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McIntyre SA, Richardson J, Carroll S, O'Kirwan S, Williams C, Pile V. Measures of mental imagery in emotional disorders: A COSMIN systematic review of psychometric properties. Clin Psychol Rev 2024; 113:102470. [PMID: 39180928 DOI: 10.1016/j.cpr.2024.102470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 07/15/2024] [Accepted: 07/26/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND Dysfunctional imagery processes characterise a range of emotional disorders. Valid, reliable, and responsive mental imagery measures may support the clinical assessment of imagery and advance research to develop theory and imagery-based interventions. We sought to review the psychometric properties of mental imagery measures relevant to emotional disorders. METHODS A systematic review registered on the Open Science Framework was conducted using COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidance. Five databases were searched. COSMIN tools were used to assess the quality of study methodologies and psychometric properties of measures. RESULTS Twenty-three articles describing twenty-one self-report measures were included. Measures assessed various imagery processes and were organised into four groups based on related emotional disorders. Study methodological quality varied: measure development and reliability studies were generally poor, while internal consistency and hypothesis testing studies were higher quality. Most measurement properties assessed were of indeterminate quality. CONCLUSION Imagery measures were heterogenous and primarily disorder specific. Due to a lack of high-quality psychometric assessment, it is unclear whether most included imagery measures are valid, reliable, or responsive. Measures had limited evidence of content validity suggesting further research could engage clinical populations to ensure their relevance and comprehensiveness.
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Affiliation(s)
- Stephen A McIntyre
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Jessica Richardson
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK; Trauma, Anxiety and Depression Clinic, South London & Maudsley NHS Trust, London, UK
| | - Susan Carroll
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK; Children's Health Ireland, Dublin, Ireland
| | - Saava O'Kirwan
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Chloe Williams
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Victoria Pile
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK.
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Blackwell SE, Schönbrodt FD, Woud ML, Wannemüller A, Bektas B, Braun Rodrigues M, Hirdes J, Stumpp M, Margraf J. Demonstration of a 'leapfrog' randomized controlled trial as a method to accelerate the development and optimization of psychological interventions. Psychol Med 2023; 53:6113-6123. [PMID: 36330836 PMCID: PMC10520605 DOI: 10.1017/s0033291722003294] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 09/14/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND The scale of the global mental health burden indicates the inadequacy not only of current treatment options, but also the pace of the standard treatment development process. The 'leapfrog' trial design is a newly-developed simple Bayesian adaptive trial design with potential to accelerate treatment development. A first leapfrog trial was conducted to provide a demonstration and test feasibility, applying the method to a low-intensity internet-delivered intervention targeting anhedonia. METHODS At the start of this online, single-blind leapfrog trial, participants self-reporting depression were randomized to an initial control arm comprising four weeks of weekly questionnaires, or one of two versions of a four-week cognitive training intervention, imagery cognitive bias modification (imagery CBM). Intervention arms were compared to control on an ongoing basis via sequential Bayesian analyses, based on a primary outcome of anhedonia at post-intervention. Results were used to eliminate and replace arms, or to promote them to become the control condition based on pre-specified Bayes factor and sample size thresholds. Two further intervention arms (variants of imagery CBM) were added into the trial as it progressed. RESULTS N = 188 participants were randomized across the five trial arms. The leapfrog methodology was successfully implemented to identify a 'winning' version of the imagery CBM, i.e. the version most successful in reducing anhedonia, following sequential elimination of the other arms. CONCLUSIONS The study demonstrates feasibility of the leapfrog design and provides a foundation for its adoption as a method to accelerate treatment development in mental health. Registration: clinicaltrials.gov, NCT04791137.
