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Chen J, Lin X, Wang N, Wang Y, Wang J, Luo F. When and how is depression associated with ostracism among college students? The mediating role of interpretation bias and the moderating role of awareness rather than acceptance. Stress Health 2024:e3454. [PMID: 39078475 DOI: 10.1002/smi.3454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 07/17/2024] [Accepted: 07/19/2024] [Indexed: 07/31/2024]
Abstract
Depression is closely related to individual social functions. The current study aimed to examine whether depression is associated with ostracism, whether interpretation bias mediates this relationship, and whether trait mindfulness moderates direct and indirect relationships between depression and ostracism. Overall, 389 Chinese college students completed the Center for Epidemiological Survey, Depression Scale, Interpretation Bias Questionnaire, Philadelphia mindfulness scale, and perceived ostracism scale at two-time points. Latent Profile analysis and moderated mediation analysis were performed. After controlling for sex and age, depression (t1) was positively correlated to perceived ostracism, with this relationship being partially mediated by negative interpretation bias (IBN, t2). The effect of IBN on perceived ostracism was weak when awareness was high at time 2. Acceptance had a non-significant moderating role in the relationship between IBN and perceived ostracism at time 2. LPA delineated three profiles: high awareness, high acceptance, and medium mindfulness. The moderating role of the different profiles in the relationship between IBN (t2) and perceived ostracism (t2) was significant. Depressed individuals appear to experience more ostracism because of IBN. Awareness might alleviate the effect of IBN on perceived ostracism.
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Affiliation(s)
- Jing Chen
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xiaoxiao Lin
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Ning Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yuzheng Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Jinyan Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Fei Luo
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Baumgardner M, LaGattuta AK, Allen KB. A Brief Measure of Positive and Negative Interpretation Biases: Development and Validation of the Ambiguous Social Scenarios Questionnaire. Assessment 2024; 31:715-731. [PMID: 37269086 DOI: 10.1177/10731911231176275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Positive and negative interpretation biases have been conceptualized as distinct constructs related to anxiety and social anxiety, but the field lacks psychometrically sound self-report measures to assess positive and negative interpretations of social ambiguity. This study examined the psychometric properties of the Ambiguous Social Scenarios Questionnaire (ASSQ) in two samples of 2,188 and 454 undergraduates with varying levels of anxiety. Results supported a bifactor model with a general interpretation bias factor and specific factors assessing positive and negative interpretation biases. The ASSQ demonstrated measurement invariance across genders and levels of social anxiety, as well as convergent and incremental validity with two existing measures of interpretation bias. It also demonstrated concurrent validity with attentional control, intolerance of uncertainty, total anxiety, and social anxiety and discriminant validity with emotional awareness. Findings support the ASSQ as a brief, valid, and reliable measure of positive and negative interpretation biases toward ambiguous social situations.
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Sicouri G, Daniel EK, Spoelma MJ, Salemink E, McDermott EA, Hudson JL. Cognitive bias modification of interpretations for anxiety and depression in children and adolescents: A meta-analysis. JCPP ADVANCES 2024; 4:e12207. [PMID: 38486951 PMCID: PMC10933640 DOI: 10.1002/jcv2.12207] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 10/19/2023] [Indexed: 03/17/2024] Open
Abstract
Background Evidence suggests that cognitive bias modification of interpretations (CBM-I) is effective in modifying interpretation biases and has a small effect on reducing anxiety in children and adolescents. However, most evidence to date is based on studies which report anxiety or general distress using ad-hoc Likert-type or Visual Analogue Scales, which are useful but do not reliably index symptoms of clinical importance. This meta-analysis aimed to establish the effects of CBM-I for children and adolescents on both anxiety and depression using psychometrically validated symptom measures, as well as state negative affect and negative and positive interpretation bias. Methods We identified studies through a systematic search. To be eligible for inclusion, studies needed to target interpretation biases, not combine CBM-I with another intervention, randomly allocate participants to CBM-I or a control condition, assess a mental health outcome (i.e., anxiety or depression symptoms using validated measures or state measures of negative affect) and/or interpretation bias and have a mean age less than 18 years. Results We identified 36 studies for inclusion in the meta-analysis. CBM-I had a small and non-significant unadjusted effect on anxiety symptoms (g = 0.16), no effect on depression symptoms (g = -0.03), and small and non-significant unadjusted effects on state negative affect both at post-training (g = 0.16) and following a stressor task (g = 0.23). In line with previous findings, CBM-I had moderate to large unadjusted effects on negative and positive interpretations (g = 0.78 and g = 0.52). No significant moderators were identified. Conclusions CBM-I is effective at modifying interpretation bias, however there were no effects on mental health outcomes. The substantial variability across studies and paucity of studies using validated symptom measures highlight the need to establish randomized controlled trial protocols that evaluate CBM-I in clinical youth samples to determine its future as a clinical intervention.
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Affiliation(s)
- Gemma Sicouri
- Black Dog InstituteUniversity of New South WalesSydneyNew South WalesAustralia
- School of PsychologyUniversity of New South WalesSydneyNew South WalesAustralia
| | - Emily K. Daniel
- Black Dog InstituteUniversity of New South WalesSydneyNew South WalesAustralia
| | - Michael J. Spoelma
- Black Dog InstituteUniversity of New South WalesSydneyNew South WalesAustralia
- Discipline of Psychiatry and Mental HealthSchool of Clinical MedicineFaculty of Medicine and HealthUniversity of New South WalesSydneyNew South WalesAustralia
| | - Elske Salemink
- Department of Clinical PsychologyUtrecht UniversityUtrechtthe Netherlands
| | - Emma A. McDermott
- Black Dog InstituteUniversity of New South WalesSydneyNew South WalesAustralia
| | - Jennifer L. Hudson
- Black Dog InstituteUniversity of New South WalesSydneyNew South WalesAustralia
- School of PsychologyUniversity of New South WalesSydneyNew South WalesAustralia
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van den Brand AJP, Hendriks-Hartensveld AEM, Havermans RC, Nederkoorn C. Child characteristic correlates of food rejection in preschool children: A narrative review. Appetite 2023; 190:107044. [PMID: 37717623 DOI: 10.1016/j.appet.2023.107044] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/27/2023] [Accepted: 09/12/2023] [Indexed: 09/19/2023]
Abstract
Dietary habits formed in early childhood are key for establishing a healthy diet later in life. Picky eating and food neophobia - the two main forms of food rejection in young children - form an important barricade to establishing such healthy habits. Understanding these types of food rejection is thus essential for promoting healthy eating behaviour in both children and adults. To this end, the present narrative review aims to provide an overview of food rejection research in preschool-aged children, focusing on recent advances in the cognitive literature. Specifically, we evaluate the link between children's cognitive development, chemosensory perception and affective evaluation of food, food knowledge, decision-making strategies, anxiety and disgust sensitivity, and food rejection behaviour. Longitudinal and experimental studies are necessary to establish how the relationships between food rejection and cognitive processes develop over time and to determine their causal directions.
