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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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Ciesinski NK, Himelein-Wachowiak M, Krick LC, Sorgi-Wilson KM, Cheung JCY, McCloskey MS. A systematic review with meta-analysis of cognitive bias modification interventions for anger and aggression. Behav Res Ther 2023; 167:104344. [PMID: 37307657 PMCID: PMC10526745 DOI: 10.1016/j.brat.2023.104344] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/05/2023] [Accepted: 06/01/2023] [Indexed: 06/14/2023]
Abstract
Aggression and anger are associated with interpretation and attention biases. Such biases have become treatment targets for anger and aggressive behavior in cognitive bias modification (CBM) interventions. Several studies have evaluated the efficacy of CBM for the treatment of anger and aggressive behavior, with inconsistent results. The present study meta-analytically analyzed 29 randomized controlled trial studies (N = 2334) published in EBSCOhost and PubMed between March 2013 and March 2023 assessing the efficacy of CBM for anger and/or aggression. Included studies delivered CBMs that addressed either attention biases, interpretation biases, or both. Risk of publication bias and potential moderating effects of several participant-, treatment- and study-related factors were assessed. CBM significantly outperformed control conditions in the treatment of aggression (Hedge's G = -0.23, 95% CI [-0.35, -0.11], p < .001) and anger (Hedge's G = -0.18, 95% CI [-0.28, -0.07], p = .001) independent of treatment dose, participant demographic characteristics, and study quality, though overall effects were small. Follow-up analyses demonstrated that only CBMs targeting interpretation bias were efficacious for aggression outcomes, but not when baseline aggression was accounted for. Findings suggest that CBM demonstrates efficacy for the treatment aggressive behavior and to a lesser extent, anger.
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Affiliation(s)
| | | | - Lynette C Krick
- Department of Psychology and Neuroscience, Temple University, USA
| | | | - Joey C Y Cheung
- Department of Psychology and Neuroscience, Temple University, USA
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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: 0] [Impact Index Per Article: 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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Zeng K, Cao F, Wu Y, Zhang M, Ding X. Effects of interpretation bias modification on hostile attribution bias and reactive cyber-aggression in Chinese adolescents: a randomized controlled trial. CURRENT PSYCHOLOGY 2023:1-14. [PMID: 37359704 PMCID: PMC9999074 DOI: 10.1007/s12144-023-04433-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2023] [Indexed: 03/12/2023]
Abstract
Highly aggressive individuals tend to interpret others' motives and intentions as hostile in both offline and online social situations. The current study examined whether hostile interpretation bias can be modified to influence cyber-aggression in Chinese middle school students using an interpretation bias modification program. Gender differences and the heterogeneity of cyber-aggression were also investigated since previous studies suggest that they play important roles in determining the intervention effect. One hundred and twenty-one middle school students were randomized to receive either an eight-session interpretation bias modification task (CBM-I; n = 61) or an eight-session placebo control task (PCT; n = 60) over four weeks. Measures of hostile attribution bias and cyber-aggression were administered at baseline, post-training, and at one week follow-up. Results showed that compared to PCT, participants in CBM-I showed a significant reduction in reactive cyber-aggression. However, contrary to our expectation, there was no significant difference between the two groups in the reduction of hostile attribution bias after training. The moderated mediation analysis revealed that the effect of CBM-I on hostile attribution bias and the mediating role of hostile attribution bias in the relationship between CBM-I condition and reactive cyber-aggression was only observed among females, but not among males. These findings provide initial evidence for the potential of CBM-I in reducing hostile attribution bias and cyber-aggression. However, for male students, CBM-I might not be effective enough as expected. Supplementary Information The online version contains supplementary material available at 10.1007/s12144-023-04433-3.
