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Cognitive bias modification

Cognitive bias modification (CBM) refers to procedures used in psychology that aim to directly change biases in cognitive processes, such as biased attention toward threat (vs. benign) stimuli and biased interpretation of ambiguous stimuli as threatening.[1] The procedures are designed to modify information processing via cognitive tasks that use basic learning principles and repeated practice to encourage a healthier thinking style in line with the training contingency.

An example of a cognitive bias modification for interpretation (CBM–I) paradigm utilized in MindTrails, an online program developed by anxiety researchers at the University of Virginia. The program displays a cognitive task that disambiguates a scenario to be either positively or negatively valenced (correct responses highlighted in orange).

CBM research emerged as investigators used the same techniques to assess attention bias to the manipulation of attention bias.[2] This allowed for tests of the causal relationship between cognitive biases and emotional states (e.g., does selectively attending to threatening information cause greater anxiety). Over time, CBM paradigms were developed to modify biases in other areas of information processing, including interpretation, memory, motivation (e.g., approach–avoidance behaviors), and attributional style. The early success of the procedures in inducing change in bias led researchers to see the potential benefit of CBM as an intervention for emotional and behavioral disorders. Given that the maladaptive cognitive processes implicated in models of emotional vulnerability and dysfunction are targeted by CBM, there is considerable interest in the theoretical and applied importance of the techniques. As such, many recent studies of CBM have targeted cognitive biases in people with anxiety and depressive symptoms.[3]

Research on the effectiveness of CBM in shifting attention and interpretation biases has indicated promising evidence in adult populations, though there are also some null results.[4] Additionally, CBM can reduce anxiety symptoms and stress vulnerability in some cases though these effects are more mixed. There is also some evidence of CBM’s effectiveness in depression symptomatology. Researchers have pointed to the practical benefits offered by CBM, such as scalability and ease of dissemination, potential for augmentation effects with cognitive-behavioral therapy, and cost-effectiveness.[5] Further research on CBM is needed, however, as the evidence for its long-term effects are less clear, including in children.[4]

Types edit

 
An example of a cognitive bias modification for attention (CBM-A) paradigm. A single trial is presented in which a fixation cross appears, followed by two pictures – one smoking and one neutral. This is followed by a probe to which the individual must respond.

Two common features are used in the majority of CBM methodologies.[6] First, the cognitive bias targeted for change represents a pattern of selective information processing that is known to characterize psychopathology. For example, individuals with anxiety disorders are characterized by an automatic tendency to attend toward threat, while paying less attention to neutral stimuli. Second, the cognitive bias is altered in a manner that does not involve instructing the individual to intentionally change such information-processing selectivity. Rather, change in the cognitive bias is induced by introducing a contingency designed such that successful task performance will be enhanced by adoption of a new pattern of responding.

Two of the most common types of CBM target attention and interpretation biases.[2] Another type of CBM, approach–avoidance training, targets motivation biases associated with approach and avoidance behaviors.

Attention bias modification edit

Cognitive bias modification for attention (CBM-A) or attention bias modification (ABM) cognitive tasks are typically designed to draw attention to neutral or positive stimuli, and avoid negative or threatening stimuli.[7] The cognitive tasks utilized in ABM were originally designed for the assessment of attentional bias and later adapted as training tasks.[2]

Common paradigms to manipulate visual attention include the spatial cueing task and visual search task, in addition to the visual probe task. In a typical visual probe trial, a central fixation cross is presented, followed by the brief appearance of a threat and non-threat cue, such as a face with an angry expression and a face with a neutral expression.[7] One of the cues is replaced by a probe, such as a small dot, letter or arrow. The aim is to respond as quickly as possible to identify the probe with a button-press response, for example, to indicate the letter shown or direction of the arrow presented. By having the probe occur routinely in the location where the neutral (rather than negative or threatening) face appeared, the individual learns though practice that attending to the neutral stimulus will enhance their performance on the task because they will be faster to identify the probe.

