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Does Modification of Implicit Associations Regarding Contamination Affect Approach Behavior and Attentional Bias?

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Abstract

Individuals with contamination concerns show aberrant interpretational and attentional processes. Yet, it is unclear whether threat-related associations play a causal role in anxiety symptoms and attentional bias. The objective of our study was to investigate if training implicit associations affects stress reactivity and attention in the context of contamination concerns. In a double-blind randomized design, we used a modified Implicit Associations Task (IAT) to train associations between contamination and danger in a non-clinical sample (N = 121). Dependent measures were a brief-IAT to assess changes in associations, contamination-related behavior approach tasks, and a spatial cueing task to measure attentional bias. Results show that training successfully modified implicit associations. However, there were no transfer effects on approach behavior or attention. Findings suggest that the modified IAT is a useful task for training implicit associations, but that transfer to other domains (attention and behavior) is limited. Limitations and future implications are discussed.

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Notes

  1. We assessed current depressive symptoms and suicidal ideation again upon arrival prior to study conduction. Participants were excluded prior to the study when they had a sum score of more than 19 or a score of more than 1 on the item no 9 in the BDI-II (N = 0).

  2. In the following we will describe the blocks using the notation contamination/dangerous and contamination/not dangerous. This includes the blocks with reversed positions of same categories.

  3. Words of the cleanliness set were used as neutral words for the spatial cueing task. To keep consistent with other studies, we refer to them as neutral words (since they are not related to danger or specific concerns) for the spatial cueing task.

  4. The spatial cueing task contained 192 trials. Due to an error in programming, general threatening words were presented only on the left side of the screen. We did not use them for analyses to avoid bias of presentation location.

  5. We provide further analyses in the Supplementary Material confirming our conclusion that increase in stress reactivity occurred in response to the BATs and is not related to other aspects of the experiment. Please find a time-course of adverse emotionality ratings assessed over visual analogue scales in the Supplementary Material.

  6. We also conducted the same analyses with only both of the active training groups (NT vs. PT), since analyses of the B-IAT suggested significant differences only between those two. Results showed the same pattern, and there were no further significant results supporting hypothesis testing.

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Acknowledgements

We thank Laura Brockhoff, Christina Martin, Ina Tuxhorn and Steffi Wenderlich for their assistance in data collection and preparation. We thank Celeste Brennecka for her valuable support with language and style.

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Correspondence to Ulrike Buhlmann.

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Conflict of Interest

Christina Dusend, Laura M. S. de Putter, Ernst H. W. Koster, Fanny A. Dietel, and Ulrike Buhlmann declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Research Involving Human and Animal Participants

This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Dusend, C., De Putter, L.M.S., Koster, E.H.W. et al. Does Modification of Implicit Associations Regarding Contamination Affect Approach Behavior and Attentional Bias?. Cogn Ther Res 43, 693–704 (2019). https://doi.org/10.1007/s10608-018-09991-6

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  • DOI: https://doi.org/10.1007/s10608-018-09991-6

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