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Affiliation(s)
- Ke Zeng
- Department of Medical Psychology, School of Medical Humanities, Capital Medical University, Beijing, China
| | - Feizhen Cao
- Department of Psychology, Ningbo University, Ningbo, China
| | - Yajun Wu
- Fengqiao Middle School, Jiaxing, China
| | - Manhua Zhang
- Department of Medical Psychology, School of Medical Humanities, Capital Medical University, Beijing, China
| | - Xinfang Ding
- Department of Medical Psychology, School of Medical Humanities, Capital Medical University, Beijing, China
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Hummer TA, Wood ZM, Miller K, McCarthy RL, Brickman JE, Neumann D. Assessment of Boys' Responses to Interpersonal Conflict in Virtual Reality. Games Health J 2023; 12:53-62. [PMID: 36301265 PMCID: PMC9894598 DOI: 10.1089/g4h.2022.0054] [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: 02/05/2023] Open
Abstract
Background: Continuous advances in virtual reality (VR) technology have increased its potential for clinical use in the research, assessment, and treatment of mental health difficulties. One potential target for VR use is childhood behavior problems, which are often associated with social-cognitive deficits that can be difficult to measure or modify. Materials and Methods: We enrolled 36 boys between the ages of 8-13 to assess the usability of a VR device and its feasibility as a psychiatric tool for youth. Each participant experienced three virtual school cafeteria scenes that varied in antisocial content and the intentions of a virtual counterpart (VC) (control, ambiguous, or hostile). Following each scene, participants completed questions about ease and comfort in using the headset as well as an assessment of hostile attribution bias (HAB). HAB is the tendency to attribute hostile motivations to others' behaviors, which contributes to antisocial thoughts and behaviors. Following this VR use, participants completed a standard text assessment of HAB. Results: In general, participants reported the VR headset to be enjoyable and easy to use, and scenes worked as intended, with VCs in the hostile scene rated the meanest. In addition, boys with more conduct problems reported that virtual characters were meaner to them, despite no difference in text vignette measures of HAB. Conclusion: This study provides preliminary evidence supporting the further development of VR programs to assess and treat childhood behavior problems.
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Affiliation(s)
- Tom A. Hummer
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Zebulun M. Wood
- Departments of Media Arts and Science and Human Centered Computing, School of Informatics and Computing, Indiana University-Purdue University Indianapolis (IUPUI), Indianapolis, Indiana, USA
| | - Kevin Miller
- Departments of Media Arts and Science and Human Centered Computing, School of Informatics and Computing, Indiana University-Purdue University Indianapolis (IUPUI), Indianapolis, Indiana, USA
| | - Rachel L. McCarthy
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jocelyn E. Brickman
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Dawn Neumann
- Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana, USA
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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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AlMoghrabi N, Franken IHA, Mayer B, van der Schoot M, Huijding J. CBM-I Training and Its Effect on Interpretations of Intent, Facial Expressions, Attention and Aggressive Behavior. EUROPES JOURNAL OF PSYCHOLOGY 2022; 17:13-27. [PMID: 35136426 PMCID: PMC8768478 DOI: 10.5964/ejop.2413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 05/27/2020] [Indexed: 12/03/2022]
Abstract
There is abundant evidence suggesting that attention and interpretation biases are powerful precursors of aggression. However, little is known how these biases may interact with one another in the development and maintenance of aggression. Using cognitive bias modification of interpretation (CBM-I), the present study examined whether training more pro-social or hostile intent attributions would affect attention bias, interpretation bias of facial expressions, aggression and mood. University students (17–48 years) were assigned to either a positive training (n = 40), negative training (n = 40), or control training (n = 40). Results showed that the positive training successfully changed measures of intent attributions in a pro-social direction compared to the control training. The negative training changed measures of intent attributions in a hostile direction but not more so than the control training. We found no generalization of the training effects to relevant other outcomes. Possible explanations underlying these findings are discussed.