The logic guiding this training task follows from the assessment version of the task in which the probe appears equally and randomly following the neutral and threat stimuli. In this case, attention bias for threat is inferred from response times to probes.[8] If an individual has a bias to direct attention to the spatial location of the threat stimuli, this should be reflected by faster response times to probes that appear in the same location as threat cues (threat-congruent trials) than non-threat cues (threat-incongruent trials). Conversely, if an individual has a bias to direct attention away from threat stimuli, this should be reflected by slower response times to probes replacing threat than non-threat cues.

Interpretation bias modification edit

Cognitive bias modification for interpretation (CBM-I) or interpretation bias modification (IBM) involves cognitive tasks that disambiguate an otherwise ambiguous sentence, paragraph, or picture to be either positively or negatively valenced.[9] Interpretation bias tasks typically aim to increase the extent individuals interpret ambiguous situations in benign ways to encourage more flexible thinking that is less rigidly negative.

The ambiguous situations paradigm is one of the most commonly-used protocols used to manipulate interpretation bias. In this task, individuals are typically presented with short paragraphs describing an ambiguous situation.[10] The emotional resolution of the paragraph is not revealed until the end of the paragraph—for example, "You ask a friend to look over some work you have done. You wonder what he will think about what you've written. He comes back with some comments, which are all very positi_e [word fragment in italics]." The resolution often features a word fragment that the individual is asked to solve. By repeatedly practicing assigning non-threatening meanings to the ambiguous situations, the individual is thought to learn that uncertainty is more likely to be resolved in a benign, rather than negative, way. The resolution of the ambiguity is typically reinforced through a brief question following the word fragment completion that requires the individual to respond in a way that matches the situation's ending as determined by the word fragment.

To see whether the ambiguous situations paradigm is successful in modifying interpretation bias, a "recognition" task that consists of a series of ambiguous scenarios is typically used as an outcome measure.[11] In this task, the scenarios remain ambiguous even after solving the word fragment—for example, "You ask a friend to look over some work you have done. You wonder what he will think about what you've written. He comes back with some comments on a Thur_day [word fragment in italics]." In the second part of the recognition task, the titles of the ambiguous scenarios are displayed, together with four sentences per scenario that reflect different ways of understanding what occurred in the scenario that weren't actually stated. These sentences represent: a) a possible positive interpretation tied to the key emotional meaning of the scenario, b) a possible negative interpretation tied to the key emotional meaning of the scenario, c) a positive sentence that is not tied to the key emotional meaning of the scenario, and d) a negative sentence that is not tied to the key emotional meaning of the scenario. Individuals rate each sentence for its similarity in meaning to the original scenario. Higher similarity ratings for the positive (vs. negative) interpretation tied to the key emotional meaning of the scenario are thought to reflect a more positive interpretation.

Approach–avoidance training edit

Approach–avoidance training involves cognitive tasks that are designed to induce approach or avoidance behaviors towards specific stimuli. In the approach–avoidance task, a commonly used training protocol, individuals are shown images with a certain distinguishing feature on a computer screen, to which they should react as fast as possible using a joystick.[12] For example, all images tilted to the left are pulled and become larger, while all images tilted to the right are pushed away and shrink in size. This zooming effect creates the visual impression that the pictures are coming closer upon pulling of the joystick, and that they move away upon pushing it.

Training involves selectively inducing avoidance of one type of stimulus and/or approach of another—for example, training avoidance behavior to alcohol-related stimuli for individuals with an alcohol use disorder by repeatedly practicing pushing the joystick when alcohol stimuli appear (and pulling the joystick for comparison stimuli), or training approach behavior to spider stimuli for individuals with arachnophobia by repeatedly practicing pulling the joystick when spider pictures appear (and pushing the joystick for comparison stimuli).[12][13]

To see whether the training paradigm was successful in modifying approach–avoidance bias, the reaction time when participants are instructed to push away the target stimuli (e.g., alcohol or spider cues) compared to when participants are instructed to push away the comparison stimuli are contrasted, along with the analogous contrast for pulling the target vs. comparison stimuli.