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Affiliation(s)
- Simon E. Blackwell
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Felix D. Schönbrodt
- Department of Psychology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Marcella L. Woud
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Andre Wannemüller
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Büsra Bektas
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Max Braun Rodrigues
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Josefine Hirdes
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Michael Stumpp
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Jürgen Margraf
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
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Kroener J, Greiner A, Sosic-Vasic Z. Cognitive bias modification for interpretation (CBM-I) for post-traumatic stress disorder: study protocol of an app-based randomised controlled trial. BMJ Open 2023; 13:e069228. [PMID: 36797017 PMCID: PMC9936272 DOI: 10.1136/bmjopen-2022-069228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
INTRODUCTION Previous studies indicate that computerised trainings implementing cognitive bias modification (CBM) for interpretation bias might be promising treatments for trauma-related cognitive distortions and symptoms. However, results are mixed, which might be related to the implemented task (sentence completion task), setting, or training duration. Within the present study, we aim to evaluate the efficacy and safety of an app-based intervention for interpretation bias using standardised imagery audio scripts, which is designed as a standalone treatment. METHODS AND ANALYSIS The study is a randomised controlled trial, implementing two parallel arms. 130 patients diagnosed with post-traumatic stress disorder (PTSD) will be allocated to either the intervention group or the waiting-list control group receiving treatment as usual. The intervention consists of 3 weeks of an app-based CBM training for interpretation bias using mental imagery, with three training sessions (20 min) per week. Two months after the last training session, 1 week of booster CBM treatment will be implemented, consisting of three additional training sessions. Outcome assessments will be conducted pretraining, 1 week post-training, 2 months post-training, as well as 1 week after the booster session (approximately 2.5 months after initial training termination). The primary outcome is interpretation bias. Secondary outcomes include PTSD-related cognitive distortions and symptom severity, as well as negative affectivity. Outcome assessment will be conducted by intention-to-treat analysis, as well as per-protocol analysis using linear mixed models. ETHICS AND DISSEMINATION The study was approved by the Ethics Committee of the State Chamber of Physicians in Baden-Wuerttemberg, Germany (number of approval: F-2022-080). Scientific findings will be published in peer-reviewed journals informing future clinical studies, which focus on the reduction of PTSD-related symptoms using CBM. TRIAL REGISTRATION NUMBER German Clinical Trials Register (DRKS00030285; https://drks.de/search/de/trial/DRKS00030285).
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Affiliation(s)
- Julia Kroener
- Department of Applied Psychotherapy and Psychiatry, Christophsbad GmbH & Co Fachkrankenhaus KG, Goppingen, Germany
- University of Ulm, Ulm, Germany
| | - Alexander Greiner
- Department of Applied Psychotherapy and Psychiatry, Christophsbad GmbH & Co Fachkrankenhaus KG, Goppingen, Germany
- University of Ulm, Ulm, Germany
| | - Zrinka Sosic-Vasic
- Department of Applied Psychotherapy and Psychiatry, Christophsbad GmbH & Co Fachkrankenhaus KG, Goppingen, Germany
- University of Ulm, Ulm, Germany
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Herrera-Rivero M, Bohn L, Witten A, Jüngling K, Kaiser S, Richter SH, Stoll M, Sachser N. Transcriptional profiles in the mouse amygdala after a cognitive judgment bias test largely depend on the genotype. Front Mol Neurosci 2022; 15:1025389. [DOI: 10.3389/fnmol.2022.1025389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 10/04/2022] [Indexed: 12/03/2022] Open
Abstract
Background: The amygdala is crucial for emotional cognitive processing. Affective or emotional states can bias cognitive processes, including attention, memory, and decision-making. This can result in optimistic or pessimistic behaviors that are partially driven by the activation of the amygdala. The resulting emotional cognitive bias is a common feature of anxiety and mood disorders, both of which are interactively influenced by genetic and environmental factors. It is also known that emotional cognitive biases can be influenced by environmental factors. However, little is known about the effects of genetics and/or gene-environment interactions on emotional cognitive biases. We investigated the effects of the genetic background and environmental enrichment on the transcriptional profiles of the mouse amygdala following a well-established cognitive bias test.Methods: Twenty-four female C57BL/6J and B6D2F1N mice were housed either in standard (control) conditions or in an enriched environment. After appropriate training, the cognitive bias test was performed on 19 mice that satisfactorily completed the training scheme to assess their responses to ambiguous cues. This allowed us to calculate an “optimism score” for each mouse. Subsequently, we dissected the anterior and posterior portions of the amygdala to perform RNA-sequencing for differential expression and other statistical analyses.Results: In general, we found only minor changes in the amygdala’s transcriptome associated with the levels of optimism in our mice. In contrast, we observed wide molecular effects of the genetic background in both housing environments. The C57BL/6J animals showed more transcriptional changes in response to enriched environments than the B6D2F1N mice. We also generally found more dysregulated genes in the posterior than in the anterior portion of the amygdala. Gene set overrepresentation analyses consistently implicated cellular metabolic responses and immune processes in the differences observed between mouse strains, while processes favoring neurogenesis and neurotransmission were implicated in the responses to environmental enrichment. In a correlation analysis, lipid metabolism in the anterior amygdala was suggested to influence the levels of optimism.Conclusions: Our observations underscore the importance of selecting appropriate animal models when performing molecular studies of affective conditions or emotional states, and suggest an important role of immune and stress responses in the genetic component of emotion regulation.