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Affiliation(s)
- Nouran AlMoghrabi
- Department of Psychology, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.,Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Ingmar H A Franken
- Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Birgit Mayer
- Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Menno van der Schoot
- Department of Educational and Family Studies, Vrije Universiteit Amsterdam, Amersterdam, the Netherlands
| | - Jorg Huijding
- Department of Child and Adolescent Studies, Utrecht University, Utrecht, the Netherlands
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8
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Murray DW, Kurian J, Soliday Hong SL, Andrade FC. Meta‐analysis of early adolescent self‐regulation interventions: Moderation by intervention and outcome type. J Adolesc 2022; 94:101-117. [DOI: 10.1002/jad.12010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 12/31/2021] [Indexed: 01/09/2023]
Affiliation(s)
- Desiree W. Murray
- School of Education University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
- Center for Health Promotion and Disease Prevention University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
| | - Jennifer Kurian
- Department of Psychology, Frank Porter Graham Child Development Institute University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
- Department of Psychology Illinois Institute of Technology Chicago Illinois USA
| | | | - Fernanda C. Andrade
- Department of Psychology and Neuroscience Duke University Durham North Carolina USA
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9
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Haller SP, Stoddard J, Botz-Zapp C, Clayton M, MacGillivray C, Perhamus G, Stiles K, Kircanski K, Penton-Voak IS, Bar-Haim Y, Munafò M, Towbin KE, Brotman MA. A Randomized Controlled Trial of Computerized Interpretation Bias Training for Disruptive Mood Dysregulation Disorder: A Fast-Fail Study. J Am Acad Child Adolesc Psychiatry 2022; 61:37-45. [PMID: 34147585 PMCID: PMC8678378 DOI: 10.1016/j.jaac.2021.05.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 04/30/2021] [Accepted: 06/10/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To examine targeted, mechanism-based interventions is the next generation of treatment innovation. Biased threat labeling of ambiguous face emotions (interpretation bias) is a potential behavioral treatment target for anger, aggression, and irritability. Changing biases in face-emotion labeling may improve irritability-related outcomes. Here, we report the first randomized, double-blind, placebo-controlled targeted trial of interpretation bias training (IBT) in youths with chronic, severe irritability. METHOD Patients with current disruptive mood dysregulation disorder (DMDD; N = 44) were randomly assigned to complete 4 sessions of active (n = 22) or sham (n = 22) computerized IBT training within a 1-week period. The first and last trainings were completed onsite, and 2 trainings were completed at home. We examined the effects of active IBT on labeling bias, primary outcome measures of irritability, and secondary outcome measures of anxiety, depression, and functional impairment. Follow-up assessments were completed immediately after the intervention as well as 1 and 2 weeks later. RESULTS We found that active IBT engaged the behavioral target in the active relative to the sham condition, as shown by a significant shift toward labeling ambiguous faces as happy. However, there was no consistent clinical improvement in active IBT relative to the sham condition either immediately after or 2 weeks after training in either the primary or secondary outcome measures. CONCLUSION Although this randomized controlled trial of IBT in youths with DMDD engaged the proposed behavioral target, there was no statistically significant improvement on clinical outcome. Identifying and changing behavioral targets is a first step in novel treatment development; these results have broader implications for target-based intervention development. CLINICAL TRIAL REGISTRATION INFORMATION Psychological Treatments for Youth With Severe Irritability; https://clinicaltrials.gov/; NCT02531893.