Criticisms and limitations edit

One concern is whether CBM modification procedures will reliably change symptoms and achieve lasting benefits. This is not yet clear from research.[14]

A 2015 meta-analysis of 49 trials looking at outcomes for anxiety and depression casts doubt on value of CBM. The paper concluded that 'CBM may have small effects on mental health problems, but it is also possible that there are no significant clinically relevant effects.' It notes that research is hampered by small, low-quality trials and by risk of publication bias.[15]

Likewise, a recent meta-analysis[16] has found that although attention bias modification (ABM) can be used as a treatment for several primary characteristics of social anxiety disorder (SAD), the durability of treatment and inability to treat secondary symptoms has been raised as potential issues. In this meta-analysis, the authors assessed the efficacy of ABM for SAD on symptoms, reactivity to speech challenge, attentional bias (AB) toward threat, and secondary symptoms at posttraining as well as SAD symptoms at 4-month follow-up. A systematic search in bibliographical databases uncovered 15 randomized studies involving 1043 individuals that compared ABM to a control training procedure. Data were extracted independently by two raters. All analyses were conducted on intent-to-treat data. Results revealed that ABM produces a small but significant reduction in SAD symptoms (g = 0.27), reactivity to speech challenge (g = 0.46), and AB (g = 0.30). These effects were moderated by characteristics of the ABM procedure, the design of the study, and trait anxiety at baseline. However, effects on secondary symptoms (g = 0.09) and SAD symptoms at 4-month follow-up (g = 0.09) were not significant. Although there was no indication of significant publication bias, the authors identified that quality of the studies was substandard and wedged the effect sizes. From a clinical point of view, these findings imply that ABM is not yet ready for wide-scale dissemination as a treatment for SAD in routine care.

