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Contains fulltext : 304965.pdf (Publisher’s version ) (Open Access), Purpose: This study delves into the combined cognitive bias hypothesis in depression, exploring the interaction between negative attention, interpretation and memory biases. We aimed to assess whether modifying attention and interpretation bias would lead to congruent changes in memory bias, and to what extend and depth this causal effect can be. Method: Ninety-nine undergraduates underwent either a positive (PT) or negative (NT) four-day attention and interpretation bias training. A set of well-established post-training assessments including free recall, recognition, autobiographic memory, and self-reference encoding tasks were used to evaluate memory bias. Affective states were measured pre- and post-training. Results: Compared to PT, participants in NT correctly retrieved more negative trained stimuli, and falsely recognized more negative synonyms of trained terms. NT also exhibited an enhanced retrieval of negative autobiographical memory. No significant differences were found between NT and PT in self-referential encoding and retrieval bias, or affective states. Discussion: The results suggested an extensive and strong transfer effect from attention and interpretation bias modification to different facets of memory bias, being found in retrieving trained emotional stimuli, in memory intrusion of negative synonyms, and in autobiographic memory recall. The findings underscored the causality between three biases, supporting the combined cognitive bias hypothesis. It might also suggest an effective new approach to modify memory bias via attention and interpretation bias training., 25 maart 2024, 13 p.

Contains fulltext : 303949.pdf (Publisher’s version ) (Open Access), Cognitive bias modification (CBM) has evolved from an experimental method testing cognitive mechanisms of psychopathology to a promising tool for accessible digital mental health care. While we are still discovering the conditions under which clinically relevant effects occur, the dire need for accessible, effective, and low-cost mental health tools underscores the need for implementation where such tools are available. Providing our expert opinion as Association for Cognitive Bias Modification members, we first discuss the readiness of different CBM approaches for clinical implementation, then discuss key considerations with regard to implementation. Evidence is robust for approach bias modification as an adjunctive intervention for alcohol use disorders and interpretation bias modification as a stand-alone intervention for anxiety disorders. Theoretical predictions regarding the mechanisms by which bias and symptom change occur await further testing. We propose that CBM interventions with demonstrated efficacy should be provided to the targeted populations. To facilitate this, we set a research agenda based on implementation frameworks, which includes feasibility and acceptability testing, co-creation with end-users, and collaboration with industry partners., 13 p.

14 maart 2023, Item does not contain fulltext, Background: Alcohol-dependent individuals tend to selectively approach alcohol cues in the environment, demonstrating an alcohol approach bias. Approach Bias Modification (ApBM) training can reduce the approach bias and decrease relapse rates in alcohol-dependent patients when added to abstinence-focused treatment. It has therefore become part of regular treatment. Moreover, in Selective Inhibition (SI-) Training, responses to one category of stimuli (i.e., alcohol stimuli) are selectively inhibited in an adapted Go/No-Go-Task. SI-Training has been found to effectively devalue the inhibited category, and to reduce consumption of alcohol in social drinkers. This study investigated whether SI-Training can further improve treatment effects of treatment-as-usual that includes ApBM, and if so, whether the effect is mediated by a devaluation of the inhibited alcohol stimuli. Methods: For 6 sessions, 434 abstinent alcohol-dependent inpatients were randomly assigned to receive either active (n = 214, 32% female) or sham (n= 220, 38% female) SI-Training, in addition to standard treatment including active ApBM. Ratings were used to assess changes in the evaluation of alcohol stimuli after the training. Relapse rates were assessed three months and twelve months after treatment discharge. Results: Alcohol stimuli were rated negatively before and after the training, and the training did not influence these ratings. Evaluation of nonalcoholic drinks became more positive after active SI-Training. Both ApBM and SI-Training showed the expected training effects on reaction times. Contrary to expectations, SI-Training conditions did not yield different abstinence rates three or twelve months after treatment. Conclusions: No evidence was found for the hypothesis that SI-Training would amplify the relapse-preventing effect of ApBM. Moreover, alcohol stimuli were rated negatively before and after treatment and were not influenced by SI-Training.