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Chen R, Zheng J, Li T, Zhang Q, Li C, Cui L. Cognitive bias modification of interpretation training for Chinese undergraduates with depressive symptoms. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-020-01094-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Würtz F, Zahler L, Blackwell SE, Margraf J, Bagheri M, Woud ML. Scrambled but valid? The scrambled sentences task as a measure of interpretation biases in psychopathology: A systematic review and meta-analysis. Clin Psychol Rev 2022; 93:102133. [PMID: 35219928 DOI: 10.1016/j.cpr.2022.102133] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 11/18/2021] [Accepted: 02/13/2022] [Indexed: 11/21/2022]
Abstract
The Scrambled Sentences Task (SST) is frequently used to assess interpretation biases (IBs). However, neither the range of its applications nor the quality of the empirical evidence it provides has been systematically examined. This systematic review investigates the types of samples and disorders in which the SST has been applied and evaluates its psychometric properties via a meta-analysis. The databases PubMed and EBSCOhost (including PsycINFO, PsycARTICLES, PSYNDEX, MEDLINE) were examined (last search: September 2021) and 93 studies from 91 manuscripts were included. Results showed that the SST has been applied predominantly in unselected samples or those with elevated levels of subsyndromal symptoms, with about a third of the studies employing the SST in a clinical population. While the SST was initially developed to assess depression-related IBs, it has now been extended to other disorders, in particular anxiety disorders. Results of the meta-analyses indicated good convergent validity and reliability across disorders, albeit in the context of substantial heterogeneity. Findings concerning divergent validity were mixed with high correlations across disorders between the SST and trait anxiety in particular, questioning its specificity. Future research should consider developing standardized SST versions and investigating its relationships with other measures of IB.
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Affiliation(s)
- Felix Würtz
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany.
| | - Lisa Zahler
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Simon E Blackwell
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Jürgen Margraf
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Mahdi Bagheri
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
| | - Marcella L Woud
- Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Bochum, Germany
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Jusepeitis A, Rothermund K. No elephant in the room: The incremental validity of implicit self-esteem measures. J Pers 2022; 90:916-936. [PMID: 35122254 DOI: 10.1111/jopy.12705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 01/28/2022] [Indexed: 11/26/2022]
Abstract
Correlational research aiming to validate measures and the construct of implicit self-esteem (ISE) has produced heterogeneous results in the past. We argue that this might be caused by two underappreciated obstacles: the situational malleability and construct irrelevant variance in conventional ISE measures. To minimize these problems, we applied process and latent state-trait modeling to Implicit Association Test and Name Letter Task data collected on four occasions across six weeks in a preregistered online study (initial N = 360, final N = 302). We investigated the relation of supposed trait ISE parameters with trait explicit self-esteem (ESE) and criteria. Results indicated no latent trait correlation among the different supposed indicators of ISE, small latent trait correlations of indicators of ISE and ESE, and little incremental validity of the supposed ISE measures in predicting potential criterion measures over and above ESE. These findings align with previous critical evaluations regarding the supposed measures of ISE and the conceptual validity of ISE as an association. Implications for future research on ISE are discussed.
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Affiliation(s)
- Adrian Jusepeitis
- Department of Psychology, Friedrich-Schiller-University Jena, Germany
| | - Klaus Rothermund
- Department of Psychology, Friedrich-Schiller-University Jena, Germany
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Nieto I, Vazquez C. Disentangling the mediating role of modifying interpretation bias on emotional distress using a novel cognitive bias modification program. J Anxiety Disord 2021; 83:102459. [PMID: 34358756 DOI: 10.1016/j.janxdis.2021.102459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/12/2021] [Accepted: 07/26/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Negative interpretation bias is a potential risk factor for emotional disorders. In this study, we tested a clinically inspired 4-session online Cognitive Bias Modification-Interpretation (CBM-IClin) program to modify negative interpretation biases. METHODS We randomized one hundred and twenty-one volunteer young adults (Mean age = 21.6 years, SD = 3.5; 85 % women) with varying levels of emotional distress to either an experimental or waitlist control group. Mediation analyses were used to disentangle the associations between the intervention, changes in interpretation biases (assessed by both a self-report and an experimental task), and changes in measures of cognitive vulnerability and symptoms of depression and anxiety. RESULTS The results showed that the CBM-IClin could change negative interpretation biases. Also, it had a direct effect on the change in negative memory bias, an indirect effect on the change in depression symptoms via the change in interpretation bias, and both direct and indirect effects on the change in self-reported dysfunctional attitudes. LIMITATIONS The study included a non-clinical sample of participants and it did not control for some potential confounding factors (e.g., attentional disorders). Furthermore, participants' engagement during the sessions at home was not supervised. CONCLUSIONS The CBM-IClin is a potential tool to prevent and intervene in emotional disorders in young adults and could complement other traditional CBM procedures or clinical interventions.
