Combined cognitive bias modification treatment for social anxiety disorder: a pilot trial

Background: Cognitive Bias Modification (CBM) is a promising treatment for Social Anxiety Disorder (SAD). However, previous randomized trials have not systematically examined the combination of CBM for attention (CBM‐A) and interpretation (CBM‐I) or the credibility and acceptability of these protocols. Methods: We conducted a randomized, double‐blind placebo‐controlled trial (N = 32) to examine the efficacy of a CBM treatment called Attention and Interpretation Modification (AIM) for SAD. AIM comprised eight, twice weekly computer sessions with no therapist contact. During AIM, participants (1) completed a dot probe task in which probes always followed neutral faces when paired with a disgust face, thereby directing attention away from threat and (2) completed a word–sentence association task in which they received positive feedback for making benign interpretations of word–sentence pairs and negative feedback for making negative interpretations. We also assessed participants' perceived credibility of and satisfaction with AIM. Results: Participants receiving AIM reported significantly reduced self‐reported (Liebowitz Social Anxiety Scale) symptoms of social anxiety relative to the placebo. These gains were also evident on a behavioral measure (performance on an impromptu speech). AIM met our benchmarks for credibility and acceptability in this community sample, although credibility ratings were modest. Participants reported that CBM‐I was more helpful than CBM‐A. Conclusions: A combined CBM treatment produced medium‐to‐large effects on social anxiety. Participants rated AIM as moderately credibly and acceptable. Should these findings be replicated in larger samples, AIM has the potential to be a widely accessible and efficacious treatment for SAD. Depression and Anxiety, 2011.© 2011 Wiley Periodicals, Inc.