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Affiliation(s)
- Simone P. Haller
- National Institute of Mental Health, and National Institutes of Health, Bethesda, Maryland
| | - Joel Stoddard
- University of Colorado, Anschutz Medical Campus, Aurora
| | - Christian Botz-Zapp
- National Institute of Mental Health, and National Institutes of Health, Bethesda, Maryland
| | - Michal Clayton
- National Institute of Mental Health, and National Institutes of Health, Bethesda, Maryland
| | - Caroline MacGillivray
- National Institute of Mental Health, and National Institutes of Health, Bethesda, Maryland
| | - Gretchen Perhamus
- National Institute of Mental Health, and National Institutes of Health, Bethesda, Maryland
| | - Kelsey Stiles
- National Institute of Mental Health, and National Institutes of Health, Bethesda, Maryland
| | - Katharina Kircanski
- National Institute of Mental Health, and National Institutes of Health, Bethesda, Maryland
| | | | | | | | - Kenneth E. Towbin
- National Institute of Mental Health, and National Institutes of Health, Bethesda, Maryland
| | - Melissa A. Brotman
- National Institute of Mental Health, and National Institutes of Health, Bethesda, Maryland
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10
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Schmidt NB, Vereenooghe L. Targeting hostile attributions in inclusive schools through online cognitive bias modification: A randomised experiment. Behav Res Ther 2021; 146:103949. [PMID: 34583306 DOI: 10.1016/j.brat.2021.103949] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 05/11/2021] [Accepted: 08/25/2021] [Indexed: 11/18/2022]
Abstract
The tendency to make hostile attributions in ambiguous social situations has been associated with aggression and may be targeted through cognitive bias modification for interpretations (CBM-I). Despite their high prevalence of aggression and internalising problems, children and young people with neurodevelopmental disorders (NDD) or special educational needs (SEN) are markedly absent from CBM-I studies. This pilot study investigates whether online CBM-I can reduce hostile attributions and reactive aggression in inclusive school pupils. In Study 1, 71 pupils (mean age = 12.2, SD = 1.5; 25.4% presented with NDD or SEN) were randomly allocated to complete three sessions of either CBM-I (n = 37) or active control training (n = 34). CBM-I involved interpreting ambiguous scenarios or faces in a non-hostile manner, whereas the control training involved attention and memory exercises without resolving ambiguity. Between-group comparison showed CBM-I to reduce both hostile attributions and reactive aggression. In Study 2, follow-up focus groups with 23 pupils demonstrated the acceptability of training content and delivery. Together, these findings show online CBM-I to be acceptable and effective at reducing both hostile attributions and reactive aggression in an inclusive setting. The possibility of intervention effects on behavioural outcomes and potential confounding variables require further investigation.
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Affiliation(s)
- Nora B Schmidt
- Faculty of Psychology and Sports Science, Bielefeld University, Germany.
| | - Leen Vereenooghe
- Faculty of Psychology and Sports Science, Bielefeld University, Germany
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11
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A Single-Session Combined Cognitive Bias Modification Training Targeting Attention and Interpretation Biases in Aggression. BEHAVIOUR CHANGE 2021. [DOI: 10.1017/bec.2021.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Experimental studies applying cognitive bias modification of attention (CBM-A) and interpretation (CBM-I) to reduce aggression have examined the effect of modifying each cognitive bias in isolation. In order to maximise the potential impact on both biases and symptom reduction, we examined whether a combined bias training procedure targeting both attention and interpretation biases (CBM-AI) in combination would be more effective than targeting interpretation bias (CBM-I) alone. University students (17–35 years) were randomly assigned to either a single session of CBM-AI training (n = 40), CBM-I training (n = 40), or a control condition (n = 40). Contrary to our expectations, participants showed an increase in adaptive attention and pro-social interpretation bias in all training conditions. Additionally, in none of the conditions, we found a significant change on self-reported or behavioural aggression. These findings suggest: (1) that the combined training did not have added effect over single interpretation bias training, (2) that training interpretation bias may lead to changes in attention bias, (3) that elements of the control condition unexpectedly, but interestingly, also affected attention and interpretation biases, and (4) single-session CBM procedures do not produce robust effects on self-report or behavioural measures of aggression in unselected samples.
