10.18130/BXS4-RW90
Larrazabal Carrillo, Maria Alexandra
Maria Alexandra
Larrazabal Carrillo
University of Virginia
Online Cognitive Bias Modification for Interpretation to Reduce Anxious Thinking During COVID-19
University of Virginia
2021
Dissertation
cognitive bias modification
COVID-19
psychoeducation
interpretation bias
anxiety
Teachman, Bethany
Bethany
Teachman
University of Virginia
2021-11-29
All rights reserved (no additional license for public reuse)
Anxiety disorders are highly prevalent and rates increased during the COVID-19 pandemic. However, most individuals with elevated anxiety do not access treatment due to barriers such as stigma, cost, and availability. Internet-based programs, such as cognitive bias modification for interpretation (CBM-I), hold promise as a tool to increase access to care. Before widely disseminating CBM-I, we must rigorously test its effectiveness, and determine whom it is best positioned to benefit. The present study compared CBM-I against a psychoeducation active comparison condition offered through the public website MindTrails, and also tested whether anxiety tied to COVID-19 moderated the effectiveness of these interventions. Adults with moderate-to-severe anxiety (N = 609) were randomly assigned to receive five sessions of CBM-I or psychoeducation. As predicted (https://osf.io/2dyzr), CBM-I was superior to psychoeducation at reducing anxiety symptoms (on our primary but not secondary anxiety measure: d = -0.30), reducing negative interpretation bias (d range= -0.34 to -0.47), and increasing positive interpretation bias (d = 0.83). Gains were maintained at 2- and 6-month follow-up assessments for all outcomes except positive interpretation bias. Results also indicated that individuals higher (vs. lower) in baseline COVID-19 anxiety experienced stronger decreases in anxiety symptoms while receiving CBM-I and stronger increases in anxiety while receiving psychoeducation (increases within the psychoeducation condition occurred only on one anxiety measure). These findings suggest that CBM-I may be a useful anxiety-reduction tool for individuals experiencing higher (vs. lower) anxiety tied to COVID-19. Future work is needed to further evaluate whether CBM-I is ready to be disseminated on a wider scale, and who may benefit most.