Sex differences in interpretation bias in adolescents

Interpretation biases, in which ambiguous information is interpreted negatively, have been hypothesized to place adolescent females at greater risk of developing anxiety and mood disorders than same‐aged males. We tested the hypothesis that adolescent girls interpret ambiguous scenarios more negatively, and/or less positively, than same‐aged males using the Adolescent Interpretation and Belief Questionnaire (N = 67, 11–15 years old). We also tested whether adolescent girls and boys differed in judging positive or negative interpretations to be more believable and whether the scenario content (social vs. non‐social) affected any sex difference in interpretation bias. The results showed that girls had higher average negative interpretation scores than boys, with no sex differences in positive interpretation scores. Girls and boys did not differ on which interpretation they found to be most believable. Both sexes reported that positive interpretations were less likely to come to mind, and were less believable, for social than for non‐social scenarios. These results provide preliminary evidence for sex differences in interpretation biases in adolescence and support the hypothesis that social scenarios are a specific source of anxiety to this age group. A greater understanding of the aetiology of interpretation biases will potentially enhance sex‐ and age‐specific interventions for anxiety and mood disorders.     

Anxiety Sensitivity and Negative Interpretation Biases: Their Shared and Unique Associations with Anxiety Symptoms

Anxiety sensitivity (AS) is a psychological risk factor for anxiety disorders. Negative interpretation biases are a maladaptive form of information-processing also associated with anxiety disorders. The present study explored whether AS and negative interpretation biases make independent contributions to variance in panic and generalized anxiety symptoms and whether particular interpretation bias domains (e.g., of ambiguous arousal sensations) have specific associations with panic and/or generalized anxiety symptoms. Eighty-nine female undergraduates (44 low AS; 45 high AS) completed measures of AS, interpretation biases, and panic and generalized anxiety symptoms. Findings showed that AS and negative interpretation biases both significantly added to the prediction of anxiety symptoms. Negative interpretations of ambiguous arousal sensations were uniquely associated with panic symptoms, while negative interpretations of ambiguous general and social events were uniquely associated with generalized anxiety symptoms. Findings support the conceptual validity of AS and negative interpretation biases and their unique and shared contributions to anxiety symptoms.     

Family influences on dysfunctional thinking in anxious children

Anxious children are found to interpret ambiguous stories in a negative way. The current study attempted to examine the possible influence of parental fear and parental interpretation bias on the maintenance of such an interpretation bias. Children varying in level of anxiety (n=25) and their parents, filled in a questionnaire to measure their own fears, and gave their interpretations concerning nine ambiguous stories, relevant for childhood ‘interactional’ anxieties: social anxiety, separation anxiety, and generalized anxiety. Then, parents were asked to talk with their children about three of the stories. After the family discussion the children had to give their final interpretations. Results indicated that parents' self‐reported fear level and interpretation bias were associated with children's interpretation bias before the family discussion. However, no evidence was found for the idea that parents maintain or enhance the interpretation bias of their children. That is, irrespective of parental fear and parental interpretation bias, children interpreted the ambiguous stories as less negative after discussing them with their parents. Copyright © 2003 John Wiley & Sons, Ltd.     

Interpretations and judgments regarding positive and negative social scenarios in childhood social anxiety

The present study extended our understanding of cognitive biases in childhood social anxiety. A non-clinical sample of 11-13-year olds completed social anxiety and depression scales and were presented with scenarios depicting positive and mildly negative social events. Social anxiety was associated with tendencies to interpret positive social events in a discounting fashion, to catastrophize in response to mildly negative social events, and to anticipate more negative emotional reactions to the negative events. Implications for understanding and treating social anxiety are discussed.     

Forced choice reaction time paradigm in children with separation anxiety disorder, social phobia, and nonanxious controls

Cognitive distortions refer to cognitive processes that are biased and therefore yield dysfunctional and maladaptive products (e.g., interpretation bias). Automatic aspects of information processing need to be considered and investigating these aspects requires forms of assessment other than self-report. Studies focussing on the specificity of cognitive biases across different types of anxiety disorders in childhood are rare. Thus, a forced choice reaction time paradigm with picture stimuli was used to assess the interpretation bias in anxious children online. The study investigated disorder-specific interpretation bias in 71 children with separation anxiety disorder (SAD), 31 children with social phobia, and 42 children without mental disorders, aged 5–13 years. Results indicated that children with SAD rated ambiguous separation pictures as significantly more unpleasant and more arousing than nonanxious children. However, no support was found that children with SAD and social phobia interpret ambiguous separation or social pictures in a more negative way than nonanxious children. Furthermore, no group differences were found in reaction times to all picture categories.     