See also edit

References edit

  1. ^ Beard, C. (2011). "Cognitive bias modification for anxiety: Current evidence and future directions". Expert Review of Neurotherapeutics. 11 (2): 299–311. doi:10.1586/ern.10.194. PMC 3092585. PMID 21306216.
  2. ^ a b c Kuckertz, J. M., & Amir, N. (2017). Cognitive Bias Modification. In S. G. Hoffmann, & G. S.G. Asmundson (Eds.), The Science of Cognitive Behavioral Therapy (pp. 463-491). Academic Press.
  3. ^ MacLeod, C.; Mathews, A. (2012). "Cognitive bias modification approaches to anxiety". Annual Review of Clinical Psychology. 8: 189–217. doi:10.1146/annurev-clinpsy-032511-143052. PMID 22035241.
  4. ^ a b Jones, E. B.; Sharpe, L. (2017). "Cognitive bias modification: A review of meta-analyses". Journal of Affective Disorders. 223: 175–183. doi:10.1016/j.jad.2017.07.034. PMID 28759865.
  5. ^ Beard, C. (2011). "Cognitive bias modification for anxiety: Current evidence and future directions". Expert Review of Neurotherapeutics. 11 (2): 299–311. doi:10.1586/ern.10.194. PMC 3092585. PMID 21306216.
  6. ^ MacLeod, C. & Clarke, P. J. F. (2013). Cognitive bias modification: A new frontier in cognition and emotion research. In M.D. Robinson, E. R. Watkins, & E. Harmon-Jones, E. (Eds.). Handbook of Cognition and Emotion (pp.540-562). Guilford Press.
  7. ^ a b Linetzky, M.; Pergamin-Hight, L.; Pine, D. S.; Bar-Haim, Y. (2015). "Quantitative evaluation of the clinical efficacy of attention bias modification treatment for anxiety disorders". Depression and Anxiety. 32 (6): 383–391. doi:10.1002/da.22344. PMID 25708991. S2CID 37372374.
  8. ^ Browning, M.; Holmes, E. A.; Charles, M.; Cowen, P. J.; Harmer, C. J. (2012). "Using attentional bias modification as a cognitive vaccine against depression". Biological Psychiatry. 72 (7): 572–579. doi:10.1016/j.biopsych.2012.04.014. PMC 3504298. PMID 22579509.
  9. ^ Beard, C.; Amir, N. (2008). "A multi-session interpretation modification program: Changes in interpretation and social anxiety symptoms". Behaviour Research and Therapy. 46 (10): 1135–1141. doi:10.1016/j.brat.2008.05.012. PMC 3569034. PMID 18675400.
  10. ^ Blackwell, Simon E.; Holmes, Emily A. (2010). "Modifying interpretation and imagination in clinical depression: A single case series using cognitive bias modification". Applied Cognitive Psychology. 24 (3): 338–350. doi:10.1002/acp.1680.
  11. ^ 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 (3): 337–343. doi:10.1016/j.jbtep.2011.01.003. PMC 3086981. PMID 21371415.
  12. ^ a b Rinck, M.; Becker, E. S. (2007). "Approach and avoidance in fear of spiders". Journal of Behavior Therapy and Experimental Psychiatry. 38 (2): 105–120. doi:10.1016/j.jbtep.2006.10.001. hdl:2066/55506. PMID 17126289.
  13. ^ Wiers, R. W.; Rinck, M.; Kordts, R.; Houben, K.; Strack, F. (2010). "Retraining automatic action-tendencies to approach alcohol in hazardous drinkers". Addiction. 105 (2): 279–287. doi:10.1111/j.1360-0443.2009.02775.x. hdl:2066/90079. PMID 20078486.
  14. ^ Hertel PT, Mathews A (2011). "Cognitive Bias Modification: Past Perspectives, Current Findings, and Future Applications". Perspectives on Psychological Science: A Journal of the Association for Psychological Science. 6 (6): 521–536. doi:10.1177/1745691611421205. PMID 26168375. S2CID 1359292.
  15. ^ Cristea; Kok; Cuijpers (2015). "Efficacy of cognitive bias modification interventions in anxiety and depression: meta-analysis". The British Journal of Psychiatry. 206 (1): 7–16. doi:10.1192/bjp.bp.114.146761. PMID 25561486.
  16. ^ Heeren, A; Mogoaşe C; Philippot P; McNally RJ (2015). "Attention bias modification for social anxiety: A systematic review and meta-analysis". Clinical Psychology Review. 4 (2): 76–90. doi:10.1016/j.cpr.2015.06.001. PMID 26080314.