01 februari 2023, Item does not contain fulltext, This study investigated the longitudinal bidirectional associations between likeability, popularity, fear of negative evaluation, and social avoidance, to aid in preventing the negative consequences and persistent trajectories of low social status and heightened social anxiety. In total, 1741 adolescents in grades 7-9 participated at 3 yearly waves. A self-report questionnaire measured fear of negative evaluation. Peer nominations assessed likeability, popularity, and social avoidance. Lower popularity predicted more avoidance, and vice versa. More avoidance was related to lower likeability over time. Being less popular and/or more liked by peers, increased fear of negative evaluation. Support for a transactional model between social anxiety and social status was found, but distinguishing different social status and social anxiety components is necessary.

Item does not contain fulltext, In an ever-changing social world, learning and updating beliefs about others are essential for smooth interpersonal functioning. Social anxiety is a common and burdensome condition involving difficulties in interpersonal functioning. However, the processes governing the learning and updating of beliefs regarding others, processes crucial for these interactions, are poorly understood. In order to address this gap, we used a novel modification of a reversal-learning task. The task consisted of two phases. In the first (learning) phase, participants learned that interactions with certain individuals were associated with negative outcomes and other individuals with positive outcomes. In the second (updating) phase, these associations were reversed. Hence, negative individuals became positive and vice-versa, and participants had to update their initial beliefs. Study 1 (n = 87; undergraduate students) revealed that social anxiety was not associated with biases in learning positive or negative information about others. However, social anxiety was associated with a deficit in positively updating existing negative beliefs. Study 2 (n = 248; Mturk workers) replicated these findings in a representative and demographically diverse sample, controlling for depression severity and age. The current research suggests that social anxiety-related difficulty in the positive updating of negative social information may contribute to the impairment in interpersonal functioning.

Item does not contain fulltext, Childhood adversity involves a wide range of negative experiences that pose a serious threat to a child’s wellbeing. It has been consistently shown to predict (chronic) depression in subsequent stages of development, but mechanisms underlying the relationship are still less clear. Moving from a cumulative approach of lumping heterogeneous categories of childhood adversity to a dimensional approach of classifying negative experiences into two major dimensions (threat and deprivation) has facilitated the identification of specific processes by which childhood adversity can predict depression. This review aims to provide an integrative overview of how childhood adversity increases the risk for depression using the biopsychosocial framework. We will summarize findings from neuroimaging, behavioral, and social research. Recommendations for future research and preventions/interventions are also discussed.

31 mei 2023, Item does not contain fulltext, Psychopathological syndromes, such as disruptive behavior and anxiety disorders in adolescence, are characterized by distorted cognitions and problematic behavior. Biased interpretations of ambiguous social situations can elicit both aggressive and avoidance behavior. Yet, it is not well understood whether different interpretation biases are specific to different syndromes, or whether they can co-occur. We assessed both hostile and threatening interpretation biases in identical social situations, and proposed that they are uniquely related to callous-unemotional (CU) traits and social anxiety, respectively. We also explored the role of gender and age herein. The sample consisted of 390 inpatients between 10 and 18 years of age with a variety of psychiatric disorders. Hostile and threatening interpretations were assessed with the Ambiguous Social Scenario Task (ASST) consisting of 10 written vignettes. Both CU-traits and social anxiety were assessed with self-report questionnaires. Results showed that, overall, CU-traits were related to more hostile interpretations, whereas social anxiety was related to more threatening interpretations. In addition, in boys, hostile and threatening interpretations correlated significantly positive with each other. Age was not related to interpretation biases. Together, these results generally support the content-specificity of interpretation biases in concepts relevant to disruptive behavior disorders and anxiety disorders, and indicate that different interpretation biases can co-occur specifically in boys.

