Interpretive biases for ambiguous information in body dysmorphic disorder

Anxiety-disordered patients and individuals with high trait anxiety tend to interpret ambiguous information as threatening. The purpose of this study was to investigate whether interpretive biases would also occur in body dysmorphic disorder (BDD), which is characterized by a preoccupation with imagined defects in one's appearance. We tested whether BDD participants, compared with obsessive-compulsive disorder participants and healthy controls, would choose threatening interpretations for ambiguous body-related, ambiguous social, and general scenarios. As we hypothesized, BDD participants exhibited a negative interpretive bias for body-related scenarios and for social scenarios, whereas the other groups did not. Moreover, both clinical groups exhibited a negative interpretive bias for general scenarios.     

Practice makes perfect: Training the interpretation of emotional ambiguity

The interpretation of emotionally ambiguous words, sentences, or scenarios can be altered through training procedures that are collectively called cognitive bias modification for interpretation (CBM-I). In three experiments, we systematically manipulated the nature of the training in order to discriminate between emotional priming and ambiguity resolution accounts of training effects. In Experiment 1 participants completed word fragments that were consistently related to either a negative or benign interpretation of an ambiguous sentence. In a subsequent semantic priming task they demonstrated an interpretation bias, in that they were faster to identify relatedness of targets that were associated with the training-congruent meaning of an emotionally ambiguous homograph. We then manipulated the training sentences to show that interpretation bias was eliminated when participants simply completed valenced word fragments following unrelated sentences (Experiment 2), or completed fragments that were related to emotional but unambiguous sentences (Experiment 3). Only when participants were required to actively resolve emotionally ambiguous sentences during training did changes in interpretation emerge at test. Findings suggest that CBM-I achieves its effects by altering a production rule that aids the selection of meaning from emotionally ambiguous alternatives, in line with an ambiguity resolution account.     

Interpretive biases for ambiguous stimuli in social anxiety.

A growing body of literature suggests that individuals with high levels of general anxiety form threatening interpretations of ambiguous events. Although theoretical formulations of pathological social anxiety emphasize the importance of a negative interpretive-style in the etiology and maintenance of the disorder, we are unaware of any study that documents this presumed phenomenon. To address this issue, we assessed for possible interpretive biases in a group of high and low socially-anxious students. The results indicated that socially-anxious subjects showed more threatening interpretations of ambiguous, interpersonal events when compared to the low-anxious participants. However, this bias was marked not so much by an outright negative interpretation style, but rather by a failure of the socially-anxious subjects to show a positive interpretation as was evinced by the low-anxious individuals. These group differences in interpretive style appeared to be influenced by trait aspects of social anxiety rather than differences in current mood state. No group differences emerged in interpretations of events that involved non-personal stimuli suggesting there is content specificity in the interpretive biases associated with social-anxiety.     

Interpretation of ambiguous emotional information in clinically anxious children and adolescents

Cognitive theories of anxiety based on adult data predict that individuals vulnerable to anxiety should show threat - related interpretations of ambiguous material and it is proposed that this is an important maintaining factor in anxiety disorders. In the present study, interpretation of ambiguous emotional/neutral information was examined in child and adolescent anxious patients. Two groups of participants, anxious patients (n = 17) and healthy controls (n = 40), were presented with a series of homographs, each with a threatening and a neutral interpretation. For each homograph, the participants were asked to construct a sentence using the homograph. Anxious children and adolescents produced significantly more sentences consistent with threatening homograph interpretations and less consistent with neutral interpretations than did normal controls. Regression analyses revealed no relationship between age and this interpretive bias. Preliminary developmental and theoretical implications are discussed.     

Trained interpretive bias and anxiety

The relationship between anxiety and interpretive bias has been studied extensively, but the causal direction of this relationship remains largely unexplored. Do negative interpretations cause anxiety or is anxiety the cause of negative interpretations? Or are the two mutually reinforcing? The present study addressed this issue by experimentally inducing either a negative or a positive interpretive bias using Mathews and Mackintosh' [(2002). Induced emotional interpretation bias and anxiety. Journal of Abnormal Psychology, 109, 604-615] training paradigm and then examining its impact on state anxiety and anxiety vulnerability. In addition, it was investigated as to whether the interpretive bias was trained implicitly. Results indicated that style of interpreting could be manipulated. That is, when confronted with ambiguous information after the training, participants (n=118) interpreted this information congruent with their (positive or negative) training condition. Data on the issue of implicitness showed that participants tended to be explicitly aware of the valence of their training stimuli. Effects of trained interpretive bias on anxiety were only marginal and absent on anxiety vulnerability. It appears that interpretive bias can be trained reliably, but its effects on mood and vulnerability require further explanation.     

