Combined cognitive bias modification treatment for social anxiety disorder: a pilot trial

Authors

  • Courtney Beard Ph.D.,

    Corresponding author
    1. Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
    • Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Box G-BH, Providence, RI 02912
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  • Risa B. Weisberg Ph.D.,

    1. Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
    2. Department of Family Medicine, Alpert Medical School of Brown University, Providence, Rhode Island
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  • Nader Amir Ph.D.

    1. Joint Clinical Psychology Program, University of California San Diego/San Diego State University, San Diega, California
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  • Dr. Beard received a Career Development Travel Award to present these findings at the 2011 Anxiety Disorders Association of America (ADAA) annual meeting. Dr. Weisberg has received grant funding from NIMH and Pfizer, was a consultant to SciMed, received funding for manuscript preparation from CME Institute, and funding for educational development from Princeton Healthcare Communications. Dr. Amir has received grant funding from NIMH, has applied for a patent related to the current type of treatment, and is part owner of a company that markets treatments similar to the current article (conflict of interest is covered by SDSU).

Abstract

Background: Cognitive Bias Modification (CBM) is a promising treatment for Social Anxiety Disorder (SAD). However, previous randomized trials have not systematically examined the combination of CBM for attention (CBM-A) and interpretation (CBM-I) or the credibility and acceptability of these protocols. Methods: We conducted a randomized, double-blind placebo-controlled trial (N = 32) to examine the efficacy of a CBM treatment called Attention and Interpretation Modification (AIM) for SAD. AIM comprised eight, twice weekly computer sessions with no therapist contact. During AIM, participants (1) completed a dot probe task in which probes always followed neutral faces when paired with a disgust face, thereby directing attention away from threat and (2) completed a word–sentence association task in which they received positive feedback for making benign interpretations of word–sentence pairs and negative feedback for making negative interpretations. We also assessed participants' perceived credibility of and satisfaction with AIM. Results: Participants receiving AIM reported significantly reduced self-reported (Liebowitz Social Anxiety Scale) symptoms of social anxiety relative to the placebo. These gains were also evident on a behavioral measure (performance on an impromptu speech). AIM met our benchmarks for credibility and acceptability in this community sample, although credibility ratings were modest. Participants reported that CBM-I was more helpful than CBM-A. Conclusions: A combined CBM treatment produced medium-to-large effects on social anxiety. Participants rated AIM as moderately credibly and acceptable. Should these findings be replicated in larger samples, AIM has the potential to be a widely accessible and efficacious treatment for SAD. Depression and Anxiety, 2011.© 2011 Wiley Periodicals, Inc.

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