Item does not contain fulltext, The case of Susan, a kindergarten teacher who developed panic disorder as well as a mild agoraphobia after a bad case of flue, is presented. She exhibited some of the typical misinterpretations of panic disorder patients, interpreting bodily symptoms as signs of imminent danger. But, there were also some underlying dysfunctional beliefs that maintained the disorder and challenged treatment. Exposure was chosen as the main intervention, with the goal of changing the catastrophic interpretations. Special emphasis was given on the motivation and the cognitive rational preparing for the exposure. Interoceptive exposure was utilized to target the panic attacks, often in form of behavioral experiments in combination with cognitive restructuring. The agoraphobia was target with in vivo exposure, but initially did not show the hoped-for effects, due to ingrained safety behaviors. For relapse prevention underlying beliefs were targeted with cognitive therapy. At the end of the treatment, Susan experienced significant improvements, i.e., both the panic attacks and agoraphobic behaviors had vanished and she was able to enjoy life again.

11 mei 2023, Contains fulltext : 292768.pdf (Publisher’s version ) (Open Access), Background: Mindfulness-based cognitive therapy (MBCT) is an evidence-based treatment for depression. The current study focused on the long-term effects of MBCT for chronically, treatment-resistant depressed patients during a 6-months follow-up period. Additionally, predictors of treatment outcomes were explored. Method: The outcomes of MBCT on depressive symptoms, remission rates, quality of life, rumination, mindfulness skills and self-compassion were investigated in a cohort of chronically, treatment-resistant depressed outpatients (N = 106), who had taken part in an RCT comparing MBCT with treatment-as-usual (TAU). Measures were assessed pre-MBCT, post-MBCT, at 3-months follow-up, and at 6-months follow-up. Results: Results of linear mixed effect models and Bayesian repeated measures ANOVA's reveal that depressive symptoms, quality of life, rumination, mindfulness skills and self-compassion consolidated during follow-up. Remission rates even further increased over the course of follow-up. When controlling for symptoms at baseline, higher baseline levels of rumination predicted lower depressive symptoms and quality of life at 6-month follow-up. No other predictors (i.e. duration of current depressive episode, level of treatment-resistance, childhood trauma, mindfulness skills, self-compassion) were found. Limitations All participants received MBCT, therefore time or other non-specific effects might have influenced the results and replication in studies including a control condition is needed. Conclusions :Results indicate that the clinical benefits of MBCT for chronically, treatment-resistant depressed patients persist up to 6 months after completing MBCT. Duration of the current episode, level of treatment-resistance, childhood trauma and baseline levels of mindfulness skills and self-compassion did not predict treatment outcome. When controlling for baseline depressive symptoms participants with high levels of rumination seem to benefit more; however more resea

12 juni 2023, Item does not contain fulltext, Objective; Evidence points towards heightened anxiety and attention biases (AB) towards disorder-specific (threatening) stimuli in patients with anorexia nervosa (AN). To date, it is unclear how anxiety and AB interact in eating disorders (ED). The present study tests the causal role of anxiety by inducing anxiety before a dot-probe task with either ED-specific stimuli or unspecific negative (threat-related) information. We expected that anxiety would elicit AB for ED-specific, but not for unspecific threat-related stimuli. Methods: Adolescents with AN (AN, n = 32) or depression (DEP, n = 27) and healthy controls (HC, n = 29) underwent an anxiety induction or a low anxiety control task before a pictorial dot-probe task with either under-/overweight body-related pictures or non-disorder-related threatening pictures (angry faces). BMI, level of ED symptoms, anxiety, stress, and depression were assessed at baseline. Results: The anxiety induction did not affect the observed attention pattern. AN showed an AB towards underweight body pictures compared to HC, whereas no disorder-unspecific threat-related AB emerged. Regression analyses revealed that only anxiety predicted the AB towards underweight body pictures. Discussion: Further experimental research may integrate eye tracking as an additional tool, or collect information on body dissatisfaction to obtain a better understanding of how anxiety biases attention.