Threat interpretation bias as a vulnerability factor in childhood anxiety disorders

The present study examined threat interpretation biases in children 7-12 years of age with separation, social and generalised anxiety disorders (N=15), non-anxious offspring at risk due to parental anxiety (N=16) and non-anxious controls of non-anxious parents (N=14). Children provided interpretations of ambiguous situations to assess cognitive, emotional and behavioural responses. In comparison with non-anxious control children and at-risk children who did not differ from each other, anxious children reported stronger negative emotion and less ability to influence ambiguous situations. These results suggest that threat interpretation bias may be a cognitive factor associated with ongoing childhood anxiety but not a vulnerability factor associated with parental anxiety.     

The Relationship Between Attention,Interpretation, and Memory Bias During Facial Perception in Social Anxiety

Although cognitive theories suggest the interactive nature of information processing biases in contributing to social anxiety, most studies to date have investigated these biases in isolation. This study aimed at (a) testing the association between social anxiety and each of the threat-related cognitive biases: attention, interpretation, and memory bias; and (b) examining the relationship between these cognitive biases in facial perception. We recruited an unselected sample of 188 adult participants and measured their level of social anxiety and cognitive biases using faces displaying angry, disgusted, happy, and ambiguous versions of these expressions. All bias tasks were assessed with the same set of facial stimuli. Regression analyses showed that social anxiety symptoms significantly predicted attention avoidance and poorer sensitivity in recognizing threatening faces. Social anxiety was, however, unrelated to interpretation bias in our sample. Results of path analysis suggested that attention bias influenced memory bias indirectly through interpretation bias for angry but not disgusted faces. Our findings suggest that, regardless of social anxiety level, when individuals selectively oriented to faces displaying anger, the faces were interpreted to be more negative. This, in turn, predicted better memory for the angry faces. The results provided further empirical support for the combined cognitive bias hypothesis.     

Comorbid interpretation and expectancy bias in social anxiety and alcohol use

Background: In two studies, the present research examined whether being high in both social anxiety and alcohol use disorder symptoms is associated with a comorbid interpretation and expectancy bias that reflects their bidirectional relationship.

Design: Cross-sectional, quantitative surveys.

Methods: Measures of social anxiety and alcohol use disorder symptoms, as well as an interpretation and expectancy bias task assessing biases for social anxiety, drinking, and comorbid social anxiety and drinking.

Results: In Study 1 (N?=?447), individuals high (vs. low) in social anxiety had stronger social threat bias and individuals high (vs. low) in alcohol use disorder symptoms had stronger drinking bias. Those high in both social anxiety and alcohol use disorder symptoms endorsed interpretations and expectancies linking social interaction with alcohol use. Comorbid bias predicted membership into the high social anxiety/drinking group, even after taking into account single-disorder biases. In Study 2 (N?=?325), alcohol use disorder symptoms predicted drinking bias and social anxiety symptoms predicted social anxiety bias. Alcohol use disorder symptoms, social anxiety symptoms, and their interaction predicted comorbid interpretation and expectancy bias.

Conclusion: Results indicate unique cognitive vulnerability markers for persons with comorbid social anxiety and alcohol use disorder symptoms, which may improve detection and treatment of this serious comorbidity.     

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.     

Remembering the past and imagining the future: A role for nonvisual imagery in the everyday cognition of blind and sighted people

Past research has associated depression with memory biases pertaining to the frequency, duration, and specificity of past events. Associations have been proposed between both negative and positive memory biases and depression symptoms. However, research has not examined the occurrence of actual events over time in the study of memory bias. To address these limitations and investigate whether a negative or positive memory bias is associated with symptoms of depression, we collected weekly data on specific types of life events over a 4-year period from a sample of college students, and asked students to recall event frequency at the end of that period. Exaggerated recall of frequency for positive events but not other types of events was associated with depression symptoms, using both continuous and categorical measures. Moderator analyses indicated that these effects were evidenced primarily for memories involving the self and among individuals low in trait self-enhancement. The current study indicates that positive memory-frequency bias is an important type of memory bias associated with symptoms of depression. Results support the idea that the link between memory bias for positive event frequency and depressed mood arises out of a current-self vs past-self comparison.     

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.     

The Psychological Impact of Domestic Violence on Spanish Women1

This study examined the psychological impact of partner violence on 240 Spanish women who were identified as abused, comparing them to a control group of 240 non‐abused women. The abused women suffered more long‐lasting anxiety and insomnia, severe depression, and somatic symptomatology, and also had lower self‐esteem than did the non‐abused women. The severity of the psychological abuse was correlated positively with the severity of the physical abuse, while the number of years of abuse endured correlated with the women's age and number of children. The most relevant variable for predicting severe depression, social dysfunction, anxiety and insomnia, and somatic symptoms was low self‐esteem.     

