno ◽

Horstmann Annette

Keyword(s):

Cognitive Bias ◽

Brain Connectivity ◽

Inferior Frontal Gyrus ◽

Brain Regions ◽

Anterior Cingulate ◽

Angular Gyrus ◽

Unhealthy Food ◽

Obese People ◽

AbstractObjectiveObesity is associated with automatically approaching problematic stimuli, such as unhealthy food. Cognitive bias modification (CBM) could beneficially impact on problematic approach behavior. However, it is unclear which mechanisms are targeted by CBM in obesity: Candidate mechanisms include (1) altering reward value of food stimuli or (2) strengthening inhibitory abilities.Methods33 obese people completed either CBM or sham training during fMRI scanning. CBM consisted of an implicit training to approach healthy and avoid unhealthy foods.ResultsAt baseline, approach tendencies towards food were present in all participants. Avoiding vs. approaching food was associated with higher activity in the right angular gyrus (rAG). CBM resulted in a diminished approach bias towards unhealthy food, decreased activation in the rAG, and increased activation in the anterior cingulate cortex. Relatedly, functional connectivity between the rAG and right superior frontal gyrus increased. Analysis of brain connectivity during rest revealed training-related connectivity changes of the inferior frontal gyrus and bilateral middle frontal gyri.ConclusionTaken together, CBM strengthens avoidance tendencies when faced with unhealthy foods and alters activity in brain regions underpinning behavioral inhibition.

Effectiveness of Web-based Cognitive Bias Intervention for Psychiatric Disorders: A Systematic Review Protocol (Preprint)

10.2196/preprints.10427 ◽

2018 ◽

Author(s):

Melvyn Zhang ◽

Jiangbo Ying ◽

Guo Song ◽

Daniel SS Fung ◽

Helen Smith

Keyword(s):

Systematic Review ◽

Psychiatric Disorders ◽

Cognitive Bias ◽

Cognitive Biases ◽

Meta Analysis ◽

Current Evidence ◽

Future Research ◽

Web Based ◽

UNSTRUCTURED Background: Traditional psychological therapies focus mainly on modification of individuals’ conscious decision-making process. Unconscious processes such as cognitive biases have been found to be accountable for various psychiatric psychopathologies. The advances in technologies have transformed how bias modification programs are being delivered. Objective: We seek to synthesize the current evidence of web-based cognitive bias modification for psychiatric disorders, by identifying the range of conditions targeted and their current efficacy. We wish to determine if web-based attention bias modification is as efficacious as compared to conventional methods. Methods and analysis: A systematic review will be conducted, and all studies types will be included. There will not be any restrictions on the participants included in the study. A search will be conducted on the respective databases up till 2017. Selection of studies will be by the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA-P) guidelines. Quality assessment of the included studies will be assessed using the Cochrane Risk of Bias tool (for randomized trials) and the Newcastle-Ottawa scale for other study designs. A narrative synthesises of the identified articles will be conducted. A meta-analysis will be considered, only if there are sufficient articles in a domain for statistical analysis. Ethical approval for the current protocol and the planned systematic review was not required. Results: Results synthesized would be disseminated using conference presentation or published works in peer-reviewed journals. Conclusions: This review is of importance given how technology transformed the delivery of conventional therapies. The findings from this review will provide guidance for future research involving technology and cognitive bias modification interventions. Registration details: International Prospective Register for Systematic Reviews (PROSPERO) number 2017 CRD42017074754