Contains fulltext : 291585.pdf (Publisher’s version ) (Open Access), Background: Threatening and hostile interpretation biases are seen as causal and maintaining mechanisms of childhood anxiety and aggression, respectively. However, it is unclear whether these interpretation biases are specific to distinct problems or whether they are general psychopathological phenomena. The specificity versus pervasiveness of interpretation biases could also differ depending on mental health status. Therefore, in the current study, we investigated whether social anxiety and callous-unemotional (CU) traits were uniquely related to threatening and hostile interpretation biases, respectively, in both a community and a clinical sample of adolescents. Methods: A total of 161 adolescents between 10 to 15 years of age participated. The community sample consisted of 88 participants and the clinical sample consisted of 73 inpatients with a variety of psychological disorders. Social anxiety and CU-traits were assessed with self-report questionnaires. The Ambiguous Social Scenario Task was used to measure both threatening and hostile interpretations in response to written vignettes. Results: Results showed that social anxiety was uniquely related to more threatening interpretations, while CU-traits were uniquely related to more hostile interpretations. These relationships were replicated for the community sample. For the clinical sample, only the link between social anxiety and threatening interpretations was significant. Explorative analyses showed that adolescents with externalizing disorders scored higher on hostile interpretations than adolescents with internalizing disorders. Conclusions: Overall, these results support the content-specificity of threatening interpretation biases in social anxiety and of hostile interpretation biases in CU-traits. Better understanding the roles of interpretation biases in different psychopathologies might open avenues for tailored prevention and intervention paradigms.

Contains fulltext : 299473.pdf (Publisher’s version ) (Closed access), Background: Depression often leads to clinical admission. Stimulating positive memory bias through repeated retrieval can counteract a ruminative depressotypic processing style. Cognitive Bias Modification (CBM)-Memory is a psychological intervention, which was evaluated as possible adjunct treatment for depressed inpatients. Methods: A randomized controlled pilot study with a one-week follow-up was implemented to compare the effect of a four-session positive CBM-Memory intervention to a neutral CBM-Memory version. Training-congruent retrieval (as manipulation check), and transfer to rumination (as mechanistic target) and depressive symptoms (self-rated and clinician-rated; indication of clinical relevance) were assessed. Results: In the intention-to-treat sample (N = 81, Mage=35.6/SD = 11.9, 60% female), condition-congruent memory retrieval of previously presented target words was found after the training and at follow-up (large effect-sizes). Positive CBM-Memory intervention resulted in sustained recall bias and largest rumination reduction with a small-medium effect size. Additionally, the conditions did not differ significantly on the reduction in depressive symptoms. Conclusions: Positive CBM-Memory intervention yielded positive recall bias, which was still present one week later. Additionally, the positive condition did yield more decrease in trait (but not state) rumination, providing some support for rumination as mechanistic target of positive CBM-Memory. However, there was no evidence for transfer of the training effect to depressive symptoms, indicating no superiority on clinical recovery of the positive over the neutral condition. Future research should examine a higher dosage, integration of CBM in the treatment provision, and its long-term effects in a well-powered trial., 22 november 2023, 13 p.

Item does not contain fulltext, Social anxiety (SA) is associated with difficulties in positively updating negative social information when new information and feedback about chosen options (actual decisions) are received. However, it is unclear whether this difficulty persists when hidden information regarding unchosen options is explicitly presented. The aim of the current study was to address this gap. Participants (Mturk; n = 191) completed a two-phases novel task. In the task, participants chose to approach or avoid people, represented by images of faces. During the initial (learning) phase, participants learned, in a probabilistic context, which people are associated with negative outcomes and should be avoided, and which are associated with positive outcomes and should be approached. During the subsequent updating phase, people previously associated with negative outcomes became associated with positive outcomes and vice versa. Importantly, participants received feedback not only on their approach (actual) decisions, but also on their avoidance (counter-factual) decisions (e.g., approaching this person would have been beneficial). The results revealed that even when the consequences of avoidance were explicitly presented, SA was associated with difficulty in positive updating of social information. The findings support the view that biased updating of social information is a change-resistant mechanism that may underlie the maintenance of SA., 5 p.

