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.     

Am I blue? Depressed mood and the consequences of self-focus for the interpretation and recall of ambiguous words

In two experiments, dysphoric and nondysphoric students first concentrated on either self-focused or other-focused phrases and then performed an ostensibly unrelated task involving the interpretation of homographs with both personal and impersonal meanings. In Experiment 1, they constructed sentences for the homographs; dysphoric students' sentences were more emotionally negative (although not more personal) in the self-focused condition than in the other-focused condition. In Experiment 2, they freely associated to the homographs, and the percentage of personal meanings reflected by the associations revealed an effect of self versus other focus that depended on mood group. Following free associations, they attempted to recall the homographs. Dysphoric students (but not nondysphoric students) recalled a greater percentage of personally interpreted homographs if they had focused on self than if they had focused on other matters. In general, these results suggest that ruminative or self-focused thinking by people in depressed moods transfers to novel ambiguous situations, encouraging more negative interpretations and better recall of personal interpretations.     

Interpretation bias and social anxiety: does interpretation bias mediate the relationship between trait social anxiety and state anxiety responses?

Two studies aimed to examine whether high socially anxious individuals are more likely to negatively interpret ambiguous social scenarios and facial expressions compared to low socially anxious individuals. We also examined whether interpretation bias serves as a mediator of the relationship between trait social anxiety and state anxiety responses, in particular current state anxiety, bodily sensations, and perceived probability and cost of negative evaluation pertaining to a speech task. Study 1 used ambiguous social scenarios and Study 2 used ambiguous facial expressions as stimuli to objectively assess interpretation bias. Undergraduate students with high and low social anxiety completed measures of state anxiety responses at three time points: baseline, after the interpretation bias task, and after the preparation for an impromptu speech. Results showed that high socially anxious individuals were more likely to endorse threat interpretations for ambiguous social scenarios and to interpret ambiguous faces as negative than low socially anxious individuals. Furthermore, negative interpretations mediated the relationship between trait social anxiety and perceived probability of negative evaluation pertaining to the speech task in Study 1 but not Study 2. The present studies provide new insight into the role of interpretation bias in social anxiety.     

Threat-based cognitive biases in anxious children: comparison with non-anxious children before and after cognitive behavioural treatment

Attention and interpretation biases for threat stimuli were assessed in 19 anxious (ANX) children before and after cognitive behavioural therapy (CBT), and compared with responses from 19 non-anxious (NA) control children collected over the same period. Attentional bias was assessed using a picture version of the visual probe task with threat, neutral and pleasant pictures. Threat interpretation bias was assessed using both a homographs task in which children used homograph words in a sentence and their neutral or threatening meaning was assessed, and a stories task in which children rated their negative emotion, danger judgments, and influencing ability in ambiguous situations. ANX children showed attention biases towards threat on the visual probe task and threat interpretation biases on the stories task but not the homographs task at pre-treatment in comparison with NA children. Following treatment, ANX children's threat interpretation biases as assessed on the stories task reduced significantly to within levels comparable to NA children. However, ANX children continued to show larger attentional biases towards threat than pleasant pictures on the visual probe task at post-treatment, whereas NA children did not show attentional biases. Moreover, a residual threat interpretation style on the stories task at post-treatment was associated with higher anxiety symptoms in both ANX and NA children.     

Anxiety and the interpretation of ambiguous information: beyond the emotion-congruent effect

The authors investigated how anxiety influences the use of contextual information in the resolution of ambiguity. Participants heard ambiguous homophones (threat/neutral, positive/neural, and neutral/neutral) with related contextual information. State anxiety was manipulated experimentally. The interpretations of anxious participants were influenced by context to a greater extent than those of control participants. Some mood-incongruent effects were observed where anxious participants were more likely to adopt neutral interpretations of potentially threatening stimuli. Effects were observed in a spelling task (Experiments 1 and 2) and in a lexical decision task (Experiment 3), with supraliminal, and subliminal presentation of contextual cues, and with 2 different anxiety-induction procedures. Results show how anxiety affects both the content and the process of resolution of ambiguity.     