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Affiliation(s)
- Inés Nieto
- Department of Clinical Psychology, School of Psychology, Complutense University of Madrid, Spain.
| | - Carmelo Vazquez
- Department of Clinical Psychology, School of Psychology, Complutense University of Madrid, Spain
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Nieto I, Vazquez C. 'Relearning how to think': A brief online intervention to modify biased interpretations in emotional disorders-study protocol for a randomised controlled trial. Trials 2021; 22:510. [PMID: 34332616 PMCID: PMC8325786 DOI: 10.1186/s13063-021-05459-3] [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: 11/07/2020] [Accepted: 07/15/2021] [Indexed: 11/18/2022] Open
Abstract
Background Cognitive biases play an important role in the development and maintenance of emotional disorders, such as depression and anxiety. Novel procedures, known as Cognitive Bias Modification (CBM), aim to reduce these dysfunctional information processing modes. This study develops a brief clinically based online intervention programme to modify biased interpretations in depression and anxiety (CBM-IClin), overcoming some methodological issues that have been addressed in previous literature. Methods Volunteer participants will be recruited via social media and posters at the university. They will be randomly assigned to an experimental group or a waiting list control group. Both groups will complete two assessment sessions (before and after the intervention) consisting of questionnaires measuring cognitive and emotional variables as well as experimental tasks measuring cognitive biases (i.e. attention, memory, and interpretation). After the first assessment session, only participants in the experimental group will receive a link to follow the four CBM-IClin sessions at home. All participants will receive, via email, follow-up questionnaires 2 weeks and 3 months after the second assessment. Discussion This study will test the 'Relearning how to think', an online programme potentially beneficial to modify cognitive biases in emotional disorders. Several limitations of previous CBM procedures are addressed, and the impact of the programme both on objective cognitive bias tasks and clinical symptoms will be explored. Trial registration ClinicalTrials.gov NCT03987477. Prospectively registered on June 17, 2019
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Affiliation(s)
- Inés Nieto
- Department of Clinical Psychology, School of Psychology, Complutense University of Madrid, 28223, Madrid, Spain.
| | - Carmelo Vazquez
- Department of Clinical Psychology, School of Psychology, Complutense University of Madrid, 28223, Madrid, Spain
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Miragall M, Borrego A, Cebolla A, Etchemendy E, Navarro-Siurana J, Llorens R, Blackwell SE, Baños RM. Effect of an upright (vs. stooped) posture on interpretation bias, imagery, and emotions. J Behav Ther Exp Psychiatry 2020; 68:101560. [PMID: 32078947 DOI: 10.1016/j.jbtep.2020.101560] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 01/10/2020] [Accepted: 02/09/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND OBJECTIVES Adopting an upright (vs. stooped) posture has been related to positive effects on emotional and cognitive processes. However, there is no evidence concerning the effect of posture on two key processes associated with the maintenance of depression: interpretation bias and vividness of mental imagery. The objectives were to investigate the effect of adopting an upright (vs. stooped) posture on interpretation bias and vividness of positive and negative mental imagery, and to explore the interplay between these processes and depression-related emotions. METHODS The sample consisted of 54 participants (Mage = 22.00, 64.8% women), who were randomly assigned to the upright or stooped condition. Participants answered self-report measures while they were adopting a specific posture. Posture was monitored through inertial technology. RESULTS Main results were that: upright (vs. stooped) posture led to more positive interpretations of ambiguous information and increased positive emotions related to depression (happiness, optimism and vigor); time in an upright position was associated with change in interpretation bias and vividness of positive mental imagery; and level of depressive symptomatology moderated the effect of posture on the change in interpretation bias. LIMITATIONS Limitations are related to the use of non-clinical sample, the use of short-term measurements, and the lack of an experimental condition adopting the usual posture. CONCLUSIONS Posture interacts with mechanisms involved in the maintenance of depression, as well as with depression-related emotions. This study has clinical implications that should be continued explored in order to clarify the role of manipulating the posture in individuals with depressive symptomatology.