08 januari 2022, Item does not contain fulltext, Background: The tendencies to interpret social situations as threatening or hostile are called interpretation biases triggering fear or anger, avoidance or aggression, respectively. These biases play a substantial role in internalizing and externalizing problems, but the relationship is not always clear-cut. By measuring different biases in the same situation potential co-occurrences and their distinct roles in different disorders might be better understood. The current study validated an Ambiguous Social Scenario Task (ASST) in order to assess both socially anxious and socially callous interpretations, as well as their relations to emotional and behavioral problems. Methods: A final sample of 390 participants filled in the ASST and questionnaires for social anxiety and psychopathic traits. Psychometric properties of the ASST were assessed in terms of factor analyses, internal consistency, convergent and discriminant validity. Results: A four-factor solution was established with the subscales 'socially anxious', 'socially callous', 'neutral' interpretations and 'dealing with meanness'. Convergent and discriminant validity was shown for both socially anxious and socially callous interpretations. However, self-reported social anxiety correlated significantly positively with both socially anxious and callous interpretations, which also correlated positively. Conclusion: The ASST is a promising measure indicating that different interpretations might co-occur.

29 maart 2022, Item does not contain fulltext, Background: Anhedonia is apparent in different mental disorders and is suggested to be related to dysfunctions in the reward system and/or affect regulation. It may hence be a common underlying feature associated with symptom severity of mental disorders. Methods: We constructed a cross-sectional graphical Least Absolute Shrinkage and Selection Operator (LASSO) network and a relative importance network to estimate the relationships between anhedonia severity and the severity of symptom clusters of major depressive disorder (MDD), anxiety sensitivity (AS), attention-deficit hyperactivity disorder (ADHD), and autism spectrum disorder (ASD) in a sample of Dutch adult psychiatric patients (N = 557). Results: Both these networks revealed anhedonia severity and depression symptom severity as central to the network. Results suggest that anhedonia severity may be predictive of the severity of symptom clusters of MDD, AS, ADHD, and ASD. MDD symptom severity may be predictive of AS and ADHD symptom severity. Conclusions: The results suggest that anhedonia may serve as a common underlying transdiagnostic psychopathology feature, predictive of the severity of symptom clusters of depression, AS, ADHD, and ASD. Thus, anhedonia may be associated with the high comorbidity between these symptom clusters and disorders. If our results will be replicated in future studies, it is recommended for clinicians to be more vigilant about screening for anhedonia and/or depression severity in individuals diagnosed with an anxiety disorder, ADHD and/or ASD.

Item does not contain fulltext, Simultaneous execution of memory retrieval and cognitively demanding interventions alter the subjective experience of aversive memories. This principle can be used in treatment to target traumatic memories. An often-used interpretation is that cognitive demand interferes with memory reconsolidation. Laboratory models applying this technique often do not meet some important procedural steps thought necessary to trigger reconsolidation. It remains therefore unclear whether cognitively demanding interventions can alter the reconsolidation process of aversive memories. Here, 78 (41 included) healthy participants completed an established 3-day threat conditioning paradigm. Two conditioned stimuli were paired with a shock (CS+ s) and one was not (CS-). The next day, one CS+ (CS+ R), but not the other (CS+), was presented as a reminder. After 10 min, participants performed a 2-back working memory task. On day three, we assessed retention. We found successful acquisition of conditioned threat and retention (CS+ s > CS-). However, SCRs to the CS+ R and the CS+ during retention did not significantly differ. Although threat conditioning was successful, the well-established cognitively demanding intervention did not alter the reconsolidation process of conditioned threat memories. These findings challenge current views on how cognitively demand may enhance psychotherapy-outcome.

09 juni 2022, Item does not contain fulltext, Callous-unemotional (CU) traits predict behavioral problems in adolescence. But little is known about early modulatory factors. Behavioral Inhibition (BI) in particular has been suggested to protect against the development of CU-traits. This temperamental predisposition is characterized by heightened environmental sensitivity. The current prospective longitudinal study examined whether BI at 15 months of age predicted lower CU-traits across development to age 21. A longitudinal sample of normatively developing children (n = 125) was used. BI was assessed at 15 months using a standard stranger/robot paradigm. CU-traits were assessed at 2, 5, 9, 12, 14, 17, and 21 years with parent, teacher, and self-reports. Developmental pathways across all available data points were examined using Bayesian mixed models and k-means cluster analysis. Infant BI predicted lower CU-traits across development for girls, suggesting that BI buffers the long-term development of CU-traits for girls. CU-traits peaked in early adulthood. Boys scored higher and showed higher increases in CU-traits than girls from childhood onward. There was no gender difference regarding infant BI. Together, the findings demonstrated gender differences in the development of CU-traits, with a protective role of BI for girls. These results shed new light on the developmental trajectories and protective factors of CU-traits and provide starting points for interventions aiming at increasing children’s responsiveness to external cues to prevent antisocial traits and conduct problems.