cognitive, bias, modification, refers, procedures, used, psychology, that, directly, change, biases, cognitive, processes, such, biased, attention, toward, threat, benign, stimuli, biased, interpretation, ambiguous, stimuli, threatening, procedures, designed, . Cognitive bias modification CBM refers to procedures used in psychology that aim to directly change biases in cognitive processes such as biased attention toward threat vs benign stimuli and biased interpretation of ambiguous stimuli as threatening 1 The procedures are designed to modify information processing via cognitive tasks that use basic learning principles and repeated practice to encourage a healthier thinking style in line with the training contingency An example of a cognitive bias modification for interpretation CBM I paradigm utilized in MindTrails an online program developed by anxiety researchers at the University of Virginia The program displays a cognitive task that disambiguates a scenario to be either positively or negatively valenced correct responses highlighted in orange CBM research emerged as investigators used the same techniques to assess attention bias to the manipulation of attention bias 2 This allowed for tests of the causal relationship between cognitive biases and emotional states e g does selectively attending to threatening information cause greater anxiety Over time CBM paradigms were developed to modify biases in other areas of information processing including interpretation memory motivation e g approach avoidance behaviors and attributional style The early success of the procedures in inducing change in bias led researchers to see the potential benefit of CBM as an intervention for emotional and behavioral disorders Given that the maladaptive cognitive processes implicated in models of emotional vulnerability and dysfunction are targeted by CBM there is considerable interest in the theoretical and applied importance of the techniques As such many recent studies of CBM have targeted cognitive biases in people with anxiety and depressive symptoms 3 Research on the effectiveness of CBM in shifting attention and interpretation biases has indicated promising evidence in adult populations though there are also some null results 4 Additionally CBM can reduce anxiety symptoms and stress vulnerability in some cases though these effects are more mixed There is also some evidence of CBM s effectiveness in depression symptomatology Researchers have pointed to the practical benefits offered by CBM such as scalability and ease of dissemination potential for augmentation effects with cognitive behavioral therapy and cost effectiveness 5 Further research on CBM is needed however as the evidence for its long term effects are less clear including in children 4 Contents 1 Types 1 1 Attention bias modification 1 2 Interpretation bias modification 1 3 Approach avoidance training 2 Criticisms and limitations 3 See also 4 ReferencesTypes edit nbsp An example of a cognitive bias modification for attention CBM A paradigm A single trial is presented in which a fixation cross appears followed by two pictures one smoking and one neutral This is followed by a probe to which the individual must respond Two common features are used in the majority of CBM methodologies 6 First the cognitive bias targeted for change represents a pattern of selective information processing that is known to characterize psychopathology For example individuals with anxiety disorders are characterized by an automatic tendency to attend toward threat while paying less attention to neutral stimuli Second the cognitive bias is altered in a manner that does not involve instructing the individual to intentionally change such information processing selectivity Rather change in the cognitive bias is induced by introducing a contingency designed such that successful task performance will be enhanced by adoption of a new pattern of responding Two of the most common types of CBM target attention and interpretation biases 2 Another type of CBM approach avoidance training targets motivation biases associated with approach and avoidance behaviors Attention bias modification edit Cognitive bias modification for attention CBM A or attention bias modification ABM cognitive tasks are typically designed to draw attention to neutral or positive stimuli and avoid negative or threatening stimuli 7 The cognitive tasks utilized in ABM were originally designed for the assessment of attentional bias and later adapted as training tasks 2 Common paradigms to manipulate visual attention include the spatial cueing task and visual search task in addition to the visual probe task In a typical visual probe trial a central fixation cross is presented followed by the brief appearance of a threat and non threat cue such as a face with an angry expression and a face with a neutral expression 7 One of the cues is replaced by a probe such as a small dot letter or arrow The aim is to respond as quickly as possible to identify the probe with a button press response for example to indicate the letter shown or direction of the arrow presented By having the probe occur routinely in the location where the neutral rather than negative or threatening face appeared the individual learns though practice that attending to the neutral stimulus will enhance their performance on the task because they will be faster to