Cognitive bias modification of interpretation for social anxiety: A “bottom-up” intervention?
2018, 26 (5):
Cognitive models of social anxiety propose that socially anxious individuals tend to interpret ambiguous social events differently than healthy controls, embodying the presence of a negative interpretation bias and a lack of positive interpretation bias. This interpretation bias has been considered to play an important role in the etiology, maintenance, and recurrence of the disease. Many studies suggest that interpretation bias, as well as negative affect, can be directly shifted through repeated experiential practice, known as Cognitive Bias Modification of Interpretation (CBM-I). This has led to a growing interest in exploring the clinical potential of this “bottom-up” intervention. However, there has been some controversy about the heterogeneity of studies and the uncertainty about the cognitive mechanisms of this approach in the recent decade. The present article summarizes the frequently-used paradigms and reviews studies in terms of participants’ age and clinical status. Moreover, it focuses on discussing the potential cognitive mechanisms of CBM-I. An intervention model for the underlying mechanisms is proposed based on established cognitive models of social anxiety disorder and relevant factors (self-imagery, self-esteem, evaluation of threatening messages, fear of positive evaluation, long-term memory, anxiety sensitivity, and avoidance). Limitations of the studies reviewed are analyzed from five aspects: interpretation bias, social anxiety, transfer effect, experimental design and study heterogeneity. Directions for future research are addressed as well.
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