Objective: Repetitive negative thinking (RNT) e.g., worry in generalized anxiety disorder (GAD) and rumination in depression, is often targeted during psychological treatments. To test the hypothesis that negative interpretation bias contributes to worry and rumination, we assessed the effects of inducing more positive interpretations in reducing RNT. Method: Volunteers diagnosed with GAD (66) or Depression (65) were randomly allocated to one of two versions of Cognitive Bias Modification (CBM-I), either with or without RNT priming prior to training), or a control condition, each involving 10 internet-delivered sessions. Outcome measures of interpretation bias, a behavioral RNT task and self-reported worry, rumination, anxiety and depression were obtained at baseline, after home-based training and at 1-month follow up (self-report questionnaires only). Results: CBM-I training, across diagnostic groups, promoted a more positive interpretation bias and led to reductions in worry, rumination, and depressive symptoms, which were maintained at follow up. Anxiety symptoms were reduced only in the GAD group at follow up. There were no differences between CBM-I versions; brief priming of RNT did not influence CBM-I effectiveness. Level of interpretation bias post training partially mediated the effects of CBM-I on follow-up questionnaire scores. Conclusions: In contrast to some recent failures to demonstrate improvements following internet-delivered CBM, we found that self-reported RNT and negative mood were reduced by CBM-I. This is consistent with a causal role for negative interpretation bias in both worry and rumination, suggesting a useful role for CBM-I within treatments for anxiety and depression.

Repetitive negative thinking (RNT; e.g. worry and rumination) is common across emotional disorders, as is the tendency to generate negative interpretations (interpretation bias).Ameliorating negative interpretations via cognitive bias modification of interpretations (CBM-I) reduces worry/rumination, and improves mood in people diagnosed with GAD or Depression.We investigated whether these findings generalize to high worry or rumination populations, irrespective of diagnosis, and whether effects are increased by enhancing emotional engagement with training with active generation of positive resolutions of ambiguity and imagery. Method: Community volunteers with excessive worry and/or rumination who were above clinical cut-off on anxiety and/or depression measures, were allocated to an active control condition (N=54), interpretation training with prior activation of RNT (CBM_RNT; N=54), or training augmented with positive outcome generation and imagery (CBM_ENH; N=53). Interpretation bias, RNT, and mood were assessed before and following 10 internet-based sessions completed within a one-month period. RNT and mood questionnaires were also completed at 1-month follow-up. Results: After training, both forms of CBM-I (vs. control) facilitated more positive interpretations and reduced negative intrusions during a worry task. At one-month follow-up, anxiety, depression, RNT, and worry in the past week were lower in the CBM-I than control conditions, but not rumination or trait worry. Compared to standard CBM-I, the augmented form facilitated more positive interpretations, reduced negative intrusions after training, and reduced trait rumination at onemonth follow-up, but it did not augment effects on trait worry, anxiety or depression. Conclusions: Interpretation bias maintains transdiagnostic RNT and internet-based CBM-I can reduce longer-term RNT.

Worry and rumination, two forms of repetitive negative thinking (RNT), are prevalent in generalized anxiety disorder (GAD) and depression. Cognitive processing biases, especially the tendency to draw negative conclusions from ambiguous information (interpretation bias), may maintain worry and rumination. Yet the relationship between interpretation bias and both forms of RNT has not been explored in clinical versus nonclinical samples. In this cross-sectional study, participants with GAD ( n = 72), depression ( n = 79), or neither disorder ( n = 71) completed two tasks assessing interpretation bias, measures of worry and rumination, and reported negative thought intrusions during a behavioral task. Interpretation bias was associated with higher levels of worry, rumination, and negative thought intrusions. Both clinical groups generated significantly more negative interpretations than healthy comparison participants. These findings link interpretation bias to worry and rumination and establish the need for research investigating the causal role of interpretation bias in maintaining RNT.

IntroductionWorry and rumination are two forms of repetitive thinking characterised by their negative content and apparently uncontrollable nature. Although worry and rumination share common features and have been conceptualised as part of a transdiagnostic repetitive negative thinking (RNT) process, it remains unclear whether they share the same underlying cognitive mechanisms. This multisession experimental study investigates the tendency to make negative interpretations regarding ambiguous information as a cognitive mechanism underlying RNT. We compare multisession cognitive bias modification for interpretations (CBM-I) with an active control condition to examine whether repeatedly training positive interpretations reduces worry and rumination in individuals with generalised anxiety disorder or depression, respectively. Further, we examine the potential modulatory effects of engaging in RNT immediately prior to CBM-I.Design, methods and analysisA community sample of individuals meeting diagnostic criteria for either generalised anxiety disorder (n=60) or current major depressive episode (n=60) will be randomly allocated to CBM-I with prior RNT, CBM-I without prior RNT (ie, standard CBM-I), or an active control (no resolution of ambiguity) condition. All conditions receive a 3-week internet-based intervention consisting of one initial session at the first study visit and nine home-based sessions of CBM-I training (or active control). We will assess and compare the effects of CBM-I with and without prior RNT on ‘near-transfer’ measures of interpretation bias closely related to the training as well as ‘far-transfer’ outcomes related to RNT and emotional distress. Impact on questionnaire measures will additionally be assessed at 1-month follow-up. Multigroup analyses will be conducted to assess the impact of CBM-I on near-transfer and far-transfer outcome measures.

Friedrich Hayek’s account of “spontaneous order” has generated increasing interest in recent decades. His argument for the superiority of the market in distributing knowledge without the need for central oversight has appealed to progressive democratic theorists, who are wary of the hubris of state planning and attracted to possibilities for self-organization, and to Foucaultians, who have long counseled political theory to cut off the King’s head. A spontaneous social order, organized by an invisible hand, would appear to dispense with arbitrary power and foster creativity and individual liberty. This article challenges this view by highlighting the centrality of submission to Hayek’s account of spontaneous order. It shows that Hayek struggles to obscure the providentialism underpinning the account of social order he derives from Adam Ferguson and the Scottish Enlightenment. Nonetheless, his own account of spontaneous order relies on faith in the workings of the market, and submission to unintelligible market forces.