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Affiliation(s)
- Anouk J P van den Brand
- Department of Clinical Psychological Science, Faculty of Psychology & Neuroscience, Maastricht University, the Netherlands.
| | - Anouk E M Hendriks-Hartensveld
- Department of Clinical Psychological Science, Faculty of Psychology & Neuroscience, Maastricht University, the Netherlands
| | - Remco C Havermans
- Laboratory of Behavioural Gastronomy, Centre for Healthy Eating and Food Innovation, Maastricht University Campus, Venlo, the Netherlands; Youth, Food, and Health, Maastricht University Campus, Venlo, the Netherlands
| | - Chantal Nederkoorn
- Department of Clinical Psychological Science, Faculty of Psychology & Neuroscience, Maastricht University, the Netherlands
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Frommelt T, Traykova M, Platt B, Wittekind CE. The influence of outcome expectancy on interpretation bias training in social anxiety: an experimental pilot study. Pilot Feasibility Stud 2023; 9:144. [PMID: 37592317 PMCID: PMC10433573 DOI: 10.1186/s40814-023-01371-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 07/25/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Cognitive bias modification for interpretation (CBM-I) trainings have shown positive effects on interpretation bias in both active interpretation bias training conditions and structurally similar control conditions. Outcome expectations have been suggested to contribute to these placebo effects. The goal of this pilot experimental study was to test the feasibility of positive expectancy induction, to gain preliminary insight into whether this has implications for the efficacy of CBM-I training, and to assess the feasibility of recruitment and the overall study design. METHODS Socially anxious individuals aged 18 years and older received a single session (approx. 45 min) of either CBM-I or placebo training preceded by either a positive expectancy induction or no expectancy induction. We first tested whether the expectancy induction had modified participants' expectations of training. We then explored the effects of CBM-I training and expectancy induction on interpretation bias. Finally, we assessed the feasibility of recruitment and further study procedures. RESULTS Due to pandemic-related difficulties, fewer participants were recruited than initially planned. Thirty-four (22 females and 12 males) participants were randomly assigned to one of four conditions (interpretation bias training + high expectancy = 10, interpretation bias training + no expectancy = 8, placebo training + high expectancy = 11, placebo training + no expectancy = 5). Participants in the positive expectancy condition had more positive expectations of the training (CBM-I or placebo) than participants in the no expectancy condition. We were unable to conduct the planned 2 × 2 × 2 analysis of interpretation bias due to the small sample size. When looking at these groups individually, we found that participants in the active training condition and participants in the high expectancy condition showed increases in positive interpretation bias and decreases in negative interpretation bias from pre- to post-training, while participants in the placebo and no expectancy conditions showed no change. CONCLUSIONS These findings suggest that the expectancy manipulation utilized in this study may be adopted by future studies which investigate outcome expectations as an unspecific mechanism of CBM-I. Preliminary analyses suggest that participants' expectations are likely to play a role in the effect of CBM-I training, although these effects require replication in a larger sample. Several observations about the study feasibility were made which could inform future trials. TRIAL REGISTRATION Retrospectively registered on the August 23, 2022, through the German Clinical Trials Register ( DRKS00029768 ).
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Affiliation(s)
- Tonya Frommelt
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University Hospital Munich, Nußbaumstr. 5, Munich, 80336, Germany.
| | - Milena Traykova
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University Hospital Munich, Nußbaumstr. 5, Munich, 80336, Germany
| | - Belinda Platt
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University Hospital Munich, Nußbaumstr. 5, Munich, 80336, Germany
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Koumoula A, Marchionatti LE, Caye A, Karagiorga VE, Balikou P, Lontou K, Arkoulaki V, Simioni A, Serdari A, Kotsis K, Basta M, Kapsimali E, Mitropoulou A, Klavdianou N, Zeleni D, Mitroulaki S, Botzaki A, Gerostergios G, Samiotakis G, Moschos G, Giannopoulou I, Papanikolaou K, Aggeli K, Scarmeas N, Koulouvaris P, Emanuele J, Schuster K, Karyotaki E, Kalikow L, Pronoiti K, Gosmann NP, Schafer JL, Merikangas KR, Szatmari P, Cuijpers P, Georgiades K, Milham MP, Corcoran M, Burke S, Koplewicz H, Salum GA. The science of child and adolescent mental health in Greece: a nationwide systematic review. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02213-9. [PMID: 37179505 DOI: 10.1007/s00787-023-02213-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 04/11/2023] [Indexed: 05/15/2023]
Abstract
Evidence-based information is essential for effective mental health care, yet the extent and accessibility of the scientific literature are critical barriers for professionals and policymakers. To map the necessities and make validated resources accessible, we undertook a systematic review of scientific evidence on child and adolescent mental health in Greece encompassing three research topics: prevalence estimates, assessment instruments, and interventions. We searched Pubmed, Web of Science, PsycINFO, Google Scholar, and IATPOTEK from inception to December 16th, 2021. We included studies assessing the prevalence of conditions, reporting data on assessment tools, and experimental interventions. For each area, manuals informed data extraction and the methodological quality were ascertained using validated tools. This review was registered in protocols.io [68583]. We included 104 studies reporting 533 prevalence estimates, 223 studies informing data on 261 assessment instruments, and 34 intervention studies. We report the prevalence of conditions according to regions within the country. A repository of locally validated instruments and their psychometrics was compiled. An overview of interventions provided data on their effectiveness. The outcomes are made available in an interactive resource online [ https://rpubs.com/camhi/sysrev_table ]. Scientific evidence on child and adolescent mental health in Greece has now been cataloged and appraised. This timely and accessible compendium of up-to-date evidence offers valuable resources for clinical practice and policymaking in Greece and may encourage similar assessments in other countries.
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Affiliation(s)
- Anastasia Koumoula
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Lauro Estivalete Marchionatti
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Arthur Caye
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Vasiliki Eirini Karagiorga
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Panagiota Balikou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Katerina Lontou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Vicky Arkoulaki
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - André Simioni
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Aspasia Serdari
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Department of Child and Adolescent Psychiatry, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Konstantinos Kotsis
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Maria Basta
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Department of Psychiatry, University Hospital of Heraklion, Crete, Greece
- Department of Child and Adolescent Psychiatry, University Hospital of Heraklion, Crete, Greece
| | - Efi Kapsimali
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Andromachi Mitropoulou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Nikanthi Klavdianou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Domna Zeleni
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Sotiria Mitroulaki
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Anna Botzaki
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Giorgos Gerostergios
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Giorgos Samiotakis
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Giorgos Moschos
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Ioanna Giannopoulou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- 2nd Department of Psychiatry, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Katerina Papanikolaou
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Department of Child Psychiatry, Agia Sophia Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Katerina Aggeli
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Nikolaos Scarmeas
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Department of Neurology, National and Kapodistrian University of Athens, Athens, Greece
- Department of Neurology, Columbia University, New York, USA
| | - Panagiotis Koulouvaris
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Jill Emanuele
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Kenneth Schuster
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Eirini Karyotaki
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Department of Clinical Neuro and Developmental Psychology, Vrije University Amsterdam, Amsterdam, The Netherlands
| | - Lily Kalikow
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Katerina Pronoiti
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
| | - Natan Pereira Gosmann
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Julia Luiza Schafer
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, National Institute of Mental Health, Bethesda, USA
| | - Peter Szatmari
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Pim Cuijpers
- Department of Clinical Neuro and Developmental Psychology, Vrije University Amsterdam, Amsterdam, The Netherlands
| | - Katholiki Georgiades
- Department of Psychiatry and Behavioural Neurosciences & Offord Centre for Child Studies, McMaster University, Hamilton, Canada
| | - Michael P Milham
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Mimi Corcoran
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Sarah Burke
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Harold Koplewicz
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA
| | - Giovanni Abrahão Salum
- Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, New York, USA.
- Child Mind Institute, 101 E 56Th St, New York, NY, 10022, USA.
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
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7
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Bennett EM, Gray P, Lau JYF. Early Life Maltreatment and Adolescent Interpretations of Ambiguous Social Situations: Investigating Interpersonal Cognitions and Emotional Symptoms. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:1-8. [PMID: 36883186 PMCID: PMC9908788 DOI: 10.1007/s40653-022-00469-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/04/2022] [Indexed: 06/18/2023]
Abstract
In the general population, negative interpretations of social situations have been associated with risk of developing emotional disorders such as anxiety and depression. Given that childhood maltreatment poses risk for later emotional disorders, this study examined whether interpersonal cognitive style differentiated maltreated adolescents from their non-maltreated peers and correlated with emotional symptoms across each group. Forty-seven maltreated and 28 non-maltreated adolescents were recruited from New South Wales, Australia to complete a battery of questionnaires that assessed interpersonal cognitions and levels of anxiety and depression. Comparable endorsement of threatening interpretations of social situations between maltreated adolescents and their non-maltreated peers across measures was found. Furthermore, an association between anxiety and depressive symptoms and interpretation bias was found within the non-maltreatment group but not the maltreated group. Unlike general population samples, negative cognitions do not associate with emotional symptoms in victims of early maltreatment. More research is needed to investigate the cognitive factors maintaining emotional symptoms in adolescent victims of maltreatment.
