Utilising cognitive bias modification to remedy appearance and self-worth biases in eating disorder psychopathology: A systematic review

Abstract

Background and Objectives: This study systematically reviewed the impact of Cognitive Bias Modification (CBM) on biases related to attention (CBM-A) and interpretation (CBM-I) for appearance and self-worth stimuli and the subsequent impact on eating disorder (ED) psychopathology. Method: The current review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), with 12 studies meeting inclusion criteria (CBM-A n = 5; CBM-I n = 7). Results: The literature provides preliminary support for CBM-A and CBM-I efficacy in eliciting bias change in varying degrees of psychopathology (Cohen's d ranging between-1.67 and 1.34; 9 studies reflected improved bias, and 3 reflected no change or did not assess), while highlighting the less robust effects associated with improving ED psychopathology (d ranging between-1.30 and .61; 5 studies reflected symptom improvement, and 7 reflected no change or did not assess). Limitations: The review only considered peer reviewed research and did not report on the findings of unpublished data; thus, the current findings may not provide an accurate representation of CBM in EDs. Conclusions: The current findings highlight the potential of CBM as an adjunct intervention for EDs; however the limited number of investigations and high degree of heterogeneity across the included studies impedes on the generalisability of the findings.

Biased cognition in East Asian and Western cultures

“…Westerners may reap some degree of cognitive benefit by residing in East Asian cultures, while East Asian migrants may experience some potentially detrimental effects. A natural extension of the current work, once replication has confirmed these findings, would be to examine whether recent innovations involving modification of cognitive biases [51], [52] could be adapted to protect East Asian migrants to the West and improve resilience in Westerners.…”

Interpretation bias modification to reduce body dissatisfaction – a randomized controlled pilot study in women with elevated weight and shape concerns

“…Cognitive bias modification (CBM) training provides an easily accessible tool for this purpose. CBM paradigms targeting interpretation bias (CBM-I) foster positive (i.e., unbiased, balanced, or self-serving) interpretations of ambiguous information [18,19]. Despite mixed results in meta-analyses [20,21], CBM-I has shown potential to reduce psychopathology [22].…”

“…Despite mixed results in meta-analyses [20,21], CBM-I has shown potential to reduce psychopathology [22]. So far, seven studies have examined CBM-I in the domain of body image/ eating disorders (for review see [19]), of which four studies investigated appearance-based CBM-I approaches [23][24][25][26][27]. The latter showed significant positive effects on negative interpretation biases as well as corresponding symptomatology, i.e.…”

“…body dissatisfaction, body image disturbance (in terms of body size overestimation) and eating disorder pathology. Effect sizes were moderate to large (for details see [19]), which is notable given that the studies varied in 1) the examined sample, 2) the number of training sessions, and 3) the nature of the intervention/ task. However, to what degree the training paradigms that were used actually address implicit/ automatic processes may be questioned.…”

Internet‐based interpretation bias modification for body dissatisfaction: A three‐armed randomized controlled trial

“…Recent studies have explored the effects of CBM‐I in BDD (Premo, Sarfan, & Clerkin, 2016; Summers & Cougle, 2016) and ED (see Matheson, Wade, & Yiend, 2019, for a review). For instance, Summers and Cougle (2018) demonstrated that a four‐session in‐lab CBM‐I program reduced overall symptoms, but not drive for thinness, in individuals with bulimic symptoms.…”