The impact of mothers' trait anxiety on their expectations of approach‐avoidance behaviour in anxious and non‐anxious children

This study investigated estimates of approach and avoidance behaviour in clinically anxious and non‐anxious children, and whether mothers' expectations of their children's avoidance differed as a function of high trait anxiety (HTA) versus low trait anxiety (LTA). Participants were 62 clinically anxious and 60 non‐anxious children aged 7–12 years and their mothers. Estimates of avoidance were obtained using an analogue task in which children and mothers were given threat and pleasant information about two novel animals and were asked to estimate children's avoidance of the threat animal's habitat when the threat animal was present (threat condition) and absent (safe condition) from the habitat and when its presence was uncertain (ambiguous condition). Contrary to expectation, anxious children did not differ from controls in estimates of avoidance in any condition. However, relative to HTA mothers of anxious children and LTA mothers of non‐anxious children, HTA mothers estimated greater approach behaviour by their non‐anxious children in the threat condition. Findings suggest that mothers' expectations of children's approach‐avoidance behaviour is influenced by both maternal and child factors.     

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.     

Interpretive cues and ambiguity in generalized anxiety disorder

The current study investigated whether generalized anxiety disorder (GAD) individuals rely on antecedent information to interpret ambiguity and whether reliance on such preceding cues persists in the absence of potential threat. Twenty-six GAD and 23 nonanxious control college students performed a lexical decision task, using homographs (i.e. words with multiple meanings) as ambiguous primes. In half the trials, a homograph prime that possessed both threat-related, as well as neutral meanings was followed by a target word related to one of these two meanings. In addition, each ambiguous prime was immediately preceded by a series of four antecedent words that were either: (a) associated with the threatening meaning of the prime; (b) associated with the neutral meaning of the prime; or (c) unrelated to either meaning of the homograph, as well as the target. Homographs for which both meanings were neutral in valence comprised the other half of the trials. Effect size statistics suggest that GAD participants utilized the antecedent words to interpret the homograph primes with threat-related meanings, unlike their nonanxious counterparts (p<0.06). When both meanings of the homograph prime were neutral in valence, the GAD group appeared deficient in the use of preceding information to interpret the ambiguous prime.     

Facilitating a benign interpretation bias in a high socially anxious population

Previous research has shown that high socially anxious individuals lack the benign interpretation bias present in people without social anxiety. The tendency of high socially anxious people to generate more negative interpretations may lead to anticipated anxiety about future social situations. If so, developing a more benign interpretation bias could lead to a reduction in this anxiety. The current study showed that a benign interpretation bias could be facilitated (or 'trained') in a high socially anxious population. Participants in the benign training groups had repeated practice in accessing benign (positive or non-negative) interpretations of potentially threatening social scenarios. Participants in the control condition were presented with the same social scenarios but without their outcomes being specified. In a later recognition task, participants who received benign interpretation training generated more benign, and less negative, interpretations of new ambiguous social situations compared to the control group. Participants who received benign training also predicted that they would be significantly less anxious in a future social situation than those in the control group. Possible implications of the findings for therapeutic interventions in social phobia are discussed.     

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.     

Effects of training on interpretation of emotional ambiguity

In four experiments we investigated whether interpretative biases found in anxious patients and high-trait anxious individuals can be induced by training in unselected volunteers. Repeated exposure to emotionally valenced (threatening) meanings of homographs during training was followed by relatively faster resolution of word fragments and faster lexical decisions for targets that matched the trained valence. Similar effects were found whether participants generated the meanings themselves, or verified a particular meaning of the homograph. Finally, comparison with a baseline condition confirmed that systematic exposure to threatening-but not non-threatening-resolutions of ambiguous words led to generally faster access times for congruent meanings, thus resembling the interpretative bias seen in anxiety states.     

Recollection is impaired by the modification of interpretation bias

The interpretation paradigm of cognitive-bias modification (CBM-I) was modified with instructions used in process-dissociation procedures for the purpose of investigating processes contributing to performance on the transfer task. In Experiment 1, nonanxious students were trained to interpret ambiguous situations in either a negative or benign way (or they read nonambiguous scenarios). They were then asked to respond to new ambiguous situations, in the same way as contextually similar analogues during training, or to respond differently. Benign training proactively impaired memory for negative outcomes. This effect was replicated by anxious students in Experiment 2 and discussed with respect to the assumptions underlying process-dissociation procedures and directions for future research.     