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Affiliation(s)
| | - Paul Gray
- NSW Department of Family and Community Services, Liverpool, NSW Australia
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8
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Attention and interpretation cognitive bias change: A systematic review and meta-analysis of bias modification paradigms. Behav Res Ther 2022; 157:104180. [PMID: 36037642 DOI: 10.1016/j.brat.2022.104180] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 07/29/2022] [Accepted: 08/08/2022] [Indexed: 12/15/2022]
Abstract
This systematic review and meta-analysis examines the effect of Cognitive Bias Modification for attention (CBM-A) and interpretation (CBM-I) on reducing the targeted biases and investigates moderators of each approach. PsycINFO, PsychArticles, and PubMED databases were searched for randomized-controlled studies published before March 2020 with pre- and post-CBM cognitive bias outcome measures, resulting in 91 CBM-A (n = 5914 individuals) and 70 CBM-I samples (n = 4802 individuals). Random-effects models and Hedge's g calculation showed significant medium overall effects of bias reduction with moderate to high heterogeneity (CBM-A g = 0.49 [0.36, 0.64], I2 = 85.19%; CBM-I g = 0.58 [0.48, 0.68], I2 = 70.92%). Effect sizes did not differ between approaches and remained significant after trim-and-fill adjustment for possible publication bias. Moderator variables were investigated with meta-regression and subgroup analyses. Participant age, symptom type, control condition and number of trials moderated CBM-A; student and clinical status moderated CBM-I effect size. Results support attention and interpretation modification in controlled laboratory and variable (online) training settings for non-clinical and clinical samples across various symptom types (anxiety, depression, substance use, eating disorders). Further empirical evidence is necessary to determine optimal sample and methodological combinations most strongly associated with adaptive behavioral outcomes.
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9
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The Longitudinal Interplay Between Attention Bias and Interpretation Bias in Social Anxiety in Adolescents. COGNITIVE THERAPY AND RESEARCH 2022. [DOI: 10.1007/s10608-022-10304-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Abstract
Background
Cognitive biases are found to play a role in the onset and maintenance of social anxiety. However, particularly in adolescence, the link between different biases and their role in predicting social anxiety is far from clear. This study therefore investigated the interplay between attention bias and interpretation bias in relation to social anxiety in adolescence across three years.
Methods
816 adolescents in grade 7 to 9 participated at three yearly waves (52.8% boys, Mage grade7 = 12.60). Social anxiety was measured with a self-report questionnaire. Attention bias was measured with a visual search task with emotional faces. Textual vignettes assessed interpretation bias.
Results
Cross-lagged models showed that negative interpretation bias at grade 7 predicted an increase in social anxiety at grade 8. This effect was not found from grade 8 to 9. Attention bias did not predict social anxiety. Attention bias and interpretation bias were not longitudinally related to each other, nor did they interact with each other in predicting social anxiety.
Conclusions
Thus, no evidence was found for the Combined Cognitive Bias Hypothesis in social anxiety in adolescents. Instead, our results suggest that interpretation bias rather than attention bias contributes to the increase of social anxiety over time.
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10
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Subar AR, Rozenman M. Like parent, like child: Is parent interpretation bias associated with their child's interpretation bias and anxiety? A systematic review and meta-analysis. J Affect Disord 2021; 291:307-314. [PMID: 34077820 DOI: 10.1016/j.jad.2021.05.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/09/2021] [Accepted: 05/14/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Anxiety disorders are the most prevalent psychiatric problem across the lifespan, with typical onset during the pediatric period. Prior literature has examined cognitive mechanisms associated with youth anxiety and identified interpretation bias, the threatening appraisal of ambiguity, as a ubiquitous correlate and likely mechanism. A small set of studies have examined interpretation bias and anxiety in parent-child dyads, although results about this potential relationship are conflicted. This systematic review and meta-analysis investigates the association between parent interpretation bias with child interpretation bias and child anxiety. METHODS Eight studies met the rigorous inclusion criteria, which required direct assessment of interpretation bias in both youth and parent. RESULTS Meta-analysis with a random effects model indicated a small and significant correlation between parent and child interpretation biases (r = 0.14, p < .01), as well as a small and significant correlation between parent interpretation bias and child anxiety (r = = 0.20, p = .01). LIMITATIONS As only eight studies were included in this meta-analysis, reflecting the state of the extant literature, it is possible that, as data accumulate and this work continues in the future, results may or may not be replicated. CONCLUSIONS Despite variability in findings across the included empirical studies, the current meta-analysis suggests that a correlational relationship between parent interpretation bias and child bias/anxiety exists. This work has implications for conceptualizing parent interpretation bias as a possible explanatory mechanism underlying youth interpretation bias and anxiety.
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Affiliation(s)
- Anni R Subar
- University of Denver, Department of Psychology, United States.
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11
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An D, Eggum-Wilkens ND. Situation-specific shyness among Chinese adolescents: Measurement and associations with adjustment. JOURNAL OF APPLIED DEVELOPMENTAL PSYCHOLOGY 2021. [DOI: 10.1016/j.appdev.2021.101278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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12
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Mental Imagery and its Relevance for Psychopathology and Psychological Treatment in Children and Adolescents: a Systematic Review. Int J Cogn Ther 2020. [DOI: 10.1007/s41811-020-00092-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
AbstractThis review provides an overview of the current state of research concerning the role of mental imagery (MI) in mental disorders and evaluates treatment methods for changing MI in childhood. A systematic literature search using PubMed/Medline, Web of Science, and PsycINFO from 1872 to September 2020 was conducted. Fourteen studies were identified investigating MI, and fourteen studies were included referring to interventions for changing MI. Data from the included studies was entered into a data extraction sheet. The methodological quality was then evaluated. MI in childhood is vivid, frequent, and has a significant influence on cognitions and behavior in posttraumatic stress disorder (PTSD), social anxiety disorder (SAD), and depression. The imagery’s perspective might mediate the effect of MI on the intensity of anxiety. Imagery rescripting, emotive imagery, imagery rehearsal therapy, and rational-emotive therapy with imagery were found to have significant effects on symptoms of anxiety disorders and nightmares. In childhood, MI seems to contribute to the maintenance of SAD, PTSD, and depression. If adapted to the developmental stages of children, interventions targeting MI are effective in the treatment of mental disorders.
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13
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Efficacy of Interpretation Bias Modification in Patients With Chronic Pain. THE JOURNAL OF PAIN 2020; 21:648-662. [DOI: 10.1016/j.jpain.2019.10.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 09/23/2019] [Accepted: 10/07/2019] [Indexed: 11/18/2022]
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Schmidt NB, Vereenooghe L. Inclusiveness of cognitive bias modification research toward children and young people with neurodevelopmental disorders: A systematic review. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2020; 68:86-101. [PMID: 35309701 PMCID: PMC8928859 DOI: 10.1080/20473869.2020.1720156] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 01/17/2020] [Accepted: 01/18/2020] [Indexed: 06/14/2023]
Abstract
Cognitive bias modification (CBM) is increasingly used to target cognitive biases related to internalising or externalising problems, which are common in neurodevelopmental disorders (NDD). This systematic review assesses the available evidence for using CBM in children and young people with NDD, in particular regarding ambiguous interpersonal information, and the extent of their exclusion from this type of intervention research. PsycINFO, PsycARTICLES, MEDLINE, Cochrane Central Register of Controlled Trials and Science Citation Index were consulted using MeSH terms and synonyms of "neurodevelopmental disorders", "mental health problems", "cognitive bias", "modification" and "review". Data extraction focused on the efficacy of CBM for NDD, how CBM was delivered, whether studies adopted exclusion criteria relating to NDD and the rationale for such criteria. The search identified 2270 records, of which twenty-nine studies assessed CBM for interpretations and were included in the qualitative synthesis. Three studies targeted bias in NDD, whereas a third of studies explicitly excluded participants based on NDD-related criteria: most frequently intellectual impairment, reading or learning difficulties and autism spectrum disorder (ASD). Only one study provided a rationale for excluding NDD which related to the reading demands of their intervention. There is tentative evidence for the feasibility of using CBM to reduce interpretation bias in children and young people with mild intellectual disability, ASD or attention-deficit/hyperactivity disorder (ADHD). We recommend that CBM research should consider including participants with NDD, use CBM tasks and adaptations that enable this group's inclusion, or provide a sufficient rationale for their exclusion.