Threat is in the eye of the beholder: social anxiety and the interpretation of ambiguous facial expressions

The current study investigated the tendency of individuals with high levels of social anxiety to interpret ambiguous facial expressions in a threatening manner. Results obtained from self-report measures were consistent with previous studies in which highly socially anxious individuals endorsed threatening interpretations for ambiguous social information. More importantly, highly socially anxious participants showed relative facilitation of processing of threatening faces following neutral faces when a priming technique was used to eliminate artifact due to response selection bias. These findings support the hypothesized social anxiety-linked interpretive bias.     

Cognitive bias modification: induced interpretive biases affect memory

Previous research has shown that it is possible to experimentally induce interpretive biases using ambiguous scenarios. This study extends past findings by examining the effects of cognitive bias modification for interpretation on subsequent scenario recall. Participants were trained to interpret emotionally ambiguous passages in either a positive or negative direction. Transfer of the training to novel scenarios was tested. After training, participants were also asked to recall details from these novel scenarios. The results indicate that the training was effective in inducing the intended group differences in interpretive bias. Importantly, participants exhibited memory biases that corresponded to their training condition. These results suggest that manipulating interpretive biases can result in corresponding changes in memory. Findings from this study highlight the importance of future research on the relation among cognitive biases and on the possibility of modifying cognitive biases in emotional disorders.     

Interpretation of bodily symptoms in hypochondriasis.

Although it has been suggested that hypochondriasis is caused by the misinterpretation of innocuous bodily sensations, support for this hypothesis rests largely upon uncontrolled self-report. We investigated the interpretation of ambiguous bodily sensations in three experiments using separate samples of non-clinical subjects differing in level of hypochondriacal concern. Results confirmed that subjects with high hypochondriacal concern endorse more thoughts about illness interpretations of bodily sensations, but reported thought content resembled 'catastrophic' rather than the 'non-emergency' thoughts suggested by Warwick and Salkovskis (Hypochondriasis. Behavior Research and Therapy, 28, 105-117, 1990). Presence of an interpretive bias was further supported in a study of recognition bias for disambiguated versions of ambiguously threatening sentences, although this applied as much to social as to illness threats. A final experiment failed to support the hypothesis of an automatic inference bias, but did show that subjects with high hypochondriacal concern were quicker to correctly identify previously exposed illness words. Thus, reported thoughts are consistent with catastrophic interpretations of common bodily sensations, but interpretive bias may not be limited to illness threat. However, high hypochondriacal subjects do show a more specific enhanced perceptual sensitivity to illness cues, which may play a role in maintaining their concern with bodily symptoms.     

Interpretation revealed in the blink of an eye: depressive bias in the resolution of ambiguity

Self-report measures of interpretation have been criticized on methodological grounds. An approach is introduced in this article that enables the assessment of interpretive bias with a greater degree of methodological rigor than previously has been the case. Psychophysiological researchers have established that the magnitude of the human blink reflex is augmented when elicited during negative rather than neutral imagery. The 1st experiment demonstrates that the blink reflex is sensitive to the emotional valence of imagery evoked by interpretations imposed on ambiguous stimuli. In the 2nd experiment, this measure is used to assess interpretations imposed on ambiguous stimuli by individuals who differ in depression levels. The findings are consistent with the hypothesis that depression is associated with a negative interpretive bias.     

