Interpretive biases in socially anxious adults

Abstract

Social phobia is a highly prevalent and debilitating anxiety disorder that can significantly impact quality of life and produce extreme distress in social situations. Cognitive models of social phobia suggest that information-processing biases are involved in the maintenance of social anxiety. Treatment typically involves a course of Cognitive Behavioural Therapy (CBT). Recent advancements in the understanding of the mechanisms underlying social anxiety have led to specific adjunctive treatments that target processing biases. The current literature review explores the efficacy of training programs designed to modify interpretative biases. Training programs typically involve repeated exposure to positive resolutions of ambiguous lexical social stimuli. Results suggest that current techniques are able to modify interpretative biases in non-anxious, socially anxious and clinical samples of social phobia. Multi-session programs have also been shown to reduce trait anxiety and social anxiety symptoms. Evidence for the generalisability of training to subsequent socially stressful situations remains mixed and requires further research. In the present study, the validity of a novel cognitive bias modification of interpretation (CBM-I) technique using ambiguous facial stimuli was examined in an unselected sample of 65 undergraduate students. Participants were randomly allocated to receive CBM-I-threat (n=31) or CBM-I-non-threat (n=34) training. The number of angry responses in a forced alternative (angry, neutral) choice was compared at pre and post assessment to determine the efficacy of training. Participants completed a subsequent social stressor task (impromptu speech). Measures of state anxiety, physiological measures of arousal, and judgements of speech performance were taken to examine the effects of training on emotional vulnerability. Results showed that the training program successfully induced a bias towards threat in the CBM-I-threat trained group. There was also some evidence that it was able to reduce the number of threat interpretations in CBM-I-non-threat trained individuals, however this was only when facial expressions were ambiguous. Early results suggest CBM-I training may also effect anticipated and retrospective negative evaluations of social performance.

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ORCID for Matthew J. Garner: orcid.org/0000-0001-9481-2226

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