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Affiliation(s)
- Nora B. Schmidt
- Faculty of Psychology and Sports Science, Bielefeld University, Bielefeld, Germany
| | - Leen Vereenooghe
- Faculty of Psychology and Sports Science, Bielefeld University, Bielefeld, Germany
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Schwarz J, Schreiber F, Kühnemund M, Weber C, Stangier U, Melfsen S. [Cognition in children with social anxiety disorder experiencing stress]. ZEITSCHRIFT FUR KINDER- UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2020; 48:145-157. [PMID: 31920179 DOI: 10.1024/1422-4917/a000702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Cognition in children with social anxiety disorder experiencing stress Abstract. Empirical data on cognitions of children with social anxiety disorder (SAD) are inconclusive. Objective: The present study examines the significance of cognition in children with SAD. Method: Thirty children suffering from SAD and 30 control children free of diagnosis (HC) aged between 9 and 15 years took part in an experiment. Their cognition was assessed before, during, and after a stress-inducing social situation. The assessment method was a self-report measurement. Coping perception was also assessed. Results: Children with SAD did not report a higher level of negative or coping cognition than those in the HC group. An interaction was apparent on the positive cognition scale: Older children (11-12 or 13-15 years) with SAD reported less positive cognition than those in the HC group, and younger children with SAD (9-10 years) reported more than those in the HC group. No group differences were found for perceived coping. Conclusions: The findings are important to the cognitive model and for the psychological treatment of SAD in children.
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Affiliation(s)
- Judith Schwarz
- Abteilung für Klinische Psychologie und Psychotherapie, Goethe-Universität Frankfurt am Main, Deutschland
| | - Franziska Schreiber
- Abteilung für Klinische Psychologie und Psychotherapie, Goethe-Universität Frankfurt am Main, Deutschland
| | - Martina Kühnemund
- Abteilung für Klinische Psychologie und Psychotherapie, Goethe-Universität Frankfurt am Main, Deutschland
| | - Christoph Weber
- Institut für mathematische Stochastik, Otto-von-Guericke-Universität Magdeburg, Deutschland
| | - Ulrich Stangier
- Abteilung für Klinische Psychologie und Psychotherapie, Goethe-Universität Frankfurt am Main, Deutschland
| | - Siebke Melfsen
- Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Psychiatrische Universitätsklinik Zürich, Schweiz
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Zentrum für Psychische Gesundheit, Universitätsklinikum Würzburg, Deutschland
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16
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A Situational Context Training for Socially Anxious Children. COGNITIVE THERAPY AND RESEARCH 2019. [DOI: 10.1007/s10608-019-10060-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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17
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Effortful control, interpretation biases, and child anxiety symptom severity in a sample of children with anxiety disorders. J Anxiety Disord 2019; 67:102136. [PMID: 31494512 PMCID: PMC6750729 DOI: 10.1016/j.janxdis.2019.102136] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 08/20/2019] [Accepted: 08/25/2019] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Effortful control-the ability to inhibit impulsive reactions in favor of more adaptive responses-is negatively related to child anxiety severity. One potential explanation is that greater effortful control may "slow down" automatic, threat-laden interpretations, thereby lowering children's anxiety. The present investigation tested this hypothesis by examining associations between effortful control (and its subcomponents) and anxiety symptom severity, mediated by interpretation biases, in a diverse sample of clinically anxious youth. METHOD Participants (N = 105; Mage = 10.09 years, SD = 1.22; 56.7% female; 49% ethnic minority) completed a diagnostic interview; self-report measures of temperament, anxiety, and interpretation biases; a performance-based measure of interpretation biases; and a parent-child interaction task for which an index of behavioral anxiety was computed. RESULTS Significant indirect effects were found for effortful control, attentional control, and inhibitory control on child self-reported anxiety severity by way of self-reported (but not behaviorally-indexed) interpretation biases. Models predicting behaviorally-indexed child anxiety severity were not significant. DISCUSSION Greater effortful control may result in enhanced attentional capacities that allow children to assess automatic cognitions more objectively, potentially lowering their anxiety. Future work should evaluate whether targeting malleable temperamental constructs, such as effortful control, leads to clinically meaningful reductions in interpretation biases and child anxiety symptoms.
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18
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Subjective well-being, social interpretation, and relationship thriving. JOURNAL OF RESEARCH IN PERSONALITY 2019. [DOI: 10.1016/j.jrp.2018.11.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Stuijfzand S, Creswell C, Field AP, Pearcey S, Dodd H. Research Review: Is anxiety associated with negative interpretations of ambiguity in children and adolescents? A systematic review and meta-analysis. J Child Psychol Psychiatry 2018; 59:1127-1142. [PMID: 29052865 PMCID: PMC6849625 DOI: 10.1111/jcpp.12822] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/29/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND The tendency to interpret ambiguity as threat (negative interpretation) has been implicated in cognitive models of anxiety. A significant body of research has examined the association between anxiety and negative interpretation, and reviews suggest there is a robust positive association in adults. However, evidence with children and adolescents has been inconsistent. This study aimed to provide a systematic quantitative assessment of the association between anxiety and negative interpretation in children and adolescents. METHOD Following systematic searches and screening for eligibility, 345 effects sizes from 77 studies were meta-analysed. RESULTS Overall a medium positive association was found between anxiety and negative interpretation in children and adolescents ( d ^ = .62). Two variables significantly moderated this effect. Specifically, the association increased in strength with increasing age and when the content of ambiguous scenarios matched the anxiety subtype under investigation. CONCLUSIONS Results extend findings from adult literature by demonstrating an association in children and adolescents with evidence for content specificity in the association. Age effects imply a role for development. Results raise considerations for when and for whom clinical treatments for anxiety focusing on interpretation bias are appropriate. The vast majority of studies included in the review have used correlational designs and there are a limited number of studies with young children. The results should be considered with these limitations in mind.
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Affiliation(s)
- Suzannah Stuijfzand
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
| | - Cathy Creswell
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
| | | | - Samantha Pearcey
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
| | - Helen Dodd
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
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20
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Krebs G, Pile V, Grant S, Degli Esposti M, Montgomery P, Lau JYF. Research Review: Cognitive bias modification of interpretations in youth and its effect on anxiety: a meta-analysis. J Child Psychol Psychiatry 2018; 59:831-844. [PMID: 29052837 DOI: 10.1111/jcpp.12809] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/03/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Emerging evidence suggests that cognitive bias modification of interpretations (CBM-I) is effective in altering interpretation biases and reducing anxiety in adults. Less is known about the impact of CBM-I in young people, but some recent findings, including a meta-analysis of combined cognitive bias modification of interpretation and attention techniques, have cast doubt on its clinical utility. Given the current debate, this meta-analysis sought to establish the independent effects of CBM-I on interpretations biases and anxiety in youth. METHODS Studies were identified through a systematic literature search of PsycINFO, Ovid MEDLINE, PsycARTICLES, Web of Science and EMBASE between January 1992 and March 2017. Eligible studies aimed to target interpretation biases; did not combine CBM-I with another intervention; included a control condition; randomly allocated participants to conditions; assessed interpretation bias and/or anxiety as an outcome; included individuals up to age 18; and did not present previously reported data. Reference lists of included articles were checked for further eligible studies, and authors were contacted for unpublished data. RESULTS We identified 26 studies meeting eligibility criteria that included in the meta-analysis. CBM-I had moderate effects on negative and positive interpretations (g = -0.70 and g = -0.52, respectively) and a small but significant effect on anxiety assessed after training (g = -0.17) and after a stressor (g = -0.34). No significant moderators were identified. CONCLUSIONS In contrast to previous meta-analytic findings, our results indicate that CBM-I has potential but weak anxiolytic effects in youth. Our findings suggest that it may be premature to disregard the potential value of CBM-I research and further research in this field is warranted.
