Interpretation biases in social anxiety: response generation, response selection, and self-appraisals

Cognitive theories propose that the resolution of ambiguity is related to the maintenance of social anxiety. A sentence completion task was used to examine how individuals high (n=26) and low (n=23) in social anxiety resolve ambiguous social sentences. Individuals were asked to generate as many responses as came to mind for each sentence, and then to endorse the response that best completes the sentence. Total responses, first responses, and endorsed responses were examined separately. Results indicated that high anxious individuals had more negative and anxious responses and fewer positive and neutral responses than low anxious individuals on all sentence completion measures. In contrast, a self-report measure of interpretation bias indicated that more of negative and anxious appraisals were related to social anxiety, while positive and neutral appraisals were not. Results are discussed in terms of a multi-stage processing model of interpretation biases.     

The indirect effect of attention bias on memory via interpretation bias: Evidence for the combined cognitive bias hypothesis in subclinical depression

Little research has investigated functional relations among attention, interpretation, and memory biases in depressed samples. The present study tested the indirect effect of attention bias on memory through interpretation bias as an intervening variable in a mixed sample of non-depressed and subclinically depressed individuals. Subclinically depressed and non-depressed individuals completed a spatial cueing task (to measure attention bias), followed by a scrambled sentences test (to measure interpretation bias), and an incidental free recall task (to measure memory bias). Bias-corrected bootstrapping yielded evidence for the hypothesised indirect effect model, in that an emotional bias in attention is related to a congruent bias in interpretative choices which are in turn reflected in memory. These findings extend previous research and provide further support for the combined cognitive bias hypothesis in depression. Theoretical and clinical implications of our findings are discussed.     

Developing a measure of interpretation bias for depressed mood: An ambiguous scenarios test

The tendency to interpret ambiguous everyday situations in a relatively negative manner (negative interpretation bias) is central to cognitive models of depression. Limited tools are available to measure this bias, either experimentally or in the clinic. This study aimed to develop a pragmatic interpretation bias measure using an ambiguous scenarios test relevant to depressed mood (the AST-D).¹ In Study 1, after a pilot phase (N = 53), the AST-D was presented via a web-based survey (N = 208). Participants imagined and rated each AST-D ambiguous scenario. As predicted, higher dysphoric mood was associated with lower pleasantness ratings (more negative bias), independent of mental imagery measures. In Study 2, self-report ratings were compared with objective ratings of participants’ imagined outcomes of the ambiguous scenarios (N = 41). Data were collected in the experimental context of a functional Magnetic Resonance Imaging scanner. Consistent with subjective bias scores, independent judges rated more sentences as negatively valenced for the high versus low dysphoric group. Overall, results suggest the potential utility of the AST-D in assessing interpretation bias associated with depressed mood.     

Experimental modification of interpretation bias in socially anxious children: Changes in interpretation, anticipated interpersonal anxiety, and social anxiety symptoms

We report on an experimental manipulation of interpretation bias in socially anxious youths. A non-clinical sample of 10–11-year-olds selected for high social anxiety was trained over three sessions to endorse benign rather than negative interpretations of potentially threatening social scenarios. This group was subsequently less likely to endorse negative interpretations of new ambiguous social situations than children in a test–retest condition. Children who received interpretation training also showed reduced trait social anxiety and reported significantly less anxiety about an anticipated interpersonal encounter, compared with the control group.     

Validation of an interpretation bias assessment for body dissatisfaction

Currently, research on interpretation bias and body dissatisfaction is limited. The few experimental paradigms that have been used to explore this phenomenon utilized a method that may not accurately capture the nature of interpretation bias as explained by cognitive theory. The present study investigated the reliability and validity of a novel computerized assessment of interpretation bias (WSAP) for body dissatisfaction, which may more accurately reflect the cognitive processing involved in such bias by implementing the Word Sentence Association Paradigm (WSAP), a previously established method of measuring interpretation bias in other clinical populations. Undergraduate females (n = 214) completed the WSAP and other measures. Results indicate initial support for the WSAP as a valid, reliable measure of interpretation bias for body dissatisfaction. Although preliminary, this study contributes to the minimal research in this area and serves as the first psychometric investigation of the WSAP to measure such interpretation bias for body dissatisfaction.     

