Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-20T16:24:36.306Z Has data issue: false hasContentIssue false
  • English
  • Français

Socially Anxious Primary Care Patients’ Attitudes Toward Cognitive Bias Modification (CBM): A Qualitative Study

Published online by Cambridge University Press:  30 November 2011

Courtney Beard ,
Risa B. Weisberg  and
Jennifer Primack
Courtney Beard*
Affiliation:
Alpert Medical School of Brown University, USA
Risa B. Weisberg
Affiliation:
Alpert Medical School of Brown University, USA
Jennifer Primack
Affiliation:
Alpert Medical School of Brown University and Butler Hospital, USA
*
Reprint requests to Courtney Beard, Brown University, Box G-BH, Providence, RI 02912, USA. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Cognitive bias modification (CBM) is a novel treatment for anxiety disorders that utilizes computerized tasks to train attention and interpretation biases away from threat. To date, attitudes toward and acceptability of CBM have not been systematically examined. Method: We conducted qualitative interviews with 10 anxious primary care patients to examine attitudes toward and initial impressions of CBM. Interviews explored general impressions, as well as reactions to the treatment rationale and two computer programs, one targeting attention bias and one targeting interpretation bias. Three clinical psychologists independently coded transcripts and collaboratively developed categories and themes guided by grounded theory. Results: A number of facilitators and barriers emerged related to engaging in treatment in general, computerized treatment, and CBM specifically. Participants stated that the written rationale for CBM seemed relevant and helpful. However, after interacting with the attention modification program, participants frequently expressed a lack of understanding about how the program would help with anxiety. Participants reported greater understanding and engagement with the interpretation modification program. Conclusions: Participants reported a number of positive characteristics of CBM, but it may need improvements regarding its treatment rationale and credibility. Future qualitative studies with individuals who complete a CBM treatment are warranted. Implications for future CBM development and dissemination are discussed.