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Affiliation(s)
- Georgina Krebs
- OCD & Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK.,Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Victoria Pile
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Sean Grant
- Centre for Evidence-Based Intervention, University of Oxford, Oxford, UK.,RAND Corporation, Santa Monica, CA, USA
| | | | - Paul Montgomery
- Department of Social Policy and Social Work, University of Birmingham, Birmingham, UK
| | - Jennifer Y F Lau
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Cougle JR, Summers BJ, Allan NP, Dillon KH, Smith HL, Okey SA, Harvey AM. Hostile interpretation training for individuals with alcohol use disorder and elevated trait anger: A controlled trial of a web-based intervention. Behav Res Ther 2017; 99:57-66. [PMID: 28941810 DOI: 10.1016/j.brat.2017.09.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 09/09/2017] [Accepted: 09/15/2017] [Indexed: 10/18/2022]
Abstract
High trait anger is associated with more severe alcohol use problems, and alcohol has been found to facilitate aggressive behavior among individuals with high trait anger. Treatments focused on a sample with alcohol use disorder with elevated anger could reduce alcohol use problems, as well as violence and aggression. We sought to examine the efficacy of interpretation bias modification for hostility (IBM-H) in a sample with high trait anger and alcohol use disorder (AUD). Fifty-eight individuals with AUD and elevated trait anger were randomly assigned to eight web-based sessions (two per week) of IBM-H or a healthy video control condition (HVC). Measures of interpretation bias, anger, and alcohol use were administered at pre- and post-treatment and at one-month follow-up. IBM-H led to greater improvements in interpretation bias compared to HVC at post and follow-up. IBM-H also led to greater reductions in trait anger than HVC, though this was an indirect effect mediated by changes in interpretation bias. Further, IBM-H led to lower anger expression than HVC; this was a direct (non-mediated) effect. Lastly, both conditions reported decreases in alcohol use and consequences following treatment, though there were no significant differences between them. These findings provide initial support for the utility of IBM-H as a brief non-confrontational intervention for AUD with elevated trait anger. Limitations and future research directions are discussed.
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Affiliation(s)
- Jesse R Cougle
- Department of Psychology, Florida State University, United States.
| | - Berta J Summers
- Department of Psychology, Florida State University, United States
| | | | - Kirsten H Dillon
- Department of Psychiatry and Behavioral Sciences, Duke University, United States
| | - Hillary L Smith
- Department of Psychology, Florida State University, United States
| | - Sarah A Okey
- Department of Psychology, Florida State University, United States
| | - Ashleigh M Harvey
- Department of Psychology, University of Wisconsin-Milwaukee, United States
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Halldorsson B, Creswell C. Social anxiety in pre-adolescent children: What do we know about maintenance? Behav Res Ther 2017; 99:19-36. [PMID: 28881221 DOI: 10.1016/j.brat.2017.08.013] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 08/18/2017] [Accepted: 08/28/2017] [Indexed: 10/18/2022]
Abstract
The cognitive theory of social anxiety disorder (SAD) is one of the most widely accepted accounts of the maintenance of the disorder in adults, yet it remains unknown if, or to what extent, the same cognitive and behavioral maintenance mechanisms that occur in adult SAD also apply to SAD among pre-adolescent children. In contrast to the adult literature, current models of SAD in children mostly account for etiology and maintenance processes are given limited attention. Consequently, their clinical utility for the treatment of SAD in children may be limited. This narrative review, first, critically examines the different theoretical conceptualizations of the maintenance of social anxiety in the child and adult literature and illustrates how these have resulted in different treatment approaches and clinical understanding. Second, it reviews the available evidence relating to hypotheses about the maintenance of SAD in children as derived from adult cognitive and etiological models. Third, it highlights the need to attend directly to child specific maintenance mechanisms in SAD, to draw on cognitive theory, and to account for the influence of childhood-specific contextual (e.g. family and school-based interactions) and developmental factors on children's social experiences.
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Affiliation(s)
- Brynjar Halldorsson
- School of Psychology and Clinical Language Sciences, University of Reading, UK.
| | - Cathy Creswell
- School of Psychology and Clinical Language Sciences, University of Reading, UK
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Short NA, Boffa JW, Norr AM, Albanese BJ, Allan NP, Schmidt NB. Randomized Clinical Trial Investigating the Effects of an Anxiety Sensitivity Intervention on Posttraumatic Stress Symptoms: A Replication and Extension. J Trauma Stress 2017; 30:296-303. [PMID: 28585746 DOI: 10.1002/jts.22194] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 02/21/2017] [Accepted: 03/01/2017] [Indexed: 11/07/2022]
Abstract
A growing body of research suggests the importance of anxiety sensitivity (AS) in the development and maintenance of posttraumatic stress symptoms (PTSS). Specifically, AS cognitive concerns (fears of cognitive dyscontrol) may be particularly relevant for those with elevated PTSS. Preliminary research has suggested that interventions targeting AS may be beneficial in decreasing PTSS, but to date there has been no randomized controlled trial testing the direct and indirect effects of an AS cognitive concerns intervention among a clinical sample of trauma-exposed individuals. The current study tested these effects among a sample 63 trauma-exposed participants who were randomized to either an AS cognitive concerns intervention or a repeated contact control. Results indicated a direct effect of the intervention on PTSS 1 month postintervention, and that this effect was mediated by changes in AS, specifically AS cognitive concerns, during the intervention period. Effect sizes were in the small-to-medium range (variance accounted for ranged from .05 to .15; odds ratio for diagnostic change = .06). These findings provide further evidence that targeting AS may be beneficial in the treatment of PTSS, and expansion upon this area of research by demonstrating these effects may be specific to AS cognitive concerns and can be achieved within a mixed clinical sample.
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Affiliation(s)
- Nicole A Short
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Joseph W Boffa
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Aaron M Norr
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Brian J Albanese
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | | | - Norman B Schmidt
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
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Liu H, Li X, Han B, Liu X. Effects of cognitive bias modification on social anxiety: A meta-analysis. PLoS One 2017; 12:e0175107. [PMID: 28384301 PMCID: PMC5383070 DOI: 10.1371/journal.pone.0175107] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 03/21/2017] [Indexed: 12/14/2022] Open
Abstract
Background Cognitive bias modification (CBM), a set of techniques for modifying bias in information processing—is considered a novel intervention for social anxiety disorder (SAD), which has drawn considerable interest from researchers. However, the effects of CBM on SAD are not consistent. Some studies have demonstrated significant positive effects compared to control groups, while others have found no such effects. Aims We conducted a meta-analysis aimed at quantitatively assessing the effects of CBM on SAD at post-test. Method Through a systematic literature search by two independent raters, 34 articles (36 randomized studies) including 2,550 participants were identified. A multilevel modeling approach was employed to assess the effects of CBM on SAD, and to explore the potentially crucial procedures and sample characteristics that enhance the effectiveness of benign training. Results In general, there were small but significant effects of CBM on the primary symptoms of SAD (g = 0.17), cognitive bias (CB) toward threat (g = 0.32), and reactivity in stressful situations (g = 0.25), but non-significant effects on secondary symptoms. However, the interpretation modification program was more effective than was attentional bias modification in reducing SAD primary symptoms and negative CB. Laboratory training procedures produced larger primary symptom reductions compared to Internet-based training, whereas the percentage of contingency and feedback about training performance boosted cognitive effects only. Finally, the following groups were more likely to benefit from CBM: younger participants (primary symptoms and cognitive effects), women (primary symptom effects), and samples with stronger CB (stressor effects). The quality of the randomized controlled trials was less than desirable, as there was some indication of publication bias in our study. Conclusions Current findings broadly supported cognitive theories of SAD that consider a bidirectional or mutually reinforcing relationship between symptoms and CBs. However, the small therapeutic effect observed here indicates that it is necessary to develop more reliable and efficient CBM interventions that are specific to SAD.
