Modifying a negative interpretation bias for ambiguous social scenarios that depict the risk of rejection in women with anorexia nervosa

Background: A heightened sensitivity to social rejection might contribute towards the interpersonal difficulties and symptoms that characterise Anorexia Nervosa (AN). This paper examines the effect of Cognitive Bias Modification for Interpretation biases (CBM-I) training on a negative interpretation bias for ambiguous social scenarios that involve the risk of rejection and eating behaviour. Method: Women with AN received a single session of CBM- I training to develop a more benign interpretational style or a control condition (which included 50: 50 negative and benign resolutions). To measure participant's interpretation bias for social stimuli, a sentence completion task was used pre and post- training (a near- transfer outcome measure). A test meal was given after the training and salivary cortisol (stress) levels were measured as far- transfer outcome measures. Results: CBM-I training led to a significant reduction in a negative interpretation bias in both conditions. No effect on eating behaviour or stress was found, which may be expected as the training conditions did not significantly differ in interpretation bias change. Limitations: The control condition may have inadvertently reduced a negative interpretation bias as it involved listening to benign resolutions to ambiguous social scenarios for 50% of the trials. Conclusions: It is possible to modify a negative interpretation bias for social stimuli. To clarify the effect of CBM-I training on AN symptomatology, repeated, more intensive, and ecologically-valid training interventions may be required. This is because any change in eating behaviour may not be immediate, particularly in a population with a low body mass index and long-illness durations.