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Modifying Interpretation in a Clinically Depressed Sample Using ‘Cognitive Bias Modification-Errors’: A Double Blind Randomised Controlled Trial

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Abstract

Depression has been widely associated with a cognitive deficit leading to the negative interpretation of ambiguous information. Recently, cognitive bias modification (CBM) procedures have shown that such negative biases are causally related to emotional vulnerability. However, research using CBM has been notably lacking in depression. This is the first double blind randomised controlled study investigating the effect of cognitive bias modification-errors (CBM-errors), on depression and its influence on mood and resilience to stress. CBM-errors is a new form of cognitive bias modification for interpretation, which targets the full range of cognitive errors, as well as interpretation biases. Forty clinically depressed participants were randomly allocated to a positive training group or neutral text reading control group. Participants trained to make positive interpretations subsequently interpreted novel ambiguous information in a positive manner compared to controls. The results suggest that a positive cognitive bias can be induced in clinically depressed individuals using a simple computerised intervention. There was little evidence of corresponding benefits in terms of mood or response to stress, suggesting that multiple sessions are likely to be needed to confer symptom related change. A systematic investigation of the optimum number and timing of multiple sessions is now called for.

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Notes

  1. Arbitrary inference, selective abstraction, minimization, dichotomous thinking, overgeneralisation, personalization, catastrophising/magnification.

  2. Subsequent analyses performed at the request of an anonymous reviewer and reinstating both participants did not alter the pattern of the results reported on any measure.

  3. One participant had missing data on this measure.

  4. Three participants had missing data on this measure.

  5. Three participants had missing data on this measure.

  6. Alternative, less stringent scoring procedures, as reported in some papers, did not result in significant changes to the pattern of results.

  7. Combining both types of score to give a single bias score for analysis resulted in a Group × Time, F(1,31) = 3.06, p = .09.

  8. The reliable change index (RCI) was calculated following the method of Jacobson and Truax (1991). RCI is obtained by multiplying standard error of difference between two sets of test scores (here 3.65, taken from normative date on the BDI-II) by 1.96 (z-value for p < .05 significance level), which gave a value of 7.154. Thus any change in BDI-II score of 7.16 or above would be unlikely to occur in the absence of actual change.

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  1. Institute of Psychiatry, King’s College London, PO 63, De Crespigny Park, London, SE5 8AF, UK

    Jenny Yiend, Jong-Sun Lee, Sinem Tekes, Louise Atkins, Andrew Mathews, Manouk Vrinten, Christian Ferragamo & Sukhwinder Shergill

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  1. Jenny Yiend
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  2. Jong-Sun Lee
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Correspondence to Jenny Yiend.

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Yiend, J., Lee, JS., Tekes, S. et al. Modifying Interpretation in a Clinically Depressed Sample Using ‘Cognitive Bias Modification-Errors’: A Double Blind Randomised Controlled Trial. Cogn Ther Res 38, 146–159 (2014). https://doi.org/10.1007/s10608-013-9571-y

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