It depends on your perspective: The role of self-relevance in stereotype-based underperformance

Much research has examined how stereotype threat leads to the underperformance of stereotyped targets. The underlying cause for this effect, however, remains unclear. Some researchers argue that stereotype threat can be explained from a behavioral-priming perspective, while others claim that it necessarily involves concerns about confirming a negative self-relevant stereotype. The current experiment highlights the critical role of self-relevance in distinguishing between stereotype priming and stereotype threat. Results showed that when participants wrote about a stereotyped target from a first-person perspective, both targets and non-targets performed poorly under stereotype threat conditions, because writing from a first-person perspective made the stereotype self-relevant for non-targets. But when participants wrote about a stereotyped target from a third-person perspective, only targets underperformed since the stereotype was already self-relevant. Moreover, when the stereotype was made self-relevant non-targets experienced the same threat-based concerns that targets experience under stereotype threat conditions.     

The effects of modifying interpretation bias on worry in generalized anxiety disorder

This study investigated whether facilitating a benign interpretive bias decreases negative thought intrusions in generalized anxiety disorder (GAD). Clients were randomly allocated to an interpretation modification condition in which they repeatedly accessed benign meanings of emotionally ambiguous homographs and scenarios, or to a control condition in which they accessed threat and benign meanings with equal frequency. Worry frequency was assessed using a breathing focus task that involved categorising the valence of thought intrusions before and after an instructed worry period. Interpretation bias was assessed during the modification tasks, and on a different measure of interpretation bias (sentence completion) following a period of worry. The experimental procedure modified interpretations made during training, and in the later sentence completion task. Furthermore, compared to the control group, the benign group showed fewer negative thought intrusions during breathing focus (as rated by both participants and an assessor). These findings show that it is possible to induce a more benign interpretive bias in GAD clients and that this reduces negative thought intrusions.     

Interpretation and judgmental biases in social phobia

Previous research demonstrated that social phobia is characterized by content-specific interpretation and judgmental biases. The present study investigated whether this interpretation bias occurs not only in ambiguous, but also in positive and negative social events, and whether social phobic patients (SPs) are more characterized by a judgmental bias in costs than in probability. Besides, we argued that the judgmental bias observed in former studies could also be attributed to accurate estimations of SPs (of, for example, stuttering). Therefore, we assessed judgmental bias by the ratings of probability and costs of a negative evaluation (e.g. ‘people dislike me’) and not, as in previous studies, of negative social events (e.g. ‘stuttering’). SPs (n=228) and normal controls (n=33) were presented social and non-social events ranging from positive to profoundly negative. They ranked four different interpretations on likelihood to assess interpretation bias, and rated the profoundly negative interpretation on probability and cost to assess judgmental bias. SPs demonstrated content-specific interpretation and judgmental biases that also occurred in positive and negative social events. In contrast with expectations, SPs were characterized by a judgmental bias in both costs and probability.     

Mindfulness and emotional distress: The role of negatively biased cognition

Mindfulness is a receptive attention to and awareness of events and experiences as they occur. A substantial body of literature supports the usefulness of mindfulness-based approaches for preventing or reducing emotional distress (e.g., depression and anxiety). However, mechanisms by which mindfulness produces these benefits are still being explored. Cognitive theories of emotional disorder implicate negatively biased cognition as a primary source of distress, and the theoretical literature on mindfulness suggests that it may reduce biased thoughts and judgments. Thus, the present research tested a mediation model in which less negatively biased cognition explains the inverse relation between mindfulness and emotional distress. Participants completed multiple standardized measures of trait mindfulness, negatively biased cognition, and emotional distress. The proposed relations between these constructs then were examined using structural equation modeling. Support was found for a partial mediation model, and possible alternative models were ruled out. These findings highlight a previously unidentified cognitive mechanism to explain the relation between mindfulness and reduced emotional distress. Specifically, mindfulness may reduce negative, maladaptive cognitive styles, which in turn may reduce predisposition to emotional disorders.     

