Lecture 9 - Cognitive Bias Modification

Question 1

selective biases in cognitive processing in the emotional disorders

Answer 1

selective information processing biases lead to the development and maintenance of psychopathology
strongest evidence for depression and anxiety disorders (Beck & CLark, 1997, Williams et al, 1988, 1997)

Question 2

patterns of selective information processing biases in anxiety

Answer 2

negative interpretation of ambiguous information
attentional bias that favours threateneing stimuli
associated with a very early neural signal to threat
improved implicit memory for threatening information and less clear evidence of explicit memory bias

Question 3

processing biases for depression

Answer 3

enhanced explicit memory for negative information
greater retrieval of OGM
maintained attention to negative material and reduced inhibitory control at later stages of information processing
interpretation biases - eg extreme thinking

Question 4

problems with research in this area

Answer 4

largely characterised by cross-sectional designs that can no determine whether the cognitive bias plays a causal role in the development of emotional dysfunction
other studies examine whether cognitive bias preced and predicts negative emotional reactions to subsequent stressful events - VULNERABILITY hypothesis

Question 5

problems with vulnerability approach

Answer 5

possible that early measure of bias and later emotional reactivity due to a third variable that is stable across time
eg - attentional bias associated with initial mild dysphoria predicts dysphoric mood 7 weeks larer in those who experience a life stressor (Beevers & Carver, 2003)

Question 6

explain what cognitive bias modification is

Answer 6

involves directly manipulating cognitive bias and therefore providing more direct evidence for causailty
have participant repeadely experience an experimentally established contingency during performance of a simple task designed to encourage the acquisition of the positive targeted change in selective processing bias

Question 7

two steps in designing a cognitive bias modification

Answer 7

target clinical bias that is a core feature of a psychological disorder or personality trait associated with clinical dysfunction
maniplate target congitive bias by repeated practice on a task designed to facilitat a positive congitive change

Question 8

explain an example cognitive bias procedure to induce bias in selective interpretation

Answer 8

present people with a series of ambigous scenarios that they must repeatedly and consistently resolve in either a negative or positive manner to effectively resolve an incomplete word fragment that follow each passage

Question 9

results of cognitive bias modification procedure

Answer 9

induces a new interpretation bias which then generalizes to new ambiguous scenarios (mathew and Mackintosh, 2000) and lasts for several days (Yiend, Mackintosh and Mathews, 2000)
inducing a decrease in negative interpretation bias results in attenuated state anxiety reactions to a subsequent later stressor

Question 10

potential benefits of cognitive bias modification

Answer 10

has therapeutic benefits in treating the emotional disorders and potentially can be delivered without a therapist
provides a deeper understanding of the relationship between cognitive bias and emotional reactivity
has the potential to prevent the development of psychopathology by modifying the bias in vulnerable populations

Question 11

benefits of cognitive bias modification as a tool

Answer 11

cost-effective, delieverved by a computer

diversity of techniques that can be used

Question 12

questions that arise with the use of cognitive bias modification

Answer 12

how long do the benefits last
initial work done on non-clinical populations - do the effects extend to clinical populations
a narrow scope of biases have been studied

Question 13

factors to consider in the evaluation of CMB research

Answer 13

empirical evidence for its effectiveness
population studied
time course in length of evalutation - immediate vs delay
time course of treatment
cost 
adherence

Question 14

conclusions on CBM

Answer 14

dysfunctional imagery is a feature of depression - excess of intrusive mental imagery, reduced positive imagery such as reduced vividness, observer perspective and OGM
evidence that intrusive negative imagery and OGM may prospectively account for changes in depressive symptoms

Question 15

potential applications of CBM

Answer 15

reduce anhedonia
better ability to think about the future more positively
could potentially help patients engage in more rewarding behavioural activities
may be useful for psychological applications

Question 16

unresolved questions surrounding CBM

Answer 16

what mechanisms including brain areas underpin the generation and use of positive imagrey
eg use of fMRI neurofeedback to the brain regions responseive to positive visual stimuli (anterior insula, hippocampus, prefrontal regions) - found better positive mental imagery and better mood
how do imagery and verbal formats differ?

Question 17

what biases characterize PTSD

Answer 17

attention - difficulties in disengagin attention from trauma related word stimuli
interpretation - dysfunctional trauma related appraisals
memory - OGM predictor and risk factor for developing PTSD after trauma

Question 18

can CBM help with cognitive biases in PTSD?

Answer 18

evidence that training functional appraisals can reduce intrusion frequency and distress - eg focus on training to see the bigger picture and functional interpretation of analog trauma and its consequence
memory bias modification - systematic training to target OGM is promising = MEST
interpretation bias training more effective than attention bias modification training

Question 19

unresolved questions for PTSD and CBM

Answer 19

lack of studies with clinical patients as results with clinical pateitns are less consistent
mor research looking at the mechanisms that can explain change
examine different interventions fo rprevention of PTSD vs treatment
explore whether the type of trauma matters
need pre-post assessments

Question 20

concluding points of CBM

Answer 20

cognitive bias modification represents a new era in the treatment of cognitive bias associated with psychopathology
need a good empirical research base to provide evidence for its effectiveness
much more research needed with a multidisciplinary focus