How to Boost Positive Interpretations? A Meta-Analysis of the Effectiveness of Cognitive Bias Modification for Interpretation

Abstract

The current meta-analysis explores the strength of effects of cognitive bias modification training for interpretation bias (CBM-I) on positive (i.e., adaptive) interpretations and mood as well as the training and sample characteristics influencing these effects. Data-bases were searched with the key words “interpret* bias AND training” and “interpret* bias AND modif*”. Reference lists of identified articles were checked and authors of identified articles were contacted for further relevant articles and unpublished data. Studies were reviewed for inclusion with eligibility criteria being that the study (a) aimed to target interpretation biases through any kind of training, (b) assessed mood and/or interpretation bias as outcome measures, (c) allocated individuals to training conditions at random, and (d) recruited adult samples. A meta-analytic multilevel mixed-effects model was employed to assess standardized mean changes in interpretation bias, negative mood, and emotional reactivity. In addition, several training and sample characteristics were explored for their potential to enhance benign training effectiveness. On average, benign CBM-I resulted in an increase in positive interpretation bias (p<.01) and a decrease in negative mood state (p<.001), but did not affect emotional reactivity. These effects were not consistently different from control conditions with no or neutral training. However, within benign training conditions imagery instructions and more training sessions were related to larger cognitive and mood effects, whereas feedback about training performance and inclusion of non-benign training items (instead of including benign items only) boosted cognitive effects only. Finally, training was more effective in women (cognitive and mood effects) and presumably samples with symptomatic emotional dysregulation (cognitive effects). Although the effects of emotional dysregulation and number of training sessions could not well be distinguished, there is an indication that when used with imagery instructions and more training sessions, benign CBM-I can be employed as a useful complementary treatment to usual psychotherapies.

Modifying Obsessive-Compulsive Beliefs about Controlling One’s Thoughts

“…Firstly, no study to date has investigated the isolated effects of CBM-I for OCD over multiple sessions of training. Several studies have demonstrated that CBM-I can reliably alter individuals' interpretive bias, however more than one session of CBM training will likely be required for significant changes on downstream measures of psychopathology to be observed (MacLeod et al 2009;Menne-Lothmann et al 2014). Additionally, no study investigating the isolated effects of CBM-I for OCD has employed the training in a nonlaboratory setting.…”

“…Expert commentators have suggested that conducting training in more naturalistic contexts may augment the impact of CBM (MacLeod and Mathews 2012). Thirdly, studies with follow-up measures several days or weeks after training are necessary to allow participants time to consolidate and implement their new learning (Clerkin and Teachman 2011;Menne-Lothmann et al 2014).…”

Feeling happy when feeling down: The effectiveness of positive mental imagery in dysphoria

“…Similarly, our findings could be relevant in the context of cognitive bias modification where the aim is to override habitual ways of processing of emotional information. For example, a recent meta-analysis on the effectiveness of cognitive bias modification procedures to train towards a benign interpretation bias shows that the use of imagery was related to larger cognitive and emotional effects [36].…”

Modificación de Sesgos Cognitivos (MSC) en depresión: Una revisión crítica de nuevos procedimientos para el cambio de sesgos cognitivos

“…Por ejemplo, en el caso de la MSC-I en trastornos emocionales, el meta-análisis de Menne-Lothmann et al (2014) indica que el procedimiento es efectivo para reducir tanto sesgos como sintomatología y que los resultados son mejores para las mujeres. Asimismo, algunos estudios concluyen que la MSC es más eficaz en personas con depresión leve (Baert, De Raedt, Schacht y Koster, 2010;Yiend et al, 2014).…”

“…Dado que en la mejora del aprendizaje humano es esencial proporcionar feedback sobre las respuestas del individuo (Hays, Kornell y Bjork, 2010), los procedimientos de entrenamiento deberían incluir en la medida de lo posible feedback sobre el rendimiento del participante en tiempo real. Esto no ocurre en la mayor parte de los estudios de entrenamiento a pesar de que la evidencia existente sugiere que este factor potencia la reducción de los sesgos cognitivos, aunque quizás no sea tan relevante para la mejora del estado emocional (Menne-Lothmann et al, 2014). Otro aspecto que todavía queda por esclarecer es si es conveniente que el individuo conozca la contingencia del entrenamiento.…”