Memory for emotional stories in high and low depressed children

Cognitive theories of depression emphasise a vicious circle linking depressed mood and biased recall towards negative information. In line with this, depressed adults show selectively enhanced recall for negative information. This recall bias is held to be mediated by increased accessibility of negative self‐referent schemas formed as a result of adverse early experiences. Given this, surprisingly few studies have examined depression‐related recall biases from a developmental perspective. Clinically depressed children have been found to show enhanced recall of negative adjectives, particularly when self‐referent, but to date there is no evidence for similar recall biases in non‐clinically depressed groups. The current study addressed this by investigating high and low non‐clinically depressed children's (aged 5–11 years) recall of emotional stories. High depressed children showed enhanced recall of negative stories, relative to positive stories, compared to the low depressed group. This did not vary with age group. We conclude that, when child‐oriented materials are used, depression‐related biases in recall towards negative information are observable even in a non‐clinical sample of children from 5 years of age.     

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.     

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.     

What Are You Really Saying? Associations between Shyness and Verbal Irony Comprehension

Verbal irony exploits the ambiguity inherent in language by using the discrepancy between a speaker's intended meaning and the literal meaning of his or her words to achieve social goals. Irony provides a window into children's developing pragmatic competence. Yet, little research exists on individual differences that may disrupt this understanding. For example, verbal irony may challenge shy children, who tend to interpret ambiguous stimuli as being threatening and who have difficulty mentalizing in social contexts. We examined whether shyness is related to the interpretation of ironic statements. Ninety‐nine children (8–12 year olds) listened to stories wherein one character made either a literal or ironic criticism or a literal or ironic compliment. Children appraised the speaker's belief and communicative intention. Shyness was assessed using self‐report measures of social anxiety symptoms and shy negative affect. Shyness was not related to children's comprehension of the counterfactual nature of ironic statements. However, shyness was related to children's ratings of speaker meanness for ironic statements. Thus, although not related to the understanding that speakers intended to communicate their true beliefs, shyness was related to children's construal of the social meaning of irony. Such subtle differences in language interpretation may underlie some of the social difficulties facing shy children. Copyright © 2012 John Wiley & Sons, Ltd.     

Biases in attention and interpretation in adolescents with varying levels of anxiety and depression

ABSTRACT

This is the first study to investigate multiple cognitive biases in adolescence simultaneously, to examine whether anxiety and depression are associated with biases in attention and interpretation, and whether these biases are able to predict unique variance in self-reported levels of anxiety and depression. A total of 681 adolescents performed a Dot Probe Task (DPT), an Emotional Visual Search Task (EVST), and an Interpretation Recognition Task. Attention and interpretation biases were significantly correlated with anxiety. Mixed results were reported with regard to depression: evidence was found for an interpretation bias, and for an attention bias as measured with the EVST but not with the DPT. Furthermore, interpretation and attention biases predicted unique variance in anxiety and depression scores. These results indicate that attention and interpretation biases are unique processes in anxiety and depression. They also suggest that anxiety and depression are partly based on similar underlying cognitive mechanisms.     

Understanding associations between negatively biased attention and depression and social anxiety: positively biased attention is key

ABSTRACT

Background and objectives: Although research supports the premise that depressed and socially anxious individuals direct attention preferentially toward negative emotional cues, little is known about how attention to positive emotional cues might modulate this negative attention bias risk process. The purpose of this study was to determine if associations between attention biases to sad and angry faces and depression and social anxiety symptoms, respectively, would be strongest in individuals who also show biased attention away from happy faces.

Methods: Young adults (N?=?151; 79% female; M?=?19.63 years) completed self-report measures of depression and social anxiety symptoms and a dot probe task to assess attention biases to happy, sad, and angry facial expressions.

Results: Attention bias to happy faces moderated associations between attention to negatively valenced faces and psychopathology symptoms. However, attention bias toward sad faces was positively and significantly related to depression symptoms only for individuals who also selectively attended toward happy faces. Similarly, attention bias toward angry faces was positively and significantly associated with social anxiety symptoms only for individuals who also selectively attended toward happy faces.

Conclusions: These findings suggest that individuals with high levels of depression or social anxiety symptoms attend preferentially to emotional stimuli across valences.     

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.     

Social phobia and interpretation of social events

It has been suggested that social phobia may be characterized by two interpretation biases. First, a tendency to interpret ambiguous social events in a negative fashion. Second, a tendency to interpret unambiguous but mildly negative social events in a catastrophic fashion. To assess this possibility, patients with generalized social phobia, equally anxious patients with another anxiety disorder, and non-patient controls were presented with ambiguous scenarios depicting social and non-social events, and with unambiguous scenarios depicting mildly negative social events. Interpretations were assessed by participants' answers to open-ended questions and by their rankings and belief ratings for experimenter-provided, alternative explanations. Compared to both control groups, patients with generalized social phobia were more likely to interpret ambiguous social events in a negative fashion and to catastrophize in response to unambiguous, mildly negative social events.