18 april 2022, Contains fulltext : 248766.pdf (Publisher’s version ) (Open Access), This pre-registered study focused on developing a new social picture task to assess interpretation bias related to social fears in adolescents. Using such a pictorial task may increase ecological validity and readily trigger emotional processes compared to more traditional verbal tasks that are often used. In the picture task, ambiguous social pictures were presented, followed by a positive and negative interpretation. In this study, we examined how the new task relates to an already existing interpretation bias task and how the new pictorial task relates to social fears in adolescents. The sample consisted of 329 adolescents aged 12 to 18 years. Interpretation bias was assessed with the newly developed pictorial task and with more traditional verbal vignettes. Social fears were measured with self-report questionnaires. The results suggest that the pictorial task was able to assess interpretation bias comparable to the verbal vignettes, suggesting appropriate convergent validity. Interpretation bias assessed with the picture task was linked to higher levels of fear of negative evaluation, the core symptom of social anxiety, but not to social anxiety symptoms in general. The verbal task was linked to both social fears and thus still seems the preferred method to investigate interpretation bias related to social fears in adolescents. However, we do believe that with further improvement of the pictorial task, it could be a useful addition to the research field.

Item does not contain fulltext, Background and objectives: Conduct disorder (CD) is associated with deficits in social-emotional behaviour, such as increased levels of aggression. Callous-unemotional (CU-) traits foster those deficits and contribute to severe rates of instrumental aggression in CD. Previous studies of that increase in aggression have mainly focused on intentional aspects of behaviour. Unintentional behaviour, such as automatic approach and avoidance, has not been taken into account despite being highly relevant for behaviour. Therefore, the relevance of CU-traits for automatic actions and the feasibility of an approach-avoidance-task to measure those actions in CD-patients were investigated in a study series. Methods: Study 1 22 CD-patients executed an approach-avoidance task, where participants pushed or pulled pictures of emotional faces using a joystick. CU-traits were assessed via parent-report. Study 2 28 CD-patients and 19 typically developing children (TD) executed the AAT. Again, CU-traits were assessed via parent-report. Results: The AAT was a feasible instrument to measure automatic action tendencies and revealed that, while TD-children showed an avoidance bias towards angry faces, CD-patients showed a lack of automatic avoidance of anger. Across the whole sample (TD and CD combined), CU-traits predicted less threat avoidance. Limitations The small sample size may have limited the power to detect smaller approach-avoidance tendencies towards other emotions. Conclusions: The findings suggest that CD is associated with a lack of automatic avoidance of social threat and that CU-traits predict that lack of avoidance. Divergent automatic threat responding might underlie the extreme levels of instrumentally aggressive behaviour observed in CD-patients with distinctive CU-traits.

26 mei 2022, Item does not contain fulltext, Objective: The current study examined whether children with a social anxiety disorder (SAD) demonstrate divergent facial emotion processing and a disorder-specific negative interpretation bias in the processing of facial emotional expressions. This study aimed to overcome previous study limitations by including both a nonsocially anxious control group and a healthy control group to examine whether childhood SAD is characterized by a general emotion labeling deficit, and/or by a negative interpretation bias, indicated by systematic misclassifications, or a lower threshold for recognizing threatening emotions. Method: Participants were 132 children aged 7-12 years (Mage = 9.15; 45.5% female). Children with SAD (n = 42) were compared to children with other, nonsocial, anxiety disorders (n = 40) and healthy control children (n = 50) on a novel facial emotion recognition task. Children judged ambiguous happy/neutral, angry/neutral and fear/neutral faces that were morphed at different intensities (10%, 30%, 50%, 70%). Results: Children with SAD did not differ from other groups in their accuracy of identifying emotions. They did not show systematic misclassifications or a heightened sensitivity to negative, threatening faces either. Rather, children with nonsocial anxiety disorders showed a generally heightened sensitivity to emotional faces. Conclusions: The current study does not provide evidence for a general deficit in labeling of emotional faces in childhood SAD. Childhood SAD was not characterized by an interpretation bias in processing emotional faces. Children with nonsocial anxiety disorders may benefit from assistance in accurately interpreting the degree of emotionality in interpersonal situations.