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12
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Ren Z, Zhao Z, Yu X, Zhang L, Li X. Effects of cognitive bias modification for interpretation on hostile interpretation bias and self-reported aggression in juvenile delinquents. Int J Clin Health Psychol 2021; 21:100226. [PMID: 33680000 PMCID: PMC7893428 DOI: 10.1016/j.ijchp.2021.100226] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 01/04/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND/OBJECTIVE The social information processing model holds that aggressive behavior is closely related to the hostile interpretation of ambiguous social cues, suggesting the possibility that an intervention that reduces hostile interpretations could reduce aggression. This study in Mainland China evaluated the remediating effects of cognitive bias modification for interpretation (CBM-I) on the hostile interpretation bias and self-reported aggressive behaviors of male juvenile delinquents, taking into account initial hostile interpretation bias as a possible moderator of the intervention effect. METHOD Fifty-six male juvenile delinquents aged 16-18 were recruited and randomly assigned to the CBM-I group (n = 28) or the Waiting-List group (n = 28). Interpretation bias and self-reported aggressive behavior were assessed at pre-test and post-test. RESULTS The positive interpretations of participants in the CBM-I group were significantly increased compared with participants in the Waiting-List group. The intervention effect of CBM-I on self-reported physical aggression was significant only for juvenile delinquents with high pre-test hostile interpretation bias. CONCLUSIONS CBM-I can significantly improve the positive interpretation bias of juvenile delinquents, and reduce the self-reported physical aggression for some male juvenile delinquents. The results have implications for providing low-cost and high-efficiency intervention for juvenile delinquents' self-reported aggression behavior.
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Affiliation(s)
- Zhihong Ren
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Key Laboratory of Human Development and Mental Health of Hubei Province, School of Psychology, Central China Normal University, China
| | - Ziyi Zhao
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Key Laboratory of Human Development and Mental Health of Hubei Province, School of Psychology, Central China Normal University, China
| | - Xianglian Yu
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Key Laboratory of Human Development and Mental Health of Hubei Province, School of Psychology, Central China Normal University, China
- Department of Education, Jianghan University, China
| | - Lin Zhang
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Key Laboratory of Human Development and Mental Health of Hubei Province, School of Psychology, Central China Normal University, China
| | - Xu Li
- Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Key Laboratory of Human Development and Mental Health of Hubei Province, School of Psychology, Central China Normal University, China
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13
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Zajenkowska A, Prusik M, Jasielska D, Szulawski M. Hostile attribution bias among offenders and non‐offenders: Making social information processing more adequate. JOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY 2020. [DOI: 10.1002/casp.2493] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | | | - Dorota Jasielska
- Psychology Department Maria Grzegorzewska Academy of Special Education Poland
| | - Michał Szulawski
- Psychology Department Maria Grzegorzewska Academy of Special Education Poland
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14
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Cao H, Liang Y, Zhou N. Proximal Interpersonal Processes in Early Childhood, Socioemotional Capacities in Middle Childhood, and Behavioral and Social Adaptation in Early Adolescence: A Process Model toward Greater Specificity. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 48:1395-1410. [PMID: 32880816 DOI: 10.1007/s10802-020-00696-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Early proximal interpersonal processes in central microsystems have been widely linked to child subsequent adaptation. What remains sparse is research spanning multiple developmental stages and examining unique, relative implications of distinct early proximal interpersonal processes for child later adjustment in various domains and the cognitive, emotional, and behavioral mechanisms underlying such associations. Using NICHD SECCYD data, a process model was tested in which negativities and positivities in three early proximal interpersonal processes (i.e., mother-child, child care provider-child, and child care peer interactions at 6-36 months) were simultaneously linked to child internalizing problems, externalizing problems, and social relationship quality in early adolescence (6th grade) via child hostile attribution bias, emotion reactivity, and social skills in middle childhood (3rd grade). Social skills mediated the associations between positivities/negativities in early mother-child and peer interactions and later behavioral and social adaptation. Emotion reactivity was identified as a process via which negativities in early peer interactions predicted later behavioral problems. Maternal negativities were positively associated with hostile attribution biases, but such biases did not relate to later adaptation. We also identified a negative direct link between maternal positivities and later externalizing problems and a positive direct link between maternal positivities and later social relationship quality. No effects emerged for child care providers-child interactions. Improving early mother-child and peer interactions may promote adaptation in early adolescence. For children with poor early mother-child and peer interactions, training socioemotional capacities may be a way to diminish consequences of early negative interpersonal processes.