A multi-session interpretation modification program: changes in interpretation and social anxiety symptoms

Previous research suggests that socially anxious individuals interpret ambiguous social information in a more threatening manner compared to non-anxious individuals. Recently, studies have experimentally modified interpretation and shown that this subsequently affected anxiety in non-anxious individuals. If similar procedures can modify interpretation biases in socially anxious individuals, they may lead to a reduction in social anxiety symptoms. In the current study, we examined the effect of a computerized Interpretation Modification Program (IMP) on interpretation bias and social anxiety symptoms. Twenty-seven socially anxious individuals were randomly assigned to the IMP or a control condition. Participants completed eight computer sessions over four weeks. The IMP modified interpretation by providing positive feedback when participants made benign interpretations and negative feedback in response to threat interpretations. The IMP successfully decreased threat interpretations, increased benign interpretations, and decreased social anxiety symptoms compared to the control condition. Moreover, changes in benign interpretation mediated IMP's effect on social anxiety. This initial trial suggests that interpretation modification may have clinical utility when applied as a multi-session intervention.     

Experienced disgust causes a negative interpretation bias: a causal role for disgust in anxious psychopathology

This paper reports the results of an experiment investigating the effect of induced disgust on interpretational bias using the homophone spelling task. Four groups of participants experienced a disgust, anxiety, happy or neutral mood induction and then completed the homophone spelling task which requires the participant to interpret ambiguous words presented through headphones. Both the disgust and anxiety groups interpreted significantly more threat/neutral homophones as threat than both the happy and neutral groups; the disgust group also interpreted significantly fewer positive/neutral homophones as positive than the happy group. These findings are consistent with the view that induced disgust causes a negative interpretational bias which is similar to that reported for anxiety. The results could not be interpreted in terms of the disgust induction concurrently raising levels of self-reported anxiety, but could be interpreted in terms of disgust maintaining existing levels of anxiety. The effect of disgust was to facilitate negative interpretations rather than emotional interpretations regardless of valence. These findings provide the basis for a causal role for disgust in anxious psychopathology. Because the effect is a non-specific emotion-congruent one, elevated disgust levels will result in a predisposition to interpret information in a threatening way across a broad range of anxious- and threat-relevant domains.     

Processing novel compounds: Evidence for interactive meaning activation of ambiguous nouns

In three experiments, the meaning activation of ambiguous nouns in novel nominal compounds was investigated. Ambiguous nouns were unbalanced homographs occurring as the second members of the compound. Meaningful interpretations of the compounds were based on either the dominant or the subordinate meaning of the ambiguous noun. In Experiment 1, visually presented novel compounds serving as primes were followed at varying intervals by targets associatively related to distinct meanings of the ambiguous noun. In a lexical decision task, facilitation effects were found only for targets related to the meaning that was relevant for the interpretation of the compound. Experiment 2 showed that interactive activation could not be attributed to differences in semantic relatedness between the first members of compounds and targets. Experiment 3 demonstrated equal intralexical relatedness between members for both types of compounds. It is proposed that interactive activation may facilitate the interpretation of the novel compound. Compatible meaning aspects of the nouns may become more strongly activated, and incompatible meaning aspects may not become activated. The selection of meaning aspects relevant for interpretation would thereby be simplified.     

Family enhancement of cognitive style in anxious and aggressive children

Previous research has shown that anxious adults provide more threat interpretations of ambiguous stimuli than other clinic and nonclinic persons. We were interested in investigating if the same bias occurs in anxious children and how family processes impact on these children's interpretations of ambiguity. Anxious, oppositional, and nonclinical children and their parents were asked separately to interpret and provide plans of action to ambiguous scenarios. Afterwards, Each family was asked to discuss two of these situations as a family and for the child to provide a final response. The results showed that anxious and oppositional children were both more likely to interpret ambiguous scenarios in a threatening manner. However, the two clinic groups differed in that the anxious children predominantly chose avoidant solutions whereas the oppositional children chose aggressive solutions. After family discussions, both the anxious children's avoidant plans of action and the oppositional children's aggressive plans increased. Thus, this study provides the first evidence of family enhancement of avoidant and aggressive responses in children. These results support a model of anxiety that emphasizes the development of an anxious cognitive style in the context of anxiety-supporting family processes.This research was supported by grants from The National Health and Medical Research Council of Australia, The University of Queensland, and The Myer Foundation of Australia. The authors would like to thank the families, all the anxiety project staff, and Candi Peterson for her helpful feedback in the draft of this paper.     