13 mei 2022, Contains fulltext : 250281.pdf (Publisher’s version ) (Open Access), Background: Cognitive biases are found to play a role in the onset and maintenance of social anxiety. However, particularly in adolescence, the link between different biases and their role in predicting social anxiety is far from clear. This study therefore investigated the interplay between attention bias and interpretation bias in relation to social anxiety in adolescence across three years. Methods: 816 adolescents in grade 7 to 9 participated at three yearly waves (52.8% boys, M age grade7 = 12.60). Social anxiety was measured with a self-report questionnaire. Attention bias was measured with a visual search task with emotional faces. Textual vignettes assessed interpretation bias. Results: Cross-lagged models showed that negative interpretation bias at grade 7 predicted an increase in social anxiety at grade 8. This effect was not found from grade 8 to 9. Attention bias did not predict social anxiety. Attention bias and interpretation bias were not longitudinally related to each other, nor did they interact with each other in predicting social anxiety. Conclusions: Thus, no evidence was found for the Combined Cognitive Bias Hypothesis in social anxiety in adolescents. Instead, our results suggest that interpretation bias rather than attention bias contributes to the increase of social anxiety over time.

16 mei 2022, Item does not contain fulltext

Contains fulltext : 249709.pdf (Publisher’s version ) (Open Access), Background and Objectives: Worry-related negative metacognitive beliefs about worrying maintain and predict pathological worry. For the current proof-of-principle study, we developed a computerized cognitive bias modification based-reappraisal training (RT), to modify the appraisal of negative metacognitive beliefs in a high-worrying sample. A functional and dysfunctional RT were pitted against each other to investigate whether appraisals of one’s thinking and coping changed following training. Moreover, training effects on the number of negative thoughts and interpretations of the worry content were examined. Methods: Participants (N = 81) were trained to adopt a functional (disconfirmation of negative metacognitive beliefs) or dysfunctional (confirmation of negative metacognitive beliefs) appraisal style using a series of vignettes that had to be completed in line with the intended training direction. Changes in negative thoughts from pre- to post-RT were assessed with a behavioral state worry task, and transfer to interpretations with an open-ended stem sentence task. Results: Findings support the use of the RT to alter a metacognitive appraisal bias, as participants receiving the functional RT reported fewer negative appraisals of one’s thinking and coping than participants in the dysfunctional RT group. Number of negative thoughts and interpretations were not directly affected by training. Limitations: This study employed an analog sample and future research should replicate findings in a clinical sample for which negative metacognitions are more relevant. Conclusions: These findings highlight the potential of metacognitive RT for future translational studies with (clinical) samples characterized by repetitive negative thinking and/or negative metacognitive beliefs.

07 november 2022, Item does not contain fulltext, Objectives: In terms of dual process models, behaviour can be conceived of as the outcome of an interplay between reflective, top-down and impulsive, bottom-up processes. Behaviour change interventions may benefit from targeting both types of processes in a coherent way. One approach to this, in the context of reducing hazardous drinking, is to combine imagery involving real-life situations involving alcohol with the simple actions involved in Approach Bias Modification (ApBM), a form of Cognitive Bias Modification. Design We developed and tested a version of this Imagery-enhanced Approach Bias Modification (IApBM) in an experimental design, with two independent factors: imagery versus control and ApBM versus control training components (N = 139). Methods: An effect of integrating the training factors was hypothesized on the alcohol-approach bias of an alcohol Approach-Avoidance Task. Further exploratory analyses were performed for the bias on alcohol-related Single Attribute Implicit Association Tests and on alcohol-related questionnaires. Finally, the psychometric properties of an imagery interference effect during training were explored. Results: Results showed no benefit of the training and in fact suggested a negative interaction in which combining the training components appeared to block reductions in craving effected by each in isolation. The reliability of the imagery-related interference effect was high and the effect was correlated with alcohol-related scales. Conclusions: In conclusion, it appears that interference between training components decreases their individual effects when combining imagery and ApBM in the current way. The imagery-related interference effects that could be measured during training conditions may be useful as an implicit measure of automatic processes underlying hazardous drinking.

