Experimental modification of dysfunctional interpretations in individuals with contamination concerns

• Published in: Journal of behavior therapy and experimental psychiatry Vol. 59; pp. 56 - 64
• Main Authors: Conley, Sara L., Wu, Kevin D.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-06-2018; Elsevier Science Ltd
• Subjects: Ambiguity; Behavior; Behavior modification; Behavioral approach test; Bias modification; Cognitive bias; Contamination; Cues; Dysfunctional beliefs; Efficacy; Etiology; Feedback; Information processing; Interpretation bias; Obsessive compulsive disorder; OCD; Psychiatry; Dysfunctional beliefs; OCD; Interpretation bias; Obsessive-Compulsive Disorder; Bias modification; Behavioral approach test
• ISSN: 0005-7916; 1873-7943
• DOI: 10.1016/j.jbtep.2017.11.005

Dysfunctional interpretations of intrusive thoughts are implicated in the etiology and maintenance of Obsessive-Compulsive Disorder (OCD). Cognitive Bias Modification training for interpretations (CBM-I) has successfully modified dysfunctional interpretations in the context of several disorders, including OCD. However, research regarding CBM-I's impact on symptom reduction and behavior is mixed, which limits its clinical application. Further, support for the specific efficacy of CBM-I in individuals with contamination concerns is limited. The current study aimed to modify dysfunctional interpretations in individuals with contamination concerns, and examine the effect of the modification on both interpretation bias and performance on a behavioral approach task (BAT).
Participants (N = 74) completed a word-sentence association task by indicating whether a threatening or benign word was related to an ambiguous scenario. The active condition received feedback designed to reduce maladaptive interpretations; the control condition received random feedback.
Findings revealed that the active—but not the control—condition showed a significant decrease in interpretation bias for threat cues. Analyses of behavioral effects indicated that when ceiling effects were accounted for, the active condition completed more BAT steps than the control condition (p = 0.06; d = 0.45).
The current study is preliminary and requires replication with a clinical sample.
Completion of the CBM-I was beneficial for reducing dysfunctional interpretations relevant to naturally-occurring contamination concerns and, importantly, this reduction may help those individuals approach feared situations.
•Domain-specific research is needed to better discern the utility of CBM-I for OCD.•Efficacy of a CBM-I program was examined in individuals with contamination concerns.•The active condition displayed a significant decrease in threat interpretations.•The active (vs. control) condition showed increased engagement in a behavioral task.