Keywords

Cognitive bias modificationattentioninterpretationanxietytreatmentqualitative
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 40 , Issue 5 , October 2012 , pp. 618 - 633
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Amir, N., Beard, C., Burns, M. and Bomyea, J. (2009). Attention modification program in individuals with generalized anxiety disorder. Journal of Abnormal Psychology, 118, 28–33.CrossRefGoogle ScholarPubMed
Amir, N., Beard, C., Taylor, C. T., Klumpp, H., Elias, J., Burns, M., et al. (2009). Attention training in individuals with generalized social phobia: a randomized controlled trial. Journal of Consulting and Clinical Psychology, 77, 961–973.CrossRefGoogle ScholarPubMed
Beard, C. (2011). Cognitive Bias Modification (CBM) for anxiety: current evidence and future directions. Expert Review of Neurotherapeutics, 11, 299–311.CrossRefGoogle ScholarPubMed
Beard, C. and Amir, N. (2008). A multi-session interpretation modification program: changes in interpretation and social anxiety symptoms. Behaviour Research and Therapy, 46, 1135–1141.CrossRefGoogle ScholarPubMed
Beard, C., Weisberg, R. B. and Amir, N. (in press). Combined cognitive bias modification treatment for social anxiety disorder: a pilot trial. Depression and Anxiety.Google Scholar
Blanco, C., Schneier, F. R., Schmidt, A., Blanco-Jerez, C., Marshall, R. D., Sánchez-Lacay, A., et al. (2003). Pharmacological treatment of social anxiety disorder: a meta-analysis. Depression and Anxiety, 18, 29–40.CrossRefGoogle ScholarPubMed
Brosan, L., Hoppitt, L., Shelfer, L., Sillence, A. and Mackintosh, B. (2011). Cognitive bias modification for attention and interpretation reduces trait and state anxiety in anxious patients referred to an out-patient service: results from a pilot study. Journal of Behavior Therapy and Experimental Psychiatry, 1–7. doi: 10.1016/j.jbtep.2010.12.006CrossRefGoogle Scholar
Field, M. and Eastwood, B. (2005). Experimental manipulation of attentional bias increases the motivation to drink alcohol. Psychopharmacology, 183, 350–357.CrossRefGoogle ScholarPubMed
First, M. B., Spitzer, R. L., Gibbon, M. and Williams, J. B. W. (1996). Structured Clinical Interview for DSM-IV Axis I Disorders: patient edition (SCID-I/PI, version 2.0). New York: Biometrics Research Department.Google Scholar
Fresco, D. M., Coles, M. E. and Heimberg, R. G. (2001). The Liebowitz Social Anxiety Scale: a comparison of the psychometric properties of self-report and clinician-administered formats. Psychological Medicine, 31, 1025–1035.CrossRefGoogle Scholar
Glaser, B. and Strauss, A. L. (1967). The Discovery of Grounded Theory: strategies for qualitative research. Chicago: Aldine.Google Scholar
Gunter, R. W. and Whittal, M. L. (2010). Dissemination of cognitive-behavioral treatments for anxiety disorders: overcoming barriers and improving patient access. Clinical Psychology Review, 30, 194–202.CrossRefGoogle ScholarPubMed
Hakamata, Y., Lissek, S., Bar-Haim, Y., Britton, J. C., Fox, N. A., Leibenluft, E., et al. (2010). Attention bias modification treatment: a meta-analysis toward the establishment of novel treatment for anxiety. Biological Psychiatry, 68, 982–990.CrossRefGoogle ScholarPubMed
Harman, J. S., Rollman, B. L., Hanusa, B. H., Lenze, E. J. and Shear, M. K. (2002). Physician office visits of adults for anxiety disorders in the United States, 1985 to1998. Journal of General Internal Medicine, 17, 165–172.CrossRefGoogle Scholar
Hazen, R. A., Vasey, M. W. and Schmidt, N. B. (2009). Attentional retraining: a randomized clinical trial for pathological worry. Journal of Psychiatric Research, 43, 627–633.CrossRefGoogle ScholarPubMed
Heimberg, R. G., Horner, K. J. and Juster, H. R. (1999). Psychometric properties of the Liebowitz Social Anxiety Scale. Psychological Medicine, 29, 199–212.CrossRefGoogle ScholarPubMed
Hoffman, D. L. and Wittchen, H. U. (2008). Human and economic burden of generalized anxiety disorder. Depression and Anxiety, 25, 72–90. doi: PMID: 17146763CrossRefGoogle ScholarPubMed
Hoffman, E. and Mathew, S. (2008). Anxiety disorders: a comprehensive review of pharmacotherapies. Mount Sinai Journal of Medicine, 75, 248–262.CrossRefGoogle ScholarPubMed
Kessler, R. C., Berglund, P., Demier, O., Jin, R., Merikangas, K. R. and Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 593–602.CrossRefGoogle ScholarPubMed
Koster, E. H. W., Fox, E. and MacLeod, C. (2009). Introduction to the special section on cognitive bias modification in emotional disorders. Journal of Abnormal Psychology, 118, 1–4.CrossRefGoogle Scholar
Liebowitz, M. R. (1987). Social phobia. Modern Problems in Pharmacopsychiatry, 22, 141–173.CrossRefGoogle ScholarPubMed
Lovell, K. and Richards, D. (2000). Multiple access points and levels of entry (MAPLE): ensuring choice, accessibility and equity of CBT services. Behavioural and Cognitive Psychotherapy, 28, 379–391.CrossRefGoogle Scholar
MacLeod, C., Rutherford, E., Campbell, L., Ebsworthy, G. and Holker, L. (2002). Selective attention and emotional vulnerability: assessing the causal basis of their association through the experimental manipulation of attentional bias. Journal of Abnormal Psychology 111, 107–123.CrossRefGoogle ScholarPubMed
Mathews, A. and Mackintosh, B. (2000. Induced emotional interpretation bias and anxiety. Journal of Abnormal Psychology, 109, 602–615.CrossRefGoogle ScholarPubMed
Mathews, A., Ridgeway, V., Cook, E. and Yiend, J. (2007). Inducing a benign interpretational bias reduces trait anxiety. Journal of Behavior Therapy and Experimental Psychiatry, 38, 225–236.CrossRefGoogle ScholarPubMed
Mitchell, N. and Gordon, P. K. (2007). Attitudes towards computerized CBT for depression amongst a student population. Behavioural and Cognitive Psychotherapy, 35, 421–430.CrossRefGoogle Scholar
Mitte, K. (2005). Meta-analysis of cognitive-behavioral treatments for generalized anxiety disorder: a comparison with pharmacotherapy. Psychological Bulletin, 131, 785–795.CrossRefGoogle ScholarPubMed
Najmi, S. and Amir, N. (2010). The effect of attention training on a behavioral test of contamination fears in individuals with subclinical obsessive-compulsive symptoms. Journal of Abnormal Psychology, 119, 136–142.CrossRefGoogle ScholarPubMed
Olfson, M., Guardino, M., Struening, E., Schneier, F. R., Hellman, F. and Klein, D. F. (2000). Barriers to the treatment of social anxiety. American Journal of Psychiatry, 157, 521–527.CrossRefGoogle Scholar
Rozenman, M., Weersing, V. R. and Amir, N. (2011). A case series of attention modification in clinically anxious youths. Behaviour Research and Therapy, 49, 324–330. doi: 10.1016/j.brat.2011.02.007CrossRefGoogle ScholarPubMed
Rytwinski, N. K., Fresco, D. M., Heimberg, R. G., Coles, M. E., Liebowitz, M. R., Cissell, S., et al. (2009). Screening for social anxiety disorder with the self-report version of the Liebowitz Social Anxiety Scale. Depression and Anxiety, 26, 34–38.CrossRefGoogle ScholarPubMed
Schmidt, N. B., Richey, J. A., Buckner, J. D. and Timpano, K. R. (2009). Attention training for generalized social anxiety disorder. Journal of Abnormal Psychology, 118, 5–14.CrossRefGoogle ScholarPubMed
Smith, E. and Rieger, E. (2009). The effect of attentional training on body dissatisfaction and dietary restriction. European Eating Disorders Review, 17, 169–176.CrossRefGoogle ScholarPubMed
Stein, M. B., McQuaid, J. R., Laffaye, C. and McCahill, M. E. (1999). Social phobia in the primary care medical setting. The Journal of Family Practice, 48, 514–519.Google ScholarPubMed
Weisberg, R. B., Dyck, I., Culpepper, L. and Keller, M. B. (2007). Psychiatric treatment in primary care patients with anxiety disorders: a comparison of care received from primary care providers and psychiatrists. American Journal of Psychiatry, 164, 276–282.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.