Look before you leap: the role of negative urgency in appraisals of ambiguous and unambiguous scenarios in individuals high in generalized anxiety disorder symptoms

Negative interpretation bias, the propensity to make threatening interpretations of ambiguous information, is associated with symptoms of generalized anxiety disorder (GAD). Apart from its relationship with intolerance of uncertainty (IU), little is known about what explains the presence of this cognitive bias in GAD. One factor may be negative urgency (NU), the tendency to take rash action when distressed, which is related to GAD symptoms and to cognitive biases in nonclinical populations. The aim of the present study was to examine the relationship between NU and interpretation bias in individuals high in GAD symptoms (N = 111). IU, trait anxiety, and other forms of impulsivity were examined concurrently as competing correlates of interpretation bias. Greater NU and IU were found to be unique correlates of greater threatening interpretations of ambiguous scenarios. Greater NU was also a unique correlate of greater threatening interpretations of negative and positive scenarios. No other forms of impulsivity were uniquely related to interpretation bias. The findings suggest that greater NU may have a role in the tendency for individuals high in GAD symptoms to make threatening interpretations in response to ambiguous scenarios, overtly threatening situations, and situations without indication of threat or danger. Theoretical implications of these findings are discussed.     

Underspecification of syntactic ambiguities: Evidence from self-paced reading

Syntactically ambiguous sentences are sometimes read faster than disambiguated strings. Models of parsing have explained this tendency by appealing either to a race in the construction of alternative structures or to reanalysis. However, it is also possible that readers of ambiguous sentences save time by strategically underspecifying interpretations of ambiguous attachments. In a self-paced reading study, participants viewed sentences with relative clauses that could attach to one of two sites. Type of question was also manipulated between participants in order to test whether goals can influence reading/parsing strategies. The experiment revealed an ambiguity advantage in reading times, but only when participants expected superficial comprehension questions. When participants expected queries about relative clause interpretation, disambiguating regions were inspected with more care, and the ambiguity advantage was attenuated. However, even when participants expected relative clause queries, question-answering times suggested underspecified representations of ambiguous relative clause attachments. The results support the construal and "good-enough" models of parsing.     

Interpretation of ambiguous information in clinical depression

The present study used two cognitive tasks--a text comprehension task and a homophone task--to investigate whether clinically depressed individuals have a negative bias when interpreting ambiguous information. Previous research indicates that both tasks are sensitive to anxiety-related interpretive biases, and that the former is less prone to response bias effects. Negative memory biases were also assessed. Results showed that, compared with normal controls, depressed individuals made more negative interpretations on the homophone task, and they also showed an enhanced negative recall bias. However, the groups did not differ in interpretative bias on the text comprehension task. Possible explanations of the results are discussed, including the potential influences of self-referent processing and response bias.     

Implicit interpretation biases affect emotional vulnerability: A training study

Cognitive theories of emotion propose that the interpretation of emotion-eliciting situations crucially shapes affective responses. Implicit or automatic biases in these interpretations may hinder emotion regulation and thereby increase risk for the onset and maintenance of psychological disorders. In this study, participants were randomly assigned to a positive or negative interpretation bias training using ambiguous social scenarios. After the completion of the training, a stress task was administered and changes in positive and negative affect and self-esteem were assessed. The results demonstrate that the interpretation bias training was successful in that participants exhibited a tendency to interpret novel scenarios in accordance with their training condition. Importantly, the positive training condition also had a protective effect on self-esteem. Participants in this condition did not exhibit a decrease in self-esteem after the stress task, whereas participants in the negative condition did. These results demonstrate that implicit cognitive biases can be trained and that this training affects self-esteem. Implications of these findings for research on psychopathology and emotion regulation are discussed.     

Implicit interpretation biases affect emotional vulnerability: a training study

Cognitive theories of emotion propose that the interpretation of emotion-eliciting situations crucially shapes affective responses. Implicit or automatic biases in these interpretations may hinder emotion regulation and thereby increase risk for the onset and maintenance of psychological disorders. In this study, participants were randomly assigned to a positive or negative interpretation bias training using ambiguous social scenarios. After the completion of the training, a stress task was administered and changes in positive and negative affect and self-esteem were assessed. The results demonstrate that the interpretation bias training was successful in that participants exhibited a tendency to interpret novel scenarios in accordance with their training condition. Importantly, the positive training condition also had a protective effect on self-esteem. Participants in this condition did not exhibit a decrease in self-esteem after the stress task, whereas participants in the negative condition did. These results demonstrate that implicit cognitive biases can be trained and that this training affects self-esteem. Implications of these findings for research on psychopathology and emotion regulation are discussed.     