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Affiliation(s)
- Marta Miragall
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN). Instituto Carlos III, Spain.
| | - Adrián Borrego
- Neurorehabilitation and Brain Research Group, Instituto de Investigación e Innovación en Bioingeniería. Universitat Politècnica de València, Valencia, Spain.
| | - Ausiàs Cebolla
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN). Instituto Carlos III, Spain.
| | - Ernestina Etchemendy
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain.
| | - Jéssica Navarro-Siurana
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain.
| | - Roberto Llorens
- Neurorehabilitation and Brain Research Group, Instituto de Investigación e Innovación en Bioingeniería. Universitat Politècnica de València, Valencia, Spain; Servicio de Neurorrehabilitación y Daño Cerebral de los Hospitales Vithas-NISA. Fundación Hospitales NISA, Valencia, Spain.
| | - Simon E Blackwell
- Department of Psychology, Ruhr-Universität Bochum, Germany; Mental Health Research and Treatment Center, Faculty of Psychology, Ruhr-Universität Bochum, Germany.
| | - Rosa M Baños
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN). Instituto Carlos III, Spain.
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Yang K, Girgus JS. Individual differences in social hypersensitivity predict the interpretation of ambiguous feedback and self-esteem. PERSONALITY AND INDIVIDUAL DIFFERENCES 2018. [DOI: 10.1016/j.paid.2018.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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A comprehensive meta-analysis of interpretation biases in depression. Clin Psychol Rev 2017; 58:33-48. [DOI: 10.1016/j.cpr.2017.09.005] [Citation(s) in RCA: 162] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 09/20/2017] [Indexed: 11/18/2022]
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Schoth DE, Liossi C. A Systematic Review of Experimental Paradigms for Exploring Biased Interpretation of Ambiguous Information with Emotional and Neutral Associations. Front Psychol 2017; 8:171. [PMID: 28232813 PMCID: PMC5299893 DOI: 10.3389/fpsyg.2017.00171] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 01/25/2017] [Indexed: 11/23/2022] Open
Abstract
Interpretation biases have been extensively explored in a range of populations, including patients with anxiety and depressive disorders where they have been argued to influence the onset and maintenance of such conditions. Other populations in which interpretation biases have been explored include patients with chronic pain, anorexia nervosa, and alcohol dependency among others, although this literature is more limited. In this research, stimuli with threatening/emotional and neutral meanings are presented, with participant responses indicative of ambiguity resolution. A large number of paradigms have been designed and implemented in the exploration of interpretation biases, some varying in minor features only. This article provides a review of experimental paradigms available for exploring interpretation biases, with the aim to stimulate and inform the design of future research exploring cognitive biases across a range of populations. A systematic search of the experimental literature was conducted in Medline, PsychINFO, Web of Science, CINAHL, and Cochrane Library databases. Search terms were information, stimuli, and ambiguous intersected with the terms interpretation and bias*. Forty-five paradigms were found, categorized into those using ambiguous words, ambiguous images, and ambiguous scenarios. The key features, strengths and limitations of the paradigms identified are discussed.