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Affiliation(s)
- Haining Liu
- Key Lab of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Psychology Department of Chengde Medical University, Chengde, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Xianwen Li
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Buxin Han
- Key Lab of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
- * E-mail:
| | - Xiaoqian Liu
- Key Lab of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
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Cha CB, DiVasto KA. Introduction: Applying Clinical Psychological Science to Practice. J Clin Psychol 2017; 73:504-510. [PMID: 28186633 DOI: 10.1002/jclp.22448] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Mental illness is a prevalent and extraordinarily complex phenomenon. Psychologists have developed distinct approaches toward understanding and treating mental illness, rooted in divergent epistemology. This introduction to the Special Issue on Clinical Psychological Science and Practice provides a brief overview of the scientist-practitioner gap, and explores one step (of many) toward bridging this divide. Seven compelling case illustrations featured in this Special Issue apply empirical findings to case formulation, treatment selection, and assessment across complex and varied clinical presentations. This issue thereby demonstrates the feasibility of integrating research and clinical expertise in mental healthcare.
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Rozenman M, Vreeland A, Piacentini J. Thinking anxious, feeling anxious, or both? Cognitive bias moderates the relationship between anxiety disorder status and sympathetic arousal in youth. J Anxiety Disord 2017; 45:34-42. [PMID: 27923164 PMCID: PMC5863750 DOI: 10.1016/j.janxdis.2016.11.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 11/01/2016] [Accepted: 11/15/2016] [Indexed: 01/10/2023]
Abstract
Cognitive bias and physiological arousal are two putative markers that may underlie youth anxiety. However, data on relationships between cognitive bias and arousal are limited, and typically do not include behavioral measurement of these constructs in order to tap real-time processes. We aimed to examine the relationship between performance-based cognitive bias and sympathetic arousal during stress in clinically anxious and typically-developing youth. The sample included children and adolescents ages 9 to 17 (Mean age=13.18, SD=2.60) who either met diagnostic criteria for primary generalized anxiety, social phobia, or separation anxiety (N=24) or healthy controls who had no history of psychopathology (N=22). Youth completed performance-based measures of attention and interpretation bias. Electrodermal activity was assessed while youth participated in the Trier Social Stress Test for Children (TSST-C; Buske-Kirschbaum, Jobst, & Wustmans, 1997). A mixed models analysis indicated significant linear and non-linear changes in skin conductance, with similar slopes for both groups. Interpretation bias, but not attention bias, moderated the relationship between group status and sympathetic arousal during the TSST-C. Arousal trajectories did not differ for anxious and healthy control youth who exhibited high levels of threat interpretation bias. However, for youth who exhibited moderate and low levels of interpretation bias, the anxious group demonstrated greater arousal slopes than healthy control youth. Results provide initial evidence that the relationship between anxiety status and physiological arousal during stress may be moderated by level of interpretation bias for threat. These findings may implicate interpretation bias as a marker of sympathetic reactivity in youth. Implications for future research and limitations are discussed.
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Affiliation(s)
- Michelle Rozenman
- Division of Child & Adolescent Psychiatry, UCLA Semel Institute for Neuroscience & Human Behavior, United States.
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Orchard F, Apetroaia A, Clarke K, Creswell C. Cognitive bias modification of interpretation in children with social anxiety disorder. J Anxiety Disord 2017; 45:1-8. [PMID: 27866085 PMCID: PMC5240849 DOI: 10.1016/j.janxdis.2016.10.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Revised: 08/17/2016] [Accepted: 10/28/2016] [Indexed: 11/25/2022]
Abstract
Negative (or a lack of positive) interpretation of ambiguous social situations has been hypothesised to maintain social anxiety disorder in children, yet there is currently limited evidence to support this. Cognitive Bias Modification of Interpretation (CBM-I) provides a means to explore the causal influence of interpretation bias on social anxiety disorder, and has been associated with a reduction in social anxiety symptoms in adults. Seven to twelve year old children with a diagnosis of social anxiety disorder completed CBM-I training, adapted from materials designed for socially anxious children in the community, or no training. Effects on interpretation bias and social anxiety were assessed. The adapted CBM-I training was not associated with significant changes in benign or negative interpretation. Unsurprisingly given the lack of successful interpretation training, there were no significant changes in child or parent reported social anxiety symptoms, clinician-rated severity or diagnoses and change in interpretation was not significantly associated with change in social anxiety. These findings contrast with some studies with community populations although it is possible that more intensive CBM-I training is required to fully test this hypothesis among clinical groups.
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Affiliation(s)
- Faith Orchard
- School of Psychology and Clinical Language Sciences, University of Reading, Whiteknights Road, Reading, RG6 6AL, United Kingdom.
| | - Adela Apetroaia
- Newham College University Centre, London, E15 4HT, United Kingdom
| | - Kiri Clarke
- Division of Psychology and Language Sciences, University College London, London, WC1E 6BT, United Kingdom
| | - Cathy Creswell
- School of Psychology and Clinical Language Sciences, University of Reading, Whiteknights Road, Reading, RG6 6AL, United Kingdom
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Anxiety-Linked Differences in Older Adults’ Interpretation of Ambiguous Information. COGNITIVE THERAPY AND RESEARCH 2016. [DOI: 10.1007/s10608-016-9824-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Sicouri G, Sharpe L, Hudson JL, Dudeney J, Jaffe A, Selvadurai H, Lorimer S, Hunt C. Threat interpretation and parental influences for children with asthma and anxiety. Behav Res Ther 2016; 89:14-23. [PMID: 27846417 DOI: 10.1016/j.brat.2016.11.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 10/05/2016] [Accepted: 11/09/2016] [Indexed: 12/01/2022]
Abstract
Anxiety disorders are highly prevalent in children with asthma yet very little is known about the cognitive and parent factors that may underpin this relationship. The present study investigated interpretation biases in children with asthma and anxiety and their parents, and whether parent-child discussions influenced children's interpretations. Eighty-nine parent-child dyads were included across four groups: children with asthma and anxiety, children with anxiety only, children with asthma only and healthy children (aged between 8 and 13 years old). Interpretation bias was assessed using ambiguous scenarios. Children with anxiety showed an interpretation bias in the general threat scenarios, whereas children with asthma showed an interpretation bias in the asthma threat scenarios. Parental predictions of their child's responses showed similar results. Parent-child discussions increased avoidance for children with anxiety and no asthma across all scenarios, but only for children with asthma and anxiety in the asthma threat scenarios. The results provide partial support for a cognitive theory of asthma and anxiety in children and suggest that parents play a role in influencing children's thinking styles. Treatment programs could thus aim to target and modify interpretation biases in children with anxiety, and include parents as part of treatment.
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Affiliation(s)
- Gemma Sicouri
- School of Psychology, The University of Sydney, NSW, Australia
| | - Louise Sharpe
- School of Psychology, The University of Sydney, NSW, Australia
| | | | - Jo Dudeney
- School of Psychology, The University of Sydney, NSW, Australia
| | - Adam Jaffe
- Discipline of Paediatrics, School of Women's and Children's Health, Medicine, University of New South Wales, NSW, Australia; Department of Paediatric Respiratory Medicine, Sydney Children's Hospital, Randwick, NSW, Australia
| | - Hiran Selvadurai
- The Children's Hospital at Westmead Clinical School, Discipline of Paediatrics and Child Health, Faculty of Medicine, University of Sydney, NSW, Australia; Department of Respiratory Medicine, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Sarah Lorimer
- School of Psychology, The University of Sydney, NSW, Australia
| | - Caroline Hunt
- School of Psychology, The University of Sydney, NSW, Australia.