Interpretive bias,repressive coping,and trait anxiety

Objectives: According to vigilance–avoidance theory, repressors have an avoidant interpretive bias, i.e., they interpret ambiguous self-relevant situations in a nonthreatening fashion. This study sought to demarcate the range of situations associated with avoidant interpretive bias in repressors. Design: Four groups of participants, representing the four combinations of low- and high-trait anxiety and defensiveness, were identified. Those low in trait anxiety and high in defensiveness were categorized as repressors. Methods: Participants (N = 163) rated their likelihood of making both threatening and nonthreatening interpretations of 32 ambiguous scenarios over four domains: social, intellectual, physical, and health. Half the scenarios were self-relevant and half were other relevant. Brief measures of state anxiety were taken after each likelihood rating. Results: Repressors displayed an avoidant interpretive bias for ambiguous threats in the social and intellectual domains but not the health or physical domains. This was due to repressors' low level of trait anxiety rather than their high defensiveness. Conclusions: Individuals high in trait anxiety are especially sensitive to situations involving social evaluation but not those characterized by danger to their health or physical well-being.     

Interpretation training influences memory for prior interpretations

Anxiety is associated with memory biases when the initial interpretation of the event is taken into account. This experiment examined whether modification of interpretive bias retroactively affects memory for prior events and their initial interpretation. Before training, participants imagined themselves in emotionally ambiguous scenarios to which they provided endings that often revealed their interpretations. Then they were trained to resolve the ambiguity in other situations in a consistently positive (n = 37) or negative way (n = 38) before they tried to recall the initial scenarios and endings. Results indicated that memory for the endings was imbued with the emotional tone of the training, whereas memory for the scenarios was unaffected.     

Cancer fear and the interpretation of ambiguous information related to cancer

We tested the hypothesis that people with a high fear of cancer would be more likely to interpret ambiguous information about cancer in a negative manner compared with people low on cancer fear. Adults (n=47) aged 50–70, who scored either high (n=16) or low (n=31) on cancer fear, took part in a laboratory-based ambiguous sentences task. Participants were presented with ambiguous cancer and social threat scenarios mixed with unambiguous neutral scenarios. Interpretations were assessed in a recognition task, by asking participants to rate disambiguated sentences in terms of how similar in meaning they were to the originals. People high on cancer fear were more likely to endorse negative interpretations of the original ambiguous cancer scenarios than were people low on cancer fear. This negative interpretation bias was specific to cancer scenarios and was not observed for the social threat scenarios.     

Untrained speakers' use of prosody in syntactic disambiguation and listeners' interpretations

We investigated how naively produced prosody affects listeners' end interpretations of ambiguous utterances. Non-professional speakers who were unaware of any ambiguity produced ambiguous sentences couched in short, unambiguous passages. In a forced-choice task, listeners could not tell which context the isolated ambiguous sentences came from (Exp. 1). However, listeners were able to correctly paraphrase the least ambiguous subset of these utterances, showing that prosody can be used to resolve ambiguity (Exp. 2). Nonetheless, in everyday language use, both prosody and context are available to interpret speech. When the least ambiguous sentences were cross-spliced into contexts biasing towards their original interpretations or into contexts biasing towards their alternative interpretations, answers to content questions about the ambiguous sentence, confidence ratings, and ratings of naturalness all indicated that prosody is ignored when context is available (Exp. 3). Although listeners can use prosody to interpret ambiguous sentences, they generally do not, and this makes sense in light of the frequent lack of reliable prosodic cues in everyday speech. Received: 3 April 1998 / Accepted: 21 October 1998     

The association between ruminative thinking and negative interpretation bias in social anxiety

Cognitive models propose that both, negative interpretations of ambiguous social situations and ruminative thoughts about social events contribute to the maintenance of social anxiety disorder. It has further been postulated that ruminative thoughts fuel biased negative interpretations, however, evidence is rare. The present study used a multi-method approach to assess ruminative processing following a social interaction (post-event processing by self-report questionnaire and social rumination by experience sampling method) and negative interpretation bias (via two separate tasks) in a student sample (n?=?51) screened for high (HSA) and low social anxiety (LSA). Results support the hypothesis that group differences in negative interpretations of ambiguous social situations in HSAs vs. LSAs are mediated by higher levels of post-event processing assessed in the questionnaire. Exploratory analyses highlight the potential role of comorbid depressive symptoms. The current findings help to advance the understanding of the association between two cognitive processes involved in social anxiety and stress the importance of ruminative post-event processing.