Identifying Predictors of Symptom and Cognitive Change Following a Single Session of Cognitive Bias Modification of Interpretations

Abstract Background The present study represents the first attempt to identify potential psychological predictors of change in interpretation bias and state worry following a single session of cognitive bias modification of interpretations (CBM-I), which is a computerised training to modify interpretation bias, using two samples of worry-prone young adults. Methods High worriers with a history of anxiety and/or depression (Study 1; N = 83) and worry-prone individuals (Study 2; N = 146) completed a single session of CBM-I training. Pre-training, they completed a battery of self-report measures and tasks that assessed key moderators of CBM responses: attentional control, cognitive flexibility, sensitivity to reward, and imagery ability. Levels of interpretation bias and state worry were also assessed pre and post training to index CBM-related changes. Results In study 1 a greater ability to imagine positive events and lower levels of cognitive flexibility at baseline were associated with a greater increase in positive interpretation bias. Lower levels of cognitive flexibility pre training were associated with greater reduction in state worry post training. In study 2 higher levels of cognitive flexibility and lower levels of responses to positive affect at baseline had greater increase in positive interpretation bias, but not reductions in worry post training. Conclusions In both studies, attentional control was not a significant predictor of change in interpretation bias or state worry following a single session of CBM-I training. There were differences in the role of cognitive flexibility, emotion-focused rumination and positive mental imagery in the two samples. Given non-replications, individual differences that predict change in near and far transfer outcomes require further research. Nevertheless, the present findings provide insights to improve the outcome of CBM-I. For instance, incorporating a longer imagery training or cognitive flexibility training may be helpful.