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Spence SH, Rapee RM. The etiology of social anxiety disorder: An evidence-based model. Behav Res Ther 2016; 86:50-67. [DOI: 10.1016/j.brat.2016.06.007] [Citation(s) in RCA: 137] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 06/07/2016] [Accepted: 06/29/2016] [Indexed: 12/16/2022]
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Parental Emotion Socialization Strategies and Their Interaction with Child Interpretation Biases Among Children with Anxiety Disorders. COGNITIVE THERAPY AND RESEARCH 2016. [DOI: 10.1007/s10608-016-9783-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Vassilopoulos SP, Moberly NJ, Lau JYF. Cognitive Bias Modification Training in Children Affects Anxiety During Anticipatory Processing of Social Evaluation. Int J Cogn Ther 2015. [DOI: 10.1521/ijct.2015.8.4.318] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Salemink E, Wolters L, de Haan E. Augmentation of Treatment As Usual with online Cognitive Bias Modification of Interpretation training in adolescents with Obsessive Compulsive Disorder: A pilot study. J Behav Ther Exp Psychiatry 2015; 49:112-9. [PMID: 25724385 DOI: 10.1016/j.jbtep.2015.02.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 02/06/2015] [Accepted: 02/08/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVES Cognitive Behavioral Therapy for children and adolescents with Obsessive Compulsive Disorder (OCD) is effective. However, since almost half of patients remain symptomatic after treatment, there remains room for improvement. Cognitive Bias Modification training of Interpretations (CBM-I) is a promising new intervention, as it targets misinterpretation of intrusions, which is seen as an important characteristic in OCD. To date, there have been no published studies of CBM-I in adolescents with OCD. The aim of the current pilot study was to examine the added value of online CBM-I training as an adjunctive treatment to the Treatment As Usual (TAU; that included CBT and pharmacotherapy) in adolescents with OCD. METHODS Patients receiving TAU were randomly assigned to either an additional CBM-I training (n = 9), or to an additional placebo variant of this procedure (n = 7). RESULTS Immediate, on-line interpretations changed in response to the CBM-I training, while no such effects were observed on slower retrospective off-line interpretations. Patients in the CBM-I training condition reported fewer obsessive compulsive symptoms after training, and clinicians rated them as having fewer obsessive symptoms (corresponding to medium-large effect sizes). No such changes were observed in the placebo group. LIMITATIONS The small sample size precludes strong conclusions and replication is necessary to test the robustness of the findings. CONCLUSIONS This small randomized controlled trial is suggestive, although not conclusive, regarding the promising additive value of OC-related CBM-I training as an adjunctive intervention to TAU in an adolescent clinical population.
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Affiliation(s)
- Elske Salemink
- Addiction, Development and Psychopathology Lab (Adapt Lab), Department of Developmental Psychology, Research Priority Areas 'Yield', and 'Amsterdam Brain and Cognition', University of Amsterdam, The Netherlands; Department of Obsessive Compulsive-, Anxiety- and Tic Disorders, Academic Center for Child and Adolescent Psychiatry, de Bascule, Amsterdam, The Netherlands.
| | - Lidewij Wolters
- Department of Obsessive Compulsive-, Anxiety- and Tic Disorders, Academic Center for Child and Adolescent Psychiatry, de Bascule, Amsterdam, The Netherlands; Academic Medical Center, Department of Child and Adolescent Psychiatry, Amsterdam, The Netherlands
| | - Else de Haan
- Department of Obsessive Compulsive-, Anxiety- and Tic Disorders, Academic Center for Child and Adolescent Psychiatry, de Bascule, Amsterdam, The Netherlands; Child Development and Education, University of Amsterdam, The Netherlands
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Interpretation modification training reduces social anxiety in clinically anxious children. Behav Res Ther 2015; 75:78-84. [PMID: 26580081 DOI: 10.1016/j.brat.2015.10.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 10/15/2015] [Accepted: 10/20/2015] [Indexed: 11/20/2022]
Abstract
The present study was designed to examine the effects of training in positive interpretations in clinically anxious children. A total of 87 children between 7 and 12 years of age were randomly assigned to either a positive cognitive bias modification training for interpretation (CMB-I) or a neutral training. Training included 15 sessions in a two-week period. Children with an interpretation bias prior to training in the positive training group showed a significant reduction in interpretation bias on the social threat scenarios after training, but not children in the neutral training group. No effects on interpretation biases were found for the general threat scenarios or the non-threat scenarios. Furthermore, children in the positive training did not self-report lower anxiety than children in the neutral training group. However, mothers and fathers reported a significant reduction in social anxiety in their children after positive training, but not after neutral training. This study demonstrated that clinically anxious children with a prior interpretation bias can be trained away from negative social interpretation biases and there is some evidence that this corresponds to reductions in social anxiety. This study also highlights the importance of using specific training stimuli.
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Cox P, Bamford GM, Lau JY. Cognitive bias modification as a strategy to reduce children's fears and concerns about the secondary school transition. ANXIETY STRESS AND COPING 2015; 29:447-56. [PMID: 26110551 DOI: 10.1080/10615806.2015.1058367] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Hertel PT, Mathews A. Cognitive Bias Modification: Past Perspectives, Current Findings, and Future Applications. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2015; 6:521-36. [PMID: 26168375 DOI: 10.1177/1745691611421205] [Citation(s) in RCA: 210] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Research conducted within the general paradigm of cognitive bias modification (CBM) reveals that emotional biases in attention, interpretation, and memory are not merely associated with emotional disorders but contribute to them. After briefly describing research on both emotional biases and their modification, the authors examine similarities between CBM paradigms and older experimental paradigms used in research on learning and memory. The techniques and goals of CBM research are compared with other approaches to understanding cognition-emotion interactions. From a functional perspective, the CBM tradition reminds us to use experimental tools to evaluate assumptions about clinical phenomena and, more generally, about causal relationships between cognitive processing and emotion.
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Cristea IA, Mogoașe C, David D, Cuijpers P. Practitioner Review: Cognitive bias modification for mental health problems in children and adolescents: a meta-analysis. J Child Psychol Psychiatry 2015; 56:723-734. [PMID: 25640876 DOI: 10.1111/jcpp.12383] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/24/2014] [Indexed: 12/21/2022]
Abstract
BACKGROUND Despite accumulating research and bold claims about the efficacy of cognitive bias modification (CBM) for young populations, no meta-analysis has attempted to synthesize the research literature so far. We examined whether there was empirical evidence for the clinical efficacy of CBM interventions in youths, while also considering the methodological quality of this evidence. METHODS Studies were identified through systematic searches in bibliographical databases (PubMed, PsychInfo, Cochrane Library and EMBASE to June 2014). We included randomized controlled trials of CBM interventions, and considered both clinical outcomes and targeted biases. We examined the quality of the trials, as well as potential publication bias and possible moderators. RESULTS We identified 23 trials that reported on four types of outcomes: mental health, anxiety, depression and bias. Effect sizes were small and nonsignificant for all symptom outcomes considered. We found a moderate significant effect size for bias outcomes (Hedges' g of 0.53), with significant heterogeneity. There were no differences between types of CBM interventions, or between one versus multiple-session applications. A small but significant effect size for mental health problems arose when the intervention was delivered in schools. The quality of almost all of the included studies was suboptimal and the vast majority did not include information needed for allowing quality assessment. CONCLUSIONS We conducted the first meta-analysis of CBM interventions for children and adolescents and found no effects for mental health outcomes, but we did find moderate and significant effects on the targeted biases. Our results cast serious doubts on CBM interventions having any clinical utility for nonadult populations. Demand characteristics might play an important part in CBM research.
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Affiliation(s)
- Ioana A Cristea
- Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania.,Clinical Psychology Branch, Department of Surgical, Medical, Molecular and Critical Pathology, University of Pisa, Pisa, Italy
| | - Cristina Mogoașe
- Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - Daniel David
- Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania.,Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Pim Cuijpers
- Department of Clinical Psychology, VU University, Amsterdam, The Netherlands.,EMGO Institute for Health and Care Research, VU University and VU University Medical Centre, Amsterdam, The Netherlands
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Vassilopoulos SP, Brouzos A, Moberly NJ, Tsiligiannis G. Development and Evaluation of a Short Anger Management Group for Special Education Teachers in Greece: A Preliminary Study. ACTA ACUST UNITED AC 2015. [DOI: 10.1080/21683603.2014.938384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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40
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Remmerswaal D, Muris P, Huijding J. Transmission of Cognitive Bias and Fear From Parents to Children: An Experimental Study. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2015; 45:642-654. [DOI: 10.1080/15374416.2014.987378] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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41
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Reuland MM, Teachman BA. Interpretation bias modification for youth and their parents: a novel treatment for early adolescent social anxiety. J Anxiety Disord 2014; 28:851-64. [PMID: 25445075 PMCID: PMC4303587 DOI: 10.1016/j.janxdis.2014.09.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Accepted: 09/25/2014] [Indexed: 11/22/2022]
Abstract
Social anxiety is the most prevalent anxiety disorder of late adolescence, yet current treatments reach only a minority of youth with the disorder. Effective and easy-to-disseminate treatments are needed. This study pilot tested the efficacy of a novel, online cognitive bias modification for interpretation (CBM-I) intervention for socially anxious youth and their parents. The CBM-I intervention targeted cognitive biases associated with early adolescents' maladaptive beliefs regarding social situations, and with parents' intrusive behavior, both of which have been theoretically linked with the maintenance of social anxiety in youth. To investigate the efficacy of intervening with parents and/or children, clinically diagnosed early adolescents (ages 10-15; N=18) and their mothers were randomly assigned to one of three conditions: the first targeted early adolescents' cognitive biases related to social anxiety (Child-only condition); the second targeted parents' biases associated with intrusive behavior (Parent-only condition); and the third targeted both youth and parents' biases in tandem (Combo condition). The use of a multiple baseline design allowed for the efficient assessment of causal links between the intervention and reduction in social anxiety symptoms in youth. Results provided converging evidence indicating modest support for the efficacy of CBM-I, with no reliable differences across conditions. Taken together, results suggest that online CBM-I with anxious youth and/or their parents holds promise as an effective and easily administered component of treatment for child social anxiety that deserves further evaluation in a larger trial.