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Affiliation(s)
- Hongjian Cao
- Institute of Early Childhood Education, Faculty of Education, Beijing Normal University, 512 Ying Dong Building, No. 19 Xin Jie Kou Wai Street, Hai Dian District, Beijing, 100875, China
| | - Yue Liang
- School of Social Development and Public Policy, Beijing Normal University, No. 19 Xin Jie Kou Wai Street, Hai Dian District, Beijing, 100875, China
| | - Nan Zhou
- Institute of Early Childhood Education, Faculty of Education, Beijing Normal University, 512 Ying Dong Building, No. 19 Xin Jie Kou Wai Street, Hai Dian District, Beijing, 100875, China.
- Department of Educational Psychology and School Counseling, Faculty of Education, Beijing Normal University, 528 Ying Dong Building, No. 19 Xin Jie Kou Wai Street, Hai Dian District, Beijing, 100875, China.
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15
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Dickerson KL, Skeem JL, Montoya L, Quas JA. Using Positive Emotion Training With Maltreated Youths to Reduce Anger Bias and Physical Aggression. Clin Psychol Sci 2020; 8:773-787. [PMID: 34136312 PMCID: PMC8204906 DOI: 10.1177/2167702620902118] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Maltreated youths often overinterpret anger in others' emotional expressions, particularly expressions that are ambiguous, and this "anger bias" is associated with aggressive behavior. In the current experiment, we tested the effect of an emotion-training intervention on anger bias and subsequent aggression. Eighty-four youths, ages 8 to 17, who had been removed from home because of maltreatment and had screened positive for aggressive tendencies, served as participants. Over 4 days, youths completed positive emotion training, a computerized program in which youths classify emotional expressions. Youths in the treatment condition received feedback to encourage their recognition of happiness over anger in ambiguous expressions. Physical aggression up to 1 week posttraining was assessed on the basis of self- and staff reports. The intervention was effective in reducing youths' anger bias and somewhat so in reducing aggression-the latter of-which occurred infrequently, limiting power. Results offer direction for developmental research and cost-effective interventions for maltreated youths at risk for aggression and future justice-system involvement.
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Affiliation(s)
- Kelli L. Dickerson
- Department of Psychological Science, School of Social
Ecology, University of California, Irvine
| | - Jennifer L. Skeem
- School of Social Welfare, University of California,
Berkeley
- Goldman School of Public Policy, University of California,
Berkeley
| | - Lina Montoya
- Division of Biostatistics, School of Public Health,
University of California, Berkeley
| | - Jodi A. Quas
- Department of Psychological Science, School of Social
Ecology, University of California, Irvine
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16
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Van Bockstaele B, van der Molen MJ, van Nieuwenhuijzen M, Salemink E. Modification of hostile attribution bias reduces self-reported reactive aggressive behavior in adolescents. J Exp Child Psychol 2020; 194:104811. [PMID: 32093878 DOI: 10.1016/j.jecp.2020.104811] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 10/22/2019] [Accepted: 01/17/2020] [Indexed: 11/29/2022]
Abstract
Aggressive individuals more readily interpret others' motives and intentions in ambiguous situations as hostile. This hostile attribution bias has been argued to be causally involved in the development and maintenance of aggression, making it a target for interventions. In our current study, adolescents selected for high levels of aggression (N = 39) were assigned to either a test-retest control group or a five-session hostile attribution bias modification training, in which they were trained to make more benign interpretations of ambiguously provocative social situations. Before and after the training, we assessed hostile attribution bias and both reactive and proactive self-reported aggression in both groups. The training not only tended to produce the expected reduction in hostile attribution bias but also crucially led to decreased levels of reactive but not proactive aggression compared with the control group. Our results thus support the idea that hostile attribution bias can be targeted using training techniques and that such training-induced changes in bias may reduce aggression. However, future studies using an active control group and multiple outcome measures are needed to address the long-term effects of training.
