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The Effects of Approach–Avoidance Modification on Social Anxiety Disorder: A Pilot Study

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Abstract

Cognitive bias modification has recently been discussed as a possible intervention for mental disorders. A specific form of this novel treatment approach is approach–avoidance modification. In order to examine the efficacy of approach–avoidance modification for positive stimuli associated with social anxiety, we recruited 43 individuals with social anxiety disorder and randomly assigned them to a training (implicit training to approach smiling faces) or a control (equal approach and avoidance of smiling faces) condition in three sessions over the course of a 1-week period. Dependent measures included clinician ratings, self-report measures of social anxiety, and overt behavior during behavioral approach tasks. No group differences in any of the outcome measures were observed after training. In addition, while individuals in the training group showed increased approach tendency in one of the sessions, this effect was inconsistent across the three sessions and did not result in long-term changes in implicit approach tendencies between the groups over the course of the entire study. These results suggest that approach–avoidance modification might result in short-lasting effects on implicit approach tendencies towards feared positive stimuli, but this modification may not result in meaningful behavioral change or symptom reduction in individuals with social anxiety disorder.

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Acknowledgments

The authors are grateful to Frank Leonhardt for programming the AAT. Moreover, they would like to acknowledge the following research assistants who provided crucial and much-appreciated assistance with the project on multiple domains, including data entry, recruitment advertising, serving as study confederates, and reliability video coding: Imke Vonk, Dan Brager, Rachel Kaufmann, Brian Hall, Myles Rizvi, Brian Gambardella, and Rebecca Grossman. Without their hard work and dedication, the study would never have come to fruition. Stefan Hofmann is a paid consultant of Merck Pharmaceutical (Schering-Plough) for work unrelated to this study. This study was partially supported by NIMH grants MH-078308 and MH-081116 awarded to Stefan Hofmann. Eni Becker and Mike Rinck were supported by the Behavioural Science Institute of Radboud University Nijmegen, The Netherlands.

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Authors and Affiliations

  1. Department of Psychology, Boston University, 648 Beacon St., 6th Floor, Boston, MA, 02215, USA

    Anu Asnaani & Stefan G. Hofmann

  2. Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands

    Mike Rinck & Eni Becker

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  1. Anu Asnaani
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  2. Mike Rinck
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  3. Eni Becker
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  4. Stefan G. Hofmann
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Correspondence to Stefan G. Hofmann.

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Asnaani, A., Rinck, M., Becker, E. et al. The Effects of Approach–Avoidance Modification on Social Anxiety Disorder: A Pilot Study. Cogn Ther Res 38, 226–238 (2014). https://doi.org/10.1007/s10608-013-9580-x

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