Who Benefits from Anxiety-Related Interpretation Bias Training? The Role of Individual Differences in Interpretation Inflexibility and Intolerance of Uncertainty

• A single session CBM-I training successfully altered interpretations and emotions. • Negative interpretation inflexibility predicted bias change after positive CBM-I. • Intolerance of uncertainty predicted bias change after positive CBM-I. • The predicted change in interpretations translated into change in anxious emotions. While anxiety-related cognitive bias modification for interpretations (CBM-I) is generally effective in reducing negative interpretation bias and anxiety, individuals differ in the extent to which they benefit from CBM-I. This proof-of-concept study investigated whether interpretation inflexibility and intolerance of uncertainty account for variability in CBM-I’s effects on interpretations. Participants ( N = 274), primarily female students, completed either a positive or a negative online single-session CBM-I training. Interpretation inflexibility and intolerance of uncertainty were measured before training. Interpretations and mood state were measured before and after training. For the positive CBM-I training, higher negative interpretation inflexibility (i.e., reluctance to revise negative interpretations based on positive information) and higher intolerance of uncertainty predicted smaller reductions in negative interpretations. Changes in negative interpretations mediated the relation between these predictors and changes in anxious emotions. These findings offer new insights into the role of intolerance of uncertainty and negative interpretation inflexibility as predictors of CBM-I outcomes and highlight the potential of personalized approaches that match CBM-I training to the specific needs of individuals with anxiety.