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Affiliation(s)
- Bram Van Bockstaele
- Department of Psychology, University of Amsterdam, 1018 WT Amsterdam, the Netherlands; School of Psychological Science, University of Western Australia, WA, 6009 Crawley, Australia.
| | | | | | - Elske Salemink
- Department of Clinical Psychology, Utrecht University, P.O. Box 80140, 3508 TC Utrecht, the Netherlands
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17
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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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18
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Smeijers D, Bulten EBH, Brazil IA. The Computations of hostile biases (CHB) model: Grounding hostility biases in a unified cognitive framework. Clin Psychol Rev 2019; 73:101775. [PMID: 31726277 DOI: 10.1016/j.cpr.2019.101775] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 08/21/2019] [Accepted: 09/14/2019] [Indexed: 12/24/2022]
Abstract
Our behavior is partly a product of our perception of the world, and aggressive individuals have been found to have 'hostility biases' in their perception and interpretation of social information. Four types of hostility biases can be distinguished: the hostile attribution, interpretation, expectation, and perception bias. Such low-level biases are believed to have a profound influence on decision-making, and possibly also increase the likelihood of engaging in aggressive acts. The current review systematically examined extant research on the four types of hostility bias, with a particular focus on the associations between each type of hostility bias and aggressive behavior. The results confirmed the robust association between hostility biases and aggressive behavior. However, it is still unknown how exactly hostility biases are acquired. This is also caused by a tendency to study hostility biases separately, as if they are non-interacting phenomena. Another issue is that current approaches cannot directly quantify the latent cognitive processes pertaining to the hostility biases, thus creating an explanatory gap. To fill this gap, we embedded the results of the systematic review in a state-of-the-art computational framework, which provides a novel mechanistic account with testable predictions.
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Affiliation(s)
- Danique Smeijers
- Forensic Psychiatric Centre Pompestichting, Nijmegen, The Netherlands.
| | - Erik B H Bulten
- Forensic Psychiatric Centre Pompestichting, Nijmegen, The Netherlands
| | - Inti A Brazil
- Forensic Psychiatric Centre Pompestichting, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
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19
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Verhoef REJ, Alsem SC, Verhulp EE, De Castro BO. Hostile Intent Attribution and Aggressive Behavior in Children Revisited: A Meta-Analysis. Child Dev 2019; 90:e525-e547. [PMID: 31165477 PMCID: PMC6851691 DOI: 10.1111/cdev.13255] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 01/31/2019] [Accepted: 02/06/2019] [Indexed: 01/21/2023]
Abstract
To test specific hypotheses about the relation between hostile intent attribution (HIA) and children’s aggressive behavior, a multilevel meta‐analysis was conducted on 111 studies with 219 effect sizes and 29.272 participants. A positive association between HIA and aggression was found, but effect sizes varied widely between studies. Results suggested that HIA is a general disposition guiding behavior across a broad variety of contexts, whereas the strength of the relation between HIA and aggression depends on the level of emotional engagement. The relation is stronger for more reliable HIA measures, but is not stronger for reactive aggression or co‐morbid attention‐deficit hyperactivity disorder than for aggression in general. The importance of understanding specific moderators of effect size for theory development is discussed.
