Abstract
Cognitive-behavioural models of compulsive checking posit a dominant role for beliefs regarding one’s responsibility to prevent harm. In the current study we employed a computerised cognitive bias modification of interpretation (CBM-I) paradigm to target and modify responsibility biases in a sample of undergraduate students with high levels of checking symptoms (N = 100). Participants were randomly assigned to either a positive (decrease responsibility bias) or negative (increase responsibility bias) CBM-I training condition. Relative to participants in the negative training condition, participants in the positive training condition demonstrated reduced responsibility bias in a subsequent interpretive bias test. Positive training also resulted in more adaptive physiological responding during a responsibility stressor task. There were no differential effects of CBM-I training, however, on observed or self-reported checking or self-reported responsibility beliefs. In light of these mixed findings, we outline future avenues for improving the efficacy of CBM-I training targeting responsibility biases.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Amir, N., Beard, C., Burns, M., & Bomyea, J. (2009). Attention modification program in individuals with generalized anxiety disorder. Journal of Abnormal Psychology, 118, 28–33.
Appelhans, B. M., & Luecken, L. J. (2006). Heart rate variability as an index of regulated emotional responding. Review of General Psychology, 10, 229–240.
Arntz, A., Voncken, M., & Goosen, A. C. A. (2007). Responsibility and obsessive–compulsive disorder: An experimental test. Behaviour Research and Therapy, 45, 425–435.
Baert, S., Koster, E. H. W., & De Raedt, R. (2011). Modification of information-processing biases in emotional disorders: Clinically relevant developments in experimental psychopathology. International Journal of Cognitive Therapy, 4, 208–222.
Beadel, J., Smyth, F., & Teachman, B. (2014). Change processes during cognitive vias modification for obsessive compulsive beliefs. Cognitive Therapy and Research, 38, 103–119.
Berntson, G. G., Lozano, D. L., & Chen, Y.-J. (2005). Filter properties of root mean square successive difference (RMSSD) for heart rate. Psychophysiology, 42, 246–252.
Bouchard, C., Rhéaume, J., & Ladouceur, R. (1999). Responsibility and perfectionism in OCD: An experimental study. Behaviour Research and Therapy, 37, 239–248.
Bowler, J. O., Mackintosh, B., Dunn, B. D., Mathews, A., Dalgleish, T., & Hoppitt, L. (2012). A comparison of cognitive bias modification for interpretation and computerized cognitive behavior therapy: Effects on anxiety, depression, attentional control, and interpretive bias. Journal of Consulting and Clinical Psychology, 80, 1021–1033.
Brosan, L., Hoppitt, L., Shelfer, L., Sillence, A., & 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, 42, 258–264.
Burns, G. L., Keortge, S. G., Formea, G. M., & Sternberger, L. G. (1996). Revision of the Padua Inventory of obsessive compulsive disorder symptoms: Distinctions between worry, obsessions, and compulsions. Behaviour Research and Therapy, 34, 163–173.
Clerkin, E. M., & Teachman, B. A. (2011). Training interpretation biases among individuals with symptoms of obsessive compulsive disorder. Journal of Behavior Therapy and Experimental Psychiatry, 42, 337–343.
Cuttler, C., & Graf, P. (2009). Sub-clinical compulsive checkers show impaired performance on habitual, event- and time-cued episodic prospective memory tasks. Journal of Anxiety Disorders, 23, 813–823.
Denson, T. F., Grisham, J. R., & Moulds, M. L. (2011). Cognitive reappraisal increases heart rate variability in response to an anger provocation. Motivation and Emotion, 35, 14–22.
Foa, E. B., Amir, N., Bogert, K. V. A., Molnar, C., & Przeworski, A. (2001). Inflated perception of responsibility for harm in obsessive–compulsive disorder. Journal of Anxiety Disorders, 15, 259–275.
Foa, E. B., Sacks, M. B., Tolin, D. F., Prezworksi, A., & Amir, N. (2002). Inflated perception of responsibility for harm in OCD patients with and without checking compulsions: A replication and extension. Journal of Anxiety Disorders, 16, 443–453.
Freeston, M. H., Ladouceur, R., Gagnon, F., & Thibodeau, N. (1993). Beliefs about obsessional thoughts. Journal of Psychopathology and Behavioral Assessment, 15, 1–21.
Fullana, M. A., Mataix-Cols, D., Caspi, A., Harrington, H., Grisham, J. R., Moffitt, T. E., et al. (2009). Obsessions and compulsions in the community: Prevalence, interference, help-seeking, developmental stability, and co-occurring psychiatric conditions. American Journal of Psychiatry, 166, 329–336.