Item does not contain fulltext, Objective: Approach bias modification (ApBM) is a promising new add-on training intervention for patients with alcohol use disorder (AUD). Given that comorbid anxiety and major depressive disorders are very common in AUD, and that such comorbidity affects psychological treatments negatively, the primary aim of the present study was investigating whether ApBM training is moderated by anxiety/major depressive disorder comorbidity. The secondary aim was to examine whether ApBM's relapse-preventive effect can be replicated. Method: We conducted a large-scale randomized controlled trial (RCT) in a clinical sample of AUD inpatients (n = 729) with a follow-up assessment after 1 year. All patients received 12 weeks of inpatient treatment as usual (TAU). On top of that, patients were randomized to a 12-session ApBM (TAU + ApBM), and a no-training control condition (TAU-only). Treatment success was defined as either no relapse or a single lapse shorter than 3 days in duration, ended by the patient and followed by at least 4 weeks of abstinence. Failure was defined as relapse, passed away, no contact, or refusal to provide information. Results: We found that TAU + ApBM had significantly higher success rates than TAU-only at 1-year follow-up. Importantly, anxiety/depressive comorbidity moderated ApBM's effects: Adding ApBM to TAU increased success rates more for patients with a comorbid anxiety and/or depressive disorder than for patients without such comorbidity. Conclusions: Our data suggest that adding ApBM to TAU works better in patients with a comorbid anxiety and/or depressive disorder; a promising finding gave the high rates of comorbidity in clinical practice.

Item does not contain fulltext, This chapter covers the topics and research questions of "Experimental Psychopathology" (EP) and the experimental tasks used to answer them. We describe historical roots and current models of EP, and we characterize its relevance for Clinical Psychology. The methods of EP are described in detail, illustrating the tasks which are used to study attention, associations, approach-avoidance tendencies, interpretation, memory, cognitive control, and learning processes. We also illustrate the path that EP research has taken from the experimental assessment of clinically relevant phenomena, via the induction of potentially causal processes and their therapeutic modification, to clinical applications.

Radboud University, 20 december 2022, Promotor : Becker, E.S. Co-promotores : Lange, W.G., Luijten, M., Contains fulltext : 284212.pdf (Publisher’s version ) (Open Access), Social anxiety is common in adolescents and is characterised by the extreme and persistent fear of social situations and negative evaluation by others. The aim of this dissertation was to better understand which factors contribute to the development of social anxiety in adolescence. Specifically, two risk factors were investigated: cognitive biases (divided into 'attention bias' –where you focus your attention on in social situations; and into 'interpretation bias' - how you interpret these situations) and social status (how liked and how popular you are perceived by classmates). This dissertation shows that youth who are less liked and popular and who tend to interpret social situations in a negative way, have an increased risk of developing social anxiety. Preventions for social anxiety should therefore focus on these factors. The role of attention bias in social anxiety was not confirmed in this study.

Contains fulltext : 243997.pdf (Publisher’s version ) (Open Access), Research has identified three different types of smiles - the reward, affiliation and dominance smile - which serve expressions of happiness, connectedness, and superiority, respectively. Examining their explicit and implicit evaluations by considering a perceivers’ level of social anxiety and psychopathy may enhance our understanding of these smiles' theorised meanings, and their role in problematic social behaviour. Female participants (N=122) filled in questionnaires on social anxiety, psychopathic tendencies (i.e. the affective-interpersonal deficit and antisocial lifestyle) and callous-unemotional (CU) traits. In order to measure explicit and implicit evaluations of the three smiles, angry and neutral facial expressions, an Explicit Valence Rating Task and an Approach-Avoidance Task were administered. Results indicated that all smiles were explicitly evaluated as positive. No differences in implicit evaluations between the smile types were found. Social anxiety was not associated with either explicit or implicit smile evaluations. In contrast, CU-traits