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Affiliation(s)
- Daniel E. Schoth
- Pain Research Laboratory, Department of Psychology, University of SouthamptonSouthampton, UK
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Pictet A, Jermann F, Ceschi G. When less could be more: Investigating the effects of a brief internet-based imagery cognitive bias modification intervention in depression. Behav Res Ther 2016; 84:45-51. [DOI: 10.1016/j.brat.2016.07.008] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 07/21/2016] [Accepted: 07/25/2016] [Indexed: 11/16/2022]
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Normansell KM, Wisco BE. Negative interpretation bias as a mechanism of the relationship between rejection sensitivity and depressive symptoms. Cogn Emot 2016; 31:950-962. [DOI: 10.1080/02699931.2016.1185395] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Karys M. Normansell
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Blair E. Wisco
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC, USA
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Williams AD, O'Moore K, Blackwell SE, Smith J, Holmes EA, Andrews G. Positive imagery cognitive bias modification (CBM) and internet-based cognitive behavioral therapy (iCBT): a randomized controlled trial. J Affect Disord 2015; 178:131-41. [PMID: 25805405 PMCID: PMC4407900 DOI: 10.1016/j.jad.2015.02.026] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 02/23/2015] [Accepted: 02/24/2015] [Indexed: 12/02/2022]
Abstract
BACKGROUND Accruing evidence suggests that positive imagery-based cognitive bias modification (CBM) could have potential as a standalone targeted intervention for depressive symptoms or as an adjunct to existing treatments. We sought to establish the benefit of this form of CBM when delivered prior to Internet cognitive behavioral therapy (iCBT) for depression METHODS A randomized controlled trial (RCT) of a 1-week Internet-delivered positive CBM vs. an active control condition for participants (N=75, 69% female, mean age=42) meeting diagnostic criteria for major depression; followed by a 10-week iCBT program for both groups. RESULTS Modified intent-to-treat marginal and mixed effect models demonstrated no significant difference between conditions following the CBM intervention or the iCBT program. In both conditions there were significant reductions (Cohen׳s d .57-1.58, 95% CI=.12-2.07) in primary measures of depression and interpretation bias (PHQ9, BDI-II, AST-D). Large effect size reductions (Cohen׳s d .81-1.32, 95% CI=.31-1.79) were observed for secondary measures of distress, disability, anxiety and repetitive negative thinking (K10, WHODAS, STAI, RTQ). Per protocol analyses conducted in the sample of participants who completed all seven sessions of CBM indicated between-group superiority of the positive over control group on depression symptoms (PHQ9, BDI-II) and psychological distress (K10) following CBM (Hedges g .55-.88, 95% CI=-.03-1.46) and following iCBT (PHQ9, K10). The majority (>70%) no longer met diagnostic criteria for depression at 3-month follow-up. LIMITATIONS The control condition contained many active components and therefore may have represented a smaller 'dose' of the positive condition. CONCLUSIONS Results provide preliminary support for the successful integration of imagery-based CBM into an existing Internet-based treatment for depression.
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Affiliation(s)
- Alishia D Williams
- School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia; Clinical Research Unit for Anxiety and Depression (CRUfAD), St. Vincent׳s Hospital, Sydney, NSW, Australia.
| | - Kathleen O'Moore
- Clinical Research Unit for Anxiety and Depression (CRUfAD), St. Vincent׳s Hospital, Sydney, NSW, Australia
| | | | - Jessica Smith
- Clinical Research Unit for Anxiety and Depression (CRUfAD), St. Vincent׳s Hospital, Sydney, NSW, Australia
| | - Emily A Holmes
- MRC Cognition and Brain Sciences Unit, Cambridge, UK; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Gavin Andrews
- School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia; Clinical Research Unit for Anxiety and Depression (CRUfAD), St. Vincent׳s Hospital, Sydney, NSW, Australia
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17
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Rohrbacher H, Blackwell SE, Holmes EA, Reinecke A. Optimizing the ingredients for imagery-based interpretation bias modification for depressed mood: is self-generation more effective than imagination alone? J Affect Disord 2014; 152-154:212-8. [PMID: 24113076 PMCID: PMC3878375 DOI: 10.1016/j.jad.2013.09.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Revised: 09/05/2013] [Accepted: 09/05/2013] [Indexed: 11/25/2022]
Abstract
Negative interpretation is thought to be crucial in the development and maintenance of depression. Recently developed cognitive bias modification paradigms, intending to change these biases towards a more optimistic interpretation tendency (CBM-I), seem to offer new promising implications for cognitive therapy innovation. This study aimed to increase our knowledge of the underlying mechanisms of action of imagery-based CBM-I in the context of depressed mood. We therefore compared the efficacy of CBM-I requiring participants to imagine standardized positive resolutions to a novel, more active training version that required participants to generate the positive interpretations themselves. Fifty-four participants were randomly allocated to (1) standardized CBM-I, (2) self-generation CBM-I or (3) a control group. Outcome measures included self-report mood measures and a depression-related interpretation bias measure. Both positive training variants significantly increased the tendency to interpret fresh ambiguous material in an optimistic manner. However, only the standardized imagery CBM-I paradigm positively influenced mood.
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Affiliation(s)
- Heike Rohrbacher
- Department of Cognitive Psychology, Technische Universität Dresden, Dresden, Germany
| | | | | | - Andrea Reinecke
- Department of Psychiatry, University of Oxford, Oxford, UK,Corresponding author. Tel.: +44 1865 226471.
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