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20
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The relationship between hostile attribution bias and aggression and the mediating effect of anger rumination. PERSONALITY AND INDIVIDUAL DIFFERENCES 2019. [DOI: 10.1016/j.paid.2018.11.029] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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21
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Hiemstra W, De Castro BO, Thomaes S. Reducing Aggressive Children’s Hostile Attributions: A Cognitive Bias Modification Procedure. COGNITIVE THERAPY AND RESEARCH 2018. [DOI: 10.1007/s10608-018-9958-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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22
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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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23
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Golubchik P, Weizman A. The effect of methylphenidate treatment on suspiciousness in children with ADHD alone or comorbid with ODD. Int J Psychiatry Clin Pract 2018; 22:109-114. [PMID: 28959903 DOI: 10.1080/13651501.2017.1383436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To assess the level of the suspiciousness in children with attention deficit/hyperactivity disorder (ADHD) and comorbid oppositional defiant disorder (ODD) in comparison to ADHD alone and the response of suspiciousness symptoms to methylphenidate (MPH) treatment. METHODS In this open-label comparative study, children with DSM-IV-TR ADHD, aged 8-18 years, with (N = 30) or without (N = 30) ODD received MPH treatment for 12 weeks. The severity of ODD symptoms was assessed by the Kiddie-Schedule for Affective Disorders and Schizophrenia. The severity of ADHD symptoms was assessed by the ADHD-Rating-Scale-IV and suspiciousness was assessed at baseline and at endpoint by a scale designed especially for assessment of suspiciousness and named Suspiciousness Rating Scale (SRS). RESULTS Significant reductions in SRS scores were detected in both groups following MPH treatment (before and after: p = .0012 and p = .0273, respectively). Only in the ADHD/ODD group a significant correlation was found between the rate of improvement in ADHD, as assessed by the ADHD-RS, and the reduction in suspiciousness, as assessed by the SRS (Spearman r = 0.48, p = .0066). CONCLUSIONS In addition to the beneficial effect of MPH treatment on ADHD and ODD symptoms it also diminishes suspiciousness. However, due to the small sample size further studies are needed to confirm the present results.
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Affiliation(s)
- Pavel Golubchik
- a Child and Adolescent Outpatient Clinic , Geha Mental Health Center , Petah Tikva , Israel.,c Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel
| | - Abraham Weizman
- b Research Unit , Geha Mental Health Center , Petah Tikva , Israel.,c Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel.,d Felsenstein Medical Research Center, Sackler Faculty of Medicine , Tel Aviv University , Petah Tikva , Israel
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24
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Lisk SC, Pile V, Haller SPW, Kumari V, Lau JYF. Multisession Cognitive Bias Modification Targeting Multiple Biases in Adolescents with Elevated Social Anxiety. COGNITIVE THERAPY AND RESEARCH 2018; 42:581-597. [PMID: 30237649 PMCID: PMC6133013 DOI: 10.1007/s10608-018-9912-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Research studies applying cognitive bias modification of attention (CBM-A) and interpretations (CBM-I) training to reduce adolescent anxiety by targeting associated cognitive biases have found mixed results. This study presents a new multi-session, combined bias CBM package, which uses a mix of training techniques and stimuli to enhance user-engagement. We present preliminary data on its viability, acceptability and effectiveness on reducing symptoms and biases using an A–B case series design. 19 adolescents with elevated social anxiety reported on their social anxiety, real-life social behaviours, general anxiety, depression, and cognitive biases at pre/post time-points during a 2-week baseline phase and a 2-week intervention phase. Retention rate was high. Adolescents also reported finding the CBM training helpful, particularly CBM-I. Greater reductions in social anxiety, negative social behaviour, and general anxiety and depression, characterised the intervention but not baseline phase. There was a significant correlation between interpretation bias change and social anxiety symptom change. Our enhanced multi-session CBM programme delivered in a school-setting appeared viable and acceptable. Training-associated improvements in social anxiety will require further verification in a study with an active control condition/group.
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Affiliation(s)
- Stephen C Lisk
- 1Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF UK
| | - Victoria Pile
- 1Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF UK
| | - Simone P W Haller
- 2Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Veena Kumari
- 3Centre for Cognitive Neuroscience, College of Health and Life Sciences, Brunel University London, London, UK
| | - Jennifer Y F Lau
- 1Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF UK
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25
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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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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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