The program you’re completing is a type of intervention called cognitive bias modification (CBM), and it is designed to help you change how you think in response to situations that make you feel anxious or upset.
What Are Cognitive Biases?
Cognitive biases are tendencies to pay attention to, remember, and interpret things differently when processing information tied to your emotional responses. For example, sometimes it can be difficult to tell whether something that happens is good or bad. Our tendency to interpret these ambiguous events as positive or negative can happen very rapidly and even without our being aware of our interpretation, so it can be difficult to catch these thinking habits — even though a tendency to routinely interpret things in negative ways can make us feel more anxious or sad. That’s where CBM might help.
Changing Cognitive Biases
CBM works by giving people lots of practice processing information in new ways to help develop healthier thinking habits. These tasks may seem repetitive, and it is not always obvious what the program is doing. However, there is growing evidence that CBM can be an effective method for reducing negative feelings, like anxiety and sadness.
Several research studies have shown that CBM is effective at changing interpretations in people with clinical levels of anxiety. Further, many studies have found that CBM leads to decreases in anxiety symptoms and/or anxious reactions to potentially stressful situations, compared to control conditions (a condition that may look like the active training but is not expected to work as well).
Participants are randomly assigned to either the active training or control conditions. At the end of the study, we can test whether the active training condition was more effective in promoting healthier thinking and emotional responses. It is normal to have some concerns about being placed in a control condition. In our study, every participant will have a chance to experience the condition that we expect to be most effective.
Studies have shown that repeated training of CBM can be especially beneficial, because it provides more opportunities to practice healthier ways of thinking than a single training session. This is why we set up multiple brief sessions of training. Similarly, studies have found that biases in how you picture things in your mind are closely connected to difficulties with anxiety, which is why the program includes exercises where participants imagine certain scenarios.
The Need for Research
Although there are many examples of CBM programs helping to reduce anxiety, and even helping other problem areas like depression, substance use (e.g., alcohol abuse), eating disorders, and anger problems (among others), there are also some mixed findings. Not all studies using these approaches get the same results, and some studies find decreases in one anxiety measure but not another. Also, more research needs to be done to find the optimal number of training sessions, and to figure out how to make CBM as effective if completed online as in the clinic or lab. Though there are still open questions, one goal of this site is to work on answering these questions in order to refine and improve this promising treatment method.
Research Papers on CBM by the MindTrails Team
Here are some of the main research papers examining CBM by our team (papers marked with ★ use MindTrails data):
- Eberle, J. W., Boukhechba, M., Sun, J., Zhang, D., Funk, D., Barnes, L., & Teachman, B. A. (2020). Shifting episodic prediction with online cognitive bias modification: A randomized controlled trial. https://doi.org/10.31234/osf.io/dg7z8 ★
- Hohensee, N., Meyer, M. J., & Teachman, B. A. (in press). The effect of confidence on dropout rate and outcomes in online cognitive bias modification. Journal of Technology in Behavioral Science. ★
- Daniel, K. E., Daros, A. R., Beltzer, M. L., Boukhechba, M., Barnes, L. E., & Teachman, B. A. (2020). How anxious are you right now? Using ecological momentary assessment to evaluate the effects of cognitive bias modification for social threat interpretations. Cognitive Therapy and Research, 44(3), 538-556.
- Edwards, C. B., Portnow, S., Namaky, N., & Teachman, B. A. (2018). Training less threatening interpretations over the Internet: Impact of priming anxious imagery and using a neutral control condition. Cognitive Therapy and Research, 42(6), 832-843.
- Beadel, J. R., Mathews, A., & Teachman, B. A. (2016). Cognitive Bias Modification to enhance resilience to a panic challenge. Cognitive Therapy and Research, 40(6), 799-812.
- Beadel, J. R., Ritchey, F. C., & Teachman, B. A. (2016). Role of fear domain match and baseline bias in interpretation training for contamination fear. Journal of Experimental Psychopathology, 7(1), 49-71.
- Steinman, S. A., & Teachman, B. A. (2015). Training less threatening interpretations over the Internet: Does the number of missing letters matter? Journal of Behavior Therapy and Experimental Psychiatry, 49, 53-60.
- Beadel, J. R., Smyth, F. L., & Teachman, B. A. (2014). Change processes during cognitive bias modification for obsessive compulsive beliefs. Cognitive Therapy and Research, 38, 103-119.
- Steinman, S. A., & Teachman, B.A. (2014). Reaching new heights: Comparing interpretation bias modification to exposure therapy for extreme height fear. Journal of Consulting and Clinical Psychology, 82, 404-417.
- Clerkin, E. M., & Teachman, B. A. (2011). Training interpretation biases among individuals with symptoms of obsessive compulsive disorder. Journal of Behavior Therapy and Experimental Psychiatry, 42, 337-343. doi:10.1016/j.jbtep.2011.01.003
- Steinman, S. A. & Teachman, B. A. (2010). Modifying interpretations among individuals high in anxiety sensitivity. Journal of Anxiety Disorders, 24, 71-78. doi:10.1016/j.janxdis.2009.08.008
- Teachman, B. A., & Addison, L. M. (2008). Training non-threatening interpretations in spider fear. Cognitive Therapy and Research, 32, 448-459. doi:10.1007/s10608-006-9084-z
Below are a few resources if you’re interested in learning more about CBM or the research supporting it:
- "Behavior change in 15-minute sessions?" – American Psychological Association
- "Therapist-free therapy" – The Economist
- "A meta-analysis of the effect of cognitive bias modification on anxiety and depression" – Psychological Bulletin
- "Cognitive bias modification for anxiety: Current evidence and future directions" – Expert Review of Neurotherapeutics
- "Role of imagery in assessing and treating emotional disorders" – Clinical Psychology Review
Early research that informed the development of MindTrails
Thank you to Andrew Mathews and Bundy Mackintosh for their seminal work developing interpretation bias training:
- Mathews, A., & Mackintosh, B. (2000). Induced emotional interpretation bias and anxiety. Journal of Abnormal Psychology, 109(4), 602.
Thank you to Emily Holmes and her team for their groundbreaking work on enhancing imagery:
- Holmes, E. A., & Mathews, A. (2005). Mental imagery and emotion: A special relationship?. Emotion, 5(4), 489. https://doi.org/10.1037/1528-3522.214.171.1249
- Holmes, E. A., Mathews, A., Mackintosh, B., & Dalgleish, T. (2008). The causal effect of mental imagery on emotion assessed using picture-word cues. Emotion, 8(3), 395. https://doi.org/10.1037/1528-35126.96.36.1995