Goedhart, A. D., van der Sluis, S., Houtveen, J. H., Willemsen, G., & de Geus, E. J. C. (2007). Comparison of time and frequency domain measures of RSA in ambulatory recordings. Psychophysiology, 44, 203–215.
Haraguchi, T., Shimizu, E., Ogura, H., Fukami, G., Fujisaki, M., & Iyo, M. (2011). Alterations of responsibility beliefs through cognitive-behavioural group therapy for obsessive–compulsive disorder. Behavioural and Cognitive Psychotherapy, 39, 481–486.
Hermans, D., Martens, K., De Cort, K., Pieters, G., & Eelen, P. (2003). Reality monitoring and metacognitive beliefs related to cognitive confidence in obsessive–compulsive disorder. Behaviour Research and Therapy, 41, 383–401.
Hoppitt, L., Mathews, A., Yiend, J., & Mackintosh, B. (2010). Cognitive bias modification: The critical role of active training in modifying emotional responses. Behavior Therapy, 41, 73–81.
Ladouceur, R., Léger, E., Rhéaume, J., & Dubé, D. (1996). Correction of inflated responsibility in the treatment of obsessive–compulsive disorder. Behaviour Research and Therapy, 34, 767–774.
Ladouceur, R., Rhéaume, J., & Aublet, F. (1997). Excessive responsibility in obsessional concerns: A fine-grained experimental analysis. Behaviour Research and Therapy, 35, 423–427.
Ladouceur, R., Rhéaume, J., Freeston, M. H., Aublet, F., Jean, K., Lachance, S., et al. (1995). Experimental manipulations of responsibility: An analogue test for models of obsessive–compulsive disorder. Behaviour Research and Therapy, 33, 937–946.
Lang, P. J., Bradley, M. M., & Cuthbert, B. N. (2008). International affective picture system (IAPS): Affective ratings of pictures and instruction manual. Technical report A-8. University of Florida, Gainesville, FL.
Lang, T. J., Moulds, M. L., & Holmes, E. A. (2009). Reducing depressive intrusions via a computerized cognitive bias modification of appraisals task: Developing a cognitive vaccine. Behaviour Research and Therapy, 47, 139–145.
Lange, W.-G., Salemink, E., Windey, I., Keijsers, G. P. J., Krans, J., Becker, E. S., et al. (2010). Does modified interpretation bias influence automatic avoidance behaviour? Applied Cognitive Psychology, 24, 326–337.
Lester, K. J., Mathews, A., Davison, P. S., Burgess, J. L., & Yiend, J. (2011). Modifying cognitive errors promotes cognitive well being: A new approach to bias modification. Journal of Behavior Therapy and Experimental Psychiatry, 42, 298–308.
Lothmann, C., Holmes, E. A., Chan, S. W. Y., & Lau, J. Y. F. (2011). Cognitive bias modification training in adolescents: Effects on interpretation biases and mood. Journal of Child Psychology and Psychiatry, 52, 24–32.
MacDonald, E. M., Koerner, N. & Antony, M. M. (2013). Modification of interpretive bias: Impact on anxiety sensitivity, information processing and response to induced bodily sensations. Cognitive Therapy and Research, 37, 860–871.
MacLeod, C., & Mathews, A. (2012). Cognitive bias modification approaches to anxiety. Annual Review of Clinical Psychology, 8, 189–217.
Mancini, F., D’Olimpio, F., & Cieri, L. (2004). Manipulation of responsibility in non-clinical subjects: Does expectation of failure exacerbate obsessive–compulsive behaviours? Behaviour Research and Therapy, 42, 449–457.
Mathews, A. (2012). Effects of modifying the interpretation of emotional ambiguity. Journal of Cognitive Psychology, 24, 92–105.
Mathews, A., & Mackintosh, B. (2000). Induced emotional interpretation bias and anxiety. Journal of Abnormal Psychology, 109, 602–615.
Mendes, W. M. (2009). Assessing autonomic nervous system activity. In E. Harmon-Jones & J. Beer (Eds.), Methods in social neuroscience (pp. 118–147). New York, NY: Guilford Press.
Miu, A. C., Heilman, R. M., & Miclea, M. (2009). Reduced heart rate variability and vagal tone in anxiety: Trait versus state, and the effects of autogenic training. Autonomic Neuroscience: Basic and Clinical, 145, 99–103.
Neziroglu, F., & Stevens, K. P. (2002). Insight: Its conceptualization and assessment. In R. O. Frost & G. Steketee (Eds.), Cognitive approaches to obsessions and compulsions: Theory, assessment and treatment (pp. 183–202). Amsterdam: Pergamon.
Obsessive Compulsive Cognitions Working Group. (1997). Cognitive assessment of obsessive–compulsive disorder. Behaviour Research and Therapy, 35, 667–681.
