Cognitive Bias Modification for Social Anxiety: The Differential Impact of Modifying Attentional and/or Interpretation Bias

Cognitive Bias Modification (CBM) refers to the modification of cognitive biases, such as selectively attending to threatening information or interpreting information in a threatening way. CBM for attention (CBM-A) and interpretation (CBM-I) are efficacious in reducing anxiety vulnerability and anxiety symptoms. However, little research has investigated the potential synergies of these interventions. This study aimed to determine the relative efficacy of CBM-A, CBM-I, and combined CBM for reducing social anxiety symptoms and attenuating anxiety vulnerability in response to a social stressor task. Participants (N=116) were randomly allocated to receive CBM-A, CBM-I, combined CBM, or placebo. Results revealed that CBM-I reduced negative interpretation bias and social anxiety symptoms. Furthermore, CBM-I improved speech performance on a social stressor task. However, CBM-A procedures did not modify attentional biases or anxiety vulnerability. These findings support the efficacy of CBM-I for social anxiety; however, no evidence for the efficacy of CBM-A was found, nor was the combined cognitive bias hypothesis supported in this study.