BRIEF REPORT Interpretation of death‐relevant ambiguous stimuli as a function of death threat

According to G.A. Kelly's (1955) Personal Construct Theory, people are threatened by personal death to the extent that their conceptions of death are inconsistent with their conceptions of their present selves. As an individual difference factor, death threat predicts how people respond to death‐relevant situations and stimuli. To test the hypothesis that high death‐threat (relative to low death‐threat) persons will engage in greater denial when assigning meaning to ambiguous stimuli, college students viewed inkblots and chose between a nondeath‐relevant interpretation and a death‐relevant interpretation. As hypothesised, high death‐threat participants endorsed fewer death‐relevant interpretations than did low death‐threat participants. Self‐reported conscious fear of death did not predict this avoidance. Results are discussed in the light of historical and current work on psychological responses to death.     

In the Face of Uncertainty: A Twin Study of Ambiguous Information,Anxiety and Depression in Children

Anxiety and depression share genetic influences, and have been associated with similar cognitive biases. Psychological theories of anxiety and depression highlight threat interpretations of ambiguity. Little is known about whether genes influence cognitive style, or its links to symptoms. We assessed ambiguous word and scenario interpretations, anxiety and depression symptoms in 300 8-year-old twin pairs. There were significant correlations between both negative interpretations of ambiguous words and scenarios and depression symptoms after controlling for anxiety symptoms (r = .13 and .31, respectively), but no significant correlations with anxiety independent of depression. Genetic effects ranged from 16% for depression to 30% for ambiguous word interpretations. Non-shared environmental influences were large (68–70%). Both genetic and environmental influences contributed to the association between depression and ambiguous scenario interpretations. These findings support psychological theories, which emphasise the role of environmental stress both on the development of threat interpretations and on their links with symptoms. The data also support a role for genetic influence on threat interpretations, which may mediate responses to stress.     

Selective attention to threat in the dot probe paradigm: differentiating vigilance and difficulty to disengage

The dot probe task [J Abnorm Psychol 95 (1986) 15] is an often-used paradigm to investigate selective attention to threat. A facilitated response to probes that appear at the same location of threat information in comparison with responses to probes at the opposite location of threat information is interpreted as vigilance for threat. We argue that the findings in the dot probe paradigm are ambiguous evidence for the vigilance to threat hypothesis. Results can also be interpreted as a difficulty to disengage from threat. In this study, 44 undergraduates performed a pictorial version of the probe detection task. Taking into account the reaction times on neutral trials, we found no evidence for a facilitated detection of threatening information. It was found that the dot probe effects are at least partially due to disengagement effects. The implications of these results for the understanding of attentional bias in normal and anxious individuals are discussed.     

Training self‐assessment and task‐selection skills to foster self‐regulated learning: Do trained skills transfer across domains?

Students' ability to accurately self‐assess their performance and select a suitable subsequent learning task in response is imperative for effective self‐regulated learning. Video modeling examples have proven effective for training self‐assessment and task‐selection skills, and—importantly—such training fostered self‐regulated learning outcomes. It is unclear, however, whether trained skills would transfer across domains. We investigated whether skills acquired from training with either a specific, algorithmic task‐selection rule or a more general heuristic task‐selection rule in biology would transfer to self‐regulated learning in math. A manipulation check performed after the training confirmed that both algorithmic and heuristic training improved task‐selection skills on the biology problems compared with the control condition. However, we found no evidence that students subsequently applied the acquired skills during self‐regulated learning in math. Future research should investigate how to support transfer of task‐selection skills across domains.