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.     

Attention bias in youth: Associations with youth and mother's depressive symptoms moderated by emotion regulation and affective dynamics during family interactions

Recent research has highlighted the potential role of attention bias for emotional stimuli as a possible cognitive risk factor for depression in youth. However, differences in youth emotion regulation or maternal affect may moderate the association between maternal and youth depression and youth attention biases. The current study investigated the relationship between maternal and youth depressive symptoms and youth (aged 11–17 years) attention bias for sad and happy faces in 59 mother–youth dyads, examining whether positive and negative maternal affect observed during structured interaction tasks or youth emotion regulation tendencies moderated associations between maternal and youth depression and attention biases. Youth suppression interacted with maternal and youth depression to predict sad attentional biases in youth, while maternal positive affect interacted with maternal depression to predict happy attention biases in youth.     

Effect of cognitive bias modification-memory on depressive symptoms and autobiographical memory bias: two independent studies in high-ruminating and dysphoric samples

Memory bias is a risk factor for depression. In two independent studies, the efficacy of one CBM-Memory session on negative memory bias and depressive symptoms was tested in vulnerable samples. We compared positive to neutral (control) CBM-Memory trainings in highly-ruminating individuals (N?=?101) and individuals with elevated depressive symptoms (N?=?100). In both studies, participants studied positive, neutral, and negative Swahili words paired with their translations. In five study–test blocks, they were then prompted to retrieve either only the positive or neutral translations. Immediately following the training and one week later, we tested cued recall of all translations and autobiographical memory bias; and also measured mood, depressive symptoms, and rumination. Retrieval practice resulted in training-congruent recall both immediately after and one week after the training. Overall, there was no differential decrease in symptoms or difference in autobiographical memory bias between the training conditions. In the dysphoric but not in the high-ruminating sample, the positive training resulted in positive autobiographical bias only in dysphoric individuals with positive pre-existing bias.

We conclude that one session of positive retrieval-based CBM-Memory may not be enough to yield symptom change and affect autobiographical memory bias in vulnerable individuals.     

Social interpretation bias and generalized social phobia: the influence of developmental experiences

Patients with generalized social phobia (N = 42) and non-phobic community controls (N = 42) engaged in a social interaction with an experimental assistant whose behavior was used to create either a positive or an ambiguous social environment. Participants then rated their own performance and their partner's behavior. As a group, social phobic patients displayed negatively biased self-judgments, but failed to display biased social interpretations. Among the social phobia group, a social developmental history marked by parental hostility was associated with negative interpretations of partner behavior and a history of parental overprotection was associated with less sensitivity to partner behavior. The results supported cognitive models of social phobia, which implicate negative learning experiences in the development of information processing biases.     

Dispositional mindfulness moderates the relation between neuroticism and depressive symptoms

Negative emotional reactivity as measured by neuroticism has been shown to be an important risk factor for the development of depressive symptoms. This study investigated whether the ability to be mindful can protect against the negative effects of this temperamental vulnerability. An English community sample of N = 144 individuals who had completed a neuroticism questionnaire six years previously were assessed for current depressive symptoms and dispositional levels of mindfulness at points of assessment approximately one year apart. Dispositional mindfulness moderated the relation between neuroticism and current depressive symptoms: Neuroticism was significantly related to depression in those with low to medium levels of dispositional mindfulness but not in those with relatively high levels of mindfulness. Further analyzes focusing on particular mindfulness skills indicated that this effect was carried mostly by the ability to describe inner experience. The results suggest that dispositional mindfulness and particularly the ability to describe inner experience are helpful in dealing with negative emotional reactivity in a way that reduces the likelihood of depressive symptoms to develop.     

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.     