Rachman, S. (1997). A cognitive theory of obsessions. Behaviour Research and Therapy, 35, 793–802.
Rachman, S. (2002). A cognitive theory of compulsive checking. Behaviour Research and Therapy, 40, 625–639.
Radomsky, A. S., Shafran, R., Coughtrey, A. E., & Rachman, S. (2010). Cognitive-behavior therapy for compulsive checking in OCD. Cognitive and Behavioral Practice, 17, 119–131.
Reeves, J., Reynolds, S., Coker, S., & Wilson, C. (2010). An experimental manipulation of responsibility in children: A test of the inflated responsibility model of obsessive–compulsive disorder. Journal of Behavior Therapy and Experimental Psychiatry, 41, 228–233.
Salkovskis, P. M. (1996). Cognitive-behavioral approaches to the understanding of obsessional problems. In R. M. Rapee (Ed.), Current controversies in the anxiety disorders (pp. 33–50). New York: Guilford Press.
Salkovskis, P. M., Wroe, A. L., Gledhill, A., Morrison, N., Forrester, E., Richards, C., et al. (2000). Responsibility attitudes and interpretations are characteristic of obsessive compulsive disorder. Behaviour Research and Therapy, 38, 347–372.
Samuels, J. F., Riddle, M. A., Greenberg, B. D., Fyer, A. J., McCracken, J. T., Rauch, S. L., et al. (2006). The OCD collaborative genetics study: Methods and sample description. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, 141B, 201–207.
Sookman, D., & Steketee, G. (2009). Specialised cognitive behaviour therapy for treatment resistant obsessive compulsive disorder. In D. Sookman & R. L. Leahy (Eds.), Treatment resistant anxiety disorders: Resolving impasses to symptom remission (pp. 31–74). New York, NY: Routledge.
Steketee, G., & Frost, R. (2001). Development and initial validation of the obsessive beliefs questionnaire and the interpretation of intrusions inventory. Behaviour Research and Therapy, 39, 987–1006.
Tabachnick, B. G., & Fidell, L. S. (2007). Using multivariate statistics (5th ed.). Boston, MA: Pearson Education.
Teachman, B. A., & Addison, L. M. (2008). Training non-threatening interpretations in spider fear. Cognitive Therapy and Research, 32, 448–459.
Thayer, J. F., & Lane, R. D. (2000). A model of neurovisceral integration in emotion regulation and dysregulation. Journal of Affective Disorders, 61, 201–216.
Thayer, J. F., & Lane, R. D. (2009). Claude Bernard and the heart–brain connection: Further elaboration of a model of neurovisceral integration. Neuroscience and Biobehavioral Reviews, 33, 81–88.
van Oppen, P., Hoekstra, R. J., & Emmelkamp, P. M. G. (1995). The structure of obsessive–compulsive symptoms. Behaviour Research and Therapy, 33, 15–23.
Wheaton, M. G., Abramowitz, J. S., Berman, N. C., Riemann, B. C., & Hale, L. R. (2010). The relationship between obsessive beliefs and symptom dimensions in obsessive–compulsive disorder. Behaviour Research and Therapy, 48, 949–954.
Whitton, A. E., Grisham, J. R., Henry, J. D., & Palada, H. D. (2013). Interpretive bias modification for disgust. Journal of Experimental Psychopathology, 4, 341–359.
Williams, A. D., & Grisham, J. R. (2013). Cognitive bias modification (CBM) of obsessive compulsive beliefs. BMC Psychiatry, 13, 256. doi:10.1186/1471-244X-13-256.
Wilson, E. J., MacLeod, C., Mathews, A., & Rutherford, E. M. (2006). The causal role of interpretive bias in anxiety reactivity. Journal of Abnormal Psychology, 115, 103–111.
Yiend, J., Savulich, G., Coughtrey, A., & Shafran, R. (2011). Biased interpretation in perfectionism and its modification. Behaviour Research and Therapy, 49, 892–900.
Conflict of Interest
Jessica R. Grisham, Lauren Becker, Alishia D. Williams, Alexis E. Whitton and Steve R. Makkar declare that they have no conflict of interest. The first author was supported in part by a Discovery Project grant from the Australian Research Council (DP0984560). The third author was supported by a National Health and Medical Research Council of Australia Fellowship (630746).
Informed Consent
Informed consent was obtained prior to participation and approval was given by the UNSW Human Research Ethics Advisory Panel.
Animal Rights
No animal studies were carried out by the authors for this article.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Grisham, J.R., Becker, L., Williams, A.D. et al. Using Cognitive Bias Modification to Deflate Responsibility in Compulsive Checkers. Cogn Ther Res 38, 505–517 (2014). https://doi.org/10.1007/s10608-014-9621-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10608-014-9621-0