Effect of a cognitive bias modification of interpretations on anxiety and depressive symptoms in adults

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Anxiety and depression are common and often occur together. Both conditions are associated with a range of negative outcomes, including suicide and substance abuse. Yet, current treatments (e.g., cognitive behavioural therapy or CBT) are suboptimal, and treatments which target both disorders (i.e., transdiagnostic) are urgently needed. Cognitive models of anxiety and depression suggest that cognitive biases underpin both disorders. For example, individuals with anxiety and depression are more likely to interpret ambiguous information negatively (known as "interpretation bias"), and to ignore positive information. Cognitive bias modification training of interpretation (CBM-I) directly targets these interpretation biases to reduce anxiety and depression. Yet, despite promising evidence of CBM-I, few studies have targeted biases associated with both anxiety and depression. This study addresses this gap in the research by investigating the effectiveness and acceptability of a modified CBM-I training program for adults with high levels of symptoms of both anxiety and depression. Individuals will be randomly allocated to either a training or control condition. The training condition involves modifying biases associated with both anxiety and depression. Specifically, individuals will be trained to interpret ambiguous information more positively and to attribute positive outcomes to themselves. The training will be compared to a control condition which trains individuals to neutral interpretations of scenarios (i.e., no training). Compared to the control condition, we expect that the training will result in significant decreases in biases associated with both anxiety and depression from pre- to post-training and pre- to follow-up. We also expect that changes in biases will be associated with decreases in anxiety and depressive symptoms.

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