identify the probe The logic guiding this training task follows from the assessment version of the task in which the probe appears equally and randomly following the neutral and threat stimuli In this case attention bias for threat is inferred from response times to probes 8 If an individual has a bias to direct attention to the spatial location of the threat stimuli this should be reflected by faster response times to probes that appear in the same location as threat cues threat congruent trials than non threat cues threat incongruent trials Conversely if an individual has a bias to direct attention away from threat stimuli this should be reflected by slower response times to probes replacing threat than non threat cues Interpretation bias modification edit Cognitive bias modification for interpretation CBM I or interpretation bias modification IBM involves cognitive tasks that disambiguate an otherwise ambiguous sentence paragraph or picture to be either positively or negatively valenced 9 Interpretation bias tasks typically aim to increase the extent individuals interpret ambiguous situations in benign ways to encourage more flexible thinking that is less rigidly negative The ambiguous situations paradigm is one of the most commonly used protocols used to manipulate interpretation bias In this task individuals are typically presented with short paragraphs describing an ambiguous situation 10 The emotional resolution of the paragraph is not revealed until the end of the paragraph for example You ask a friend to look over some work you have done You wonder what he will think about what you ve written He comes back with some comments which are all very positi e word fragment in italics The resolution often features a word fragment that the individual is asked to solve By repeatedly practicing assigning non threatening meanings to the ambiguous situations the individual is thought to learn that uncertainty is more likely to be resolved in a benign rather than negative way The resolution of the ambiguity is typically reinforced through a brief question following the word fragment completion that requires the individual to respond in a way that matches the situation s ending as determined by the word fragment To see whether the ambiguous situations paradigm is successful in modifying interpretation bias a recognition task that consists of a series of ambiguous scenarios is typically used as an outcome measure 11 In this task the scenarios remain ambiguous even after solving the word fragment for example You ask a friend to look over some work you have done You wonder what he will think about what you ve written He comes back with some comments on a Thur day word fragment in italics In the second part of the recognition task the titles of the ambiguous scenarios are displayed together with four sentences per scenario that reflect different ways of understanding what occurred in the scenario that weren t actually stated These sentences represent a a possible positive interpretation tied to the key emotional meaning of the scenario b a possible negative interpretation tied to the key emotional meaning of the scenario c a positive sentence that is not tied to the key emotional meaning of the scenario and d a negative sentence that is not tied to the key emotional meaning of the scenario Individuals rate each sentence for its similarity in meaning to the original scenario Higher similarity ratings for the positive vs negative interpretation tied to the key emotional meaning of the scenario are thought to reflect a more positive interpretation Approach avoidance training edit Approach avoidance training involves cognitive tasks that are designed to induce approach or avoidance behaviors towards specific stimuli In the approach avoidance task a commonly used training protocol individuals are shown images with a certain distinguishing feature on a computer screen to which they should react as fast as possible using a joystick 12 For example all images tilted to the left are pulled and become larger while all images tilted to the right are pushed away and shrink in size This zooming effect creates the visual impression that the pictures are coming closer upon pulling of the joystick and that they move away upon pushing it Training involves selectively inducing avoidance of one type of stimulus and or approach of another for example training avoidance behavior to alcohol related stimuli for individuals with an alcohol use disorder by repeatedly practicing pushing the joystick when alcohol stimuli appear and pulling the joystick for comparison stimuli or training approach behavior to spider stimuli for individuals with arachnophobia by repeatedly practicing pulling the joystick when spider pictures appear and pushing the joystick for comparison stimuli 12 13 To see whether the training paradigm was successful in modifying approach avoidance bias the reaction time when participants are instructed to push away the target stimuli e g alcohol or spider cues compared to when participants are instructed to push away the comparison stimuli are contrasted along with the analogous contrast for pulling the target vs comparison stimuli Criticisms and limitations editOne concern is whether CBM modification procedures will reliably change symptoms and achieve lasting benefits This is not yet clear from research 14 A 2015 meta analysis of 49 