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Affiliation(s)
- Meg M Reuland
- Department of Psychology, University of Virginia, PO Box 400400, Charlottesville, VA 22904, United States.
| | - Bethany A Teachman
- Department of Psychology, University of Virginia, PO Box 400400, Charlottesville, VA 22904, United States
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42
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Brouzos A, Vassilopoulos SP, Baourda VC. Members’ perceptions of person-centered facilitative conditions and their role in outcome in a psychoeducational group for childhood social anxiety. PERSON-CENTERED AND EXPERIENTIAL PSYCHOTHERAPIES 2014. [DOI: 10.1080/14779757.2014.965843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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43
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Cognitive Bias Modification Training in Adolescents: Persistence of Training Effects. COGNITIVE THERAPY AND RESEARCH 2014. [DOI: 10.1007/s10608-014-9627-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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44
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A Multi-Session Attribution Modification Program for Children with Aggressive Behaviour: Changes in Attributions, Emotional Reaction Estimates, and Self-Reported Aggression. Behav Cogn Psychother 2014; 43:538-48. [PMID: 24762404 DOI: 10.1017/s1352465814000149] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Research suggests that aggressive children are prone to over-attribute hostile intentions to peers. AIMS The current study investigated whether this attributional style can be altered using a Cognitive Bias Modification of Interpretations (CBM-I) procedure. METHOD A sample of 10-12-year-olds selected for displaying aggressive behaviours was trained over three sessions to endorse benign rather than hostile attributions in response to ambiguous social scenarios. RESULTS Compared to a test-retest control group (n = 18), children receiving CBM-I (n = 16) were less likely to endorse hostile attributions and more likely to endorse benign attributions in response to a new set of ambiguous social situations. Furthermore, aggressive behaviour scores reduced more in the trained group than in the untrained controls. Children who received attribution training also reported less perceived anger and showed a trend to report more self-control than those in the control group. CONCLUSIONS Implications of these findings are discussed.
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Remmerswaal D, Huijding J, Bouwmeester S, Brouwer M, Muris P. Cognitive bias in action: evidence for a reciprocal relation between confirmation bias and fear in children. J Behav Ther Exp Psychiatry 2014; 45:26-32. [PMID: 23933089 DOI: 10.1016/j.jbtep.2013.07.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 07/10/2013] [Accepted: 07/11/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES Some cognitive models propose that information processing biases and fear are reciprocally related. This idea has never been formally tested. Therefore, this study investigated the existence of a vicious circle by which confirmation bias and fear exacerbate each other. METHODS One-hundred-and-seventy-one school children (8-13 years) were first provided with threatening, ambiguous, or positive information about an unknown animal. Then they completed a computerized information search task during which they could collect additional (negative, positive, or neutral) information about the novel animal. Because fear levels were repeatedly assessed during the task, it was possible to examine the reciprocal relationship between confirmation bias and fear. RESULTS A reciprocal relation of mutual reinforcement was found between confirmation bias and fear over the course of the experiment: increases in fear predicted subsequent increases in the search for negative information, and increases in the search for negative information further enhanced fear on a later point-in-time. In addition, the initial information given about the animals successfully induced diverging fear levels in the children, and determined their first inclination to search for additional information. LIMITATIONS As this study employed a community sample of primary school children, future research should test whether these results can be generalized to clinically anxious youth. CONCLUSIONS These findings provide first support for the notion that fearful individuals may become trapped in a vicious circle in which fear and a fear-related confirmation bias mutually strengthen each other, thereby maintaining the anxiety pathology.
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Creswell C, Murray L, Cooper P. Interpretation and expectation in childhood anxiety disorders: age effects and social specificity. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2014; 42:453-65. [PMID: 24293002 PMCID: PMC3936123 DOI: 10.1007/s10802-013-9795-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Theory and treatment for childhood anxiety disorders typically implicates children's negative cognitions, yet little is known about the characteristics of thinking styles of clinically anxious children. In particular, it is unclear whether differences in thinking styles between children with anxiety disorders and non-anxious children vary as a function of child age, whether particular cognitive distortions are associated with childhood anxiety disorders at different child ages, and whether cognitive content is disorder-specific. The current study addressed these questions among 120 7-12 year old children (53% female) who met diagnostic criteria for social anxiety disorder, other anxiety disorder, or who were not currently anxious. Contrary to expectations, threat interpretation was not inflated amongst anxious compared to non-anxious children at any age, although older (10-12 year old) anxious children did differ from non-anxious children on measures of perceived coping. The notion of cognitive-content specificity was not supported across the age-range. The findings challenge current treatment models of childhood anxiety, and suggest that a focus on changing anxious children's cognitions is not warranted in mid-childhood, and in late childhood cognitive approaches may be better focussed on promoting children's perceptions of control rather than challenging threat interpretations.
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Affiliation(s)
- Cathy Creswell
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, RG6 6AL, UK,
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Vassilopoulos SP, Brouzos A, Damer DE, Mellou A, Mitropoulou A. A Psychoeducational School-Based Group Intervention for Socially Anxious Children. JOURNAL FOR SPECIALISTS IN GROUP WORK 2013. [DOI: 10.1080/01933922.2013.819953] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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48
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Lau JY. Cognitive bias modification of interpretations: A viable treatment for child and adolescent anxiety? Behav Res Ther 2013; 51:614-22. [DOI: 10.1016/j.brat.2013.07.001] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Revised: 06/25/2013] [Accepted: 07/01/2013] [Indexed: 11/29/2022]
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Efficacy of Interpretation Bias Modification in Depressed Adolescents and Young Adults. COGNITIVE THERAPY AND RESEARCH 2013; 38:89-102. [PMID: 24729643 DOI: 10.1007/s10608-013-9578-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study evaluated the efficacy of a four-session Cognitive Bias Modification-Interpretation program for 45 depressed adolescents and young adults (14-21 years old; 12 males, 33 females; Beck Depressive Inventory, Second Edition ≥ 14) randomized to an active intervention condition (repeated exposure to positive outcomes of depression-relevant ambiguous scenarios; n=23) or a control condition (n=22). Both conditions experienced reductions on a Test of Interpretation Bias at post-treatment, with no significant between-group differences. When limited to those with negative bias at baseline, the intervention group showed greater improvement in interpretation bias at mid- and post-treatment. In addition, the intervention group overall had greater improvements in self-reported negative cognitions than the control group at post-intervention and two-week follow-up. However, there were no differences between groups in depression or anxiety symptom change. Potential factors contributing to mixed findings are discussed.
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50
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Lau JY, Pettit E, Creswell C. Reducing children's social anxiety symptoms: Exploring a novel parent-administered cognitive bias modification training intervention. Behav Res Ther 2013; 51:333-7. [DOI: 10.1016/j.brat.2013.03.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2013] [Revised: 03/19/2013] [Accepted: 03/19/2013] [Indexed: 11/25/2022]
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