Pathways linking temperament and depressive symptoms: A short-term prospective diary study among adolescents

The current study examined mechanisms through which trait negative affectivity (NA) and effortful control (EC) prospectively predict increases in depressive symptoms in a community sample of 110 adolescents (mean age=16.40 years) in a 9-week, multi-wave diary study. We hypothesised youth with high NA and low EC would experience greater increases in depressive symptoms because they generate more maladaptive cognitive responses to stress. NA predicted greater event-specific rumination and negative cognitive style across the study period. After controlling for trait cognitive vulnerabilities, only event-specific rumination mediated the effect of NA on subsequent depressive symptoms, suggesting that high-NA youth are more likely to ruminate about stressful events, which then predicts increases in depressive symptoms. EC did not moderate the effects of NA on either depressive symptoms or cognitive responses to stress. Results are discussed in terms of vulnerability-stress models linking temperament and depressive symptoms in adolescence.     

Intimate partner violence and depressive symptoms in women: cognitive schemas as moderators and mediators

In this study the role of cognitive schemas as moderators and mediators between intimate partner violence and depressive symptoms was examined. The sample consisted of 312 women who had suffered an abusive relationship. Participants completed measures of physical, psychological and sexual abuse, maladaptive cognitive schemas (disconnection and rejection, autonomy, and other-directedness), and depression. The evidence for a moderation effect was low and mainly restricted to schemas of the impaired autonomy domain. In contrast, the results supported mediational models in which violence was associated to the cognitive schemas, and these in turn were associated to depressive symptoms. Mediation was partial, with the schemas of the disconnection and rejection domain explaining most of the association between violence and depression. Finally, several explanations for these findings are examined, and their implications for the concept and measure of the cognitive schemas are discussed.     

Negative interpretation bias as a mechanism of the relationship between rejection sensitivity and depressive symptoms

Rejection sensitivity and negative cognitive biases have been identified as important risk factors for depression. Rejection sensitivity is defined as the tendency to anxiously anticipate, easily perceive, and overreact to rejection. Although prior studies have found an association between one component of rejection sensitivity, the tendency to anxiously anticipate rejection, and depression, little is known about the mechanisms through which anxious anticipation of rejection might confer depression risk. One possibility is that rejection anticipation leads to negatively biased interpretations, a cognitive risk factor for depression. Results from two studies (one cross-sectional, one longitudinal) indicate that negative interpretation biases mediate the association between the anxious anticipation of rejection and depressive symptoms. These findings indicate that interpretation biases represent a mechanism through which anxious anticipation of rejection confers risk for depression, and suggest that interventions designed to challenge negative interpretations may help to decrease depression risk among individuals who anticipate rejection.     

A Single-Session Online Cognitive Bias Modification of Interpretations Modified for Adults With Anxiety and Depressive Symptoms

Anxiety and depression are common, co-occurring, and costly mental health disorders. Cognitive bias modification aims to modify biases to reduce associated symptoms. Few studies have targeted multiple biases associated with both anxiety and depression, and those that have lacked a control condition. This study piloted a single-session online cognitive bias modification (known as CBM-IA) designed to target two biases associated with anxiety and depression—interpretation bias and attribution style—in adults with varying levels of anxiety and depressive symptoms. Participants (18–26 years) with at least mild levels of anxiety/stress and depressive symptoms on the DASS-21 were randomly allocated to an intervention (n = 23) or a control (n = 22) condition. The training consisted of a single-session online CBM-IA to encourage positive interpretations and a positive attribution style.Interpretation bias, attribution style, anxious and depressive mood states, and anxiety, stress and depressive symptoms improved at posttraining and at follow-up, irrespective of condition. Changes in interpretation bias from pre- to posttraining were significantly associated with changes in anxious mood state. CBM-IA, as implemented in this single-session pilot study, did not significantly reduce targeted biases and symptoms compared to a control condition. This adds to the mixed evidence on the efficacy of single-session CBM-I for altering biases and symptoms.