trials looking at outcomes for anxiety and depression casts doubt on value of CBM The paper concluded that CBM may have small effects on mental health problems but it is also possible that there are no significant clinically relevant effects It notes that research is hampered by small low quality trials and by risk of publication bias 15 Likewise a recent meta analysis 16 has found that although attention bias modification ABM can be used as a treatment for several primary characteristics of social anxiety disorder SAD the durability of treatment and inability to treat secondary symptoms has been raised as potential issues In this meta analysis the authors assessed the efficacy of ABM for SAD on symptoms reactivity to speech challenge attentional bias AB toward threat and secondary symptoms at posttraining as well as SAD symptoms at 4 month follow up A systematic search in bibliographical databases uncovered 15 randomized studies involving 1043 individuals that compared ABM to a control training procedure Data were extracted independently by two raters All analyses were conducted on intent to treat data Results revealed that ABM produces a small but significant reduction in SAD symptoms g 0 27 reactivity to speech challenge g 0 46 and AB g 0 30 These effects were moderated by characteristics of the ABM procedure the design of the study and trait anxiety at baseline However effects on secondary symptoms g 0 09 and SAD symptoms at 4 month follow up g 0 09 were not significant Although there was no indication of significant publication bias the authors identified that quality of the studies was substandard and wedged the effect sizes From a clinical point of view these findings imply that ABM is not yet ready for wide scale dissemination as a treatment for SAD in routine care See also editCognitive bias mitigation Cognitive vulnerability Debiasing Unconscious bias trainingReferences edit Beard C 2011 Cognitive bias modification for anxiety Current evidence and future directions Expert Review of Neurotherapeutics 11 2 299 311 doi 10 1586 ern 10 194 PMC 3092585 PMID 21306216 a b c Kuckertz J M amp Amir N 2017 Cognitive Bias Modification In S G Hoffmann amp G S G Asmundson Eds The Science of Cognitive Behavioral Therapy pp 463 491 Academic Press MacLeod C Mathews A 2012 Cognitive bias modification approaches to anxiety Annual Review of Clinical Psychology 8 189 217 doi 10 1146 annurev clinpsy 032511 143052 PMID 22035241 a b Jones E B Sharpe L 2017 Cognitive bias modification A review of meta analyses Journal of Affective Disorders 223 175 183 doi 10 1016 j jad 2017 07 034 PMID 28759865 Beard C 2011 Cognitive bias modification for anxiety Current evidence and future directions Expert Review of Neurotherapeutics 11 2 299 311 doi 10 1586 ern 10 194 PMC 3092585 PMID 21306216 MacLeod C amp Clarke P J F 2013 Cognitive bias modification A new frontier in cognition and emotion research In M D Robinson E R Watkins amp E Harmon Jones E Eds Handbook of Cognition and Emotion pp 540 562 Guilford Press a b Linetzky M Pergamin Hight L Pine D S Bar Haim Y 2015 Quantitative evaluation of the clinical efficacy of attention bias modification treatment for anxiety disorders Depression and Anxiety 32 6 383 391 doi 10 1002 da 22344 PMID 25708991 S2CID 37372374 Browning M Holmes E A Charles M Cowen P J Harmer C J 2012 Using attentional bias modification as a cognitive vaccine against depression Biological Psychiatry 72 7 572 579 doi 10 1016 j biopsych 2012 04 014 PMC 3504298 PMID 22579509 Beard C Amir N 2008 A multi session interpretation modification program Changes in interpretation and social anxiety symptoms Behaviour Research and Therapy 46 10 1135 1141 doi 10 1016 j brat 2008 05 012 PMC 3569034 PMID 18675400 Blackwell Simon E Holmes Emily A 2010 Modifying interpretation and imagination in clinical depression A single case series using cognitive bias modification Applied Cognitive Psychology 24 3 338 350 doi 10 1002 acp 1680 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 3 337 343 doi 10 1016 j jbtep 2011 01 003 PMC 3086981 PMID 21371415 a b Rinck M Becker E S 2007 Approach and avoidance in fear of spiders Journal of Behavior Therapy and Experimental Psychiatry 38 2 105 120 doi 10 1016 j jbtep 2006 10 001 hdl 2066 55506 PMID 17126289 Wiers R W Rinck M Kordts R Houben K Strack F 2010 Retraining automatic action tendencies to approach alcohol in hazardous drinkers Addiction 105 2 279 287 doi 10 1111 j 1360 0443 2009 02775 x hdl 2066 90079 PMID 20078486 Hertel PT Mathews A 2011 Cognitive Bias Modification Past Perspectives Current Findings and Future Applications Perspectives on Psychological Science A Journal of the Association for Psychological Science 6 6 521 536 doi 10 1177 1745691611421205 PMID 26168375 S2CID 1359292 Cristea Kok Cuijpers 2015 Efficacy of cognitive bias modification interventions in anxiety and depression meta analysis The British Journal of Psychiatry 206 1 7 16 doi 10 1192 bjp bp 114 146761 PMID 25561486 Heeren A Mogoase C Philippot P McNally RJ 2015 Attention bias modification for social anxiety A systematic review and meta analysis Clinical Psychology Review 4 2 76 90 doi 10 1016 j cpr 2015 06 001 PMID 26080314 Retrieved from https en wikipedia org w index php title Cognitive bias modification amp oldid 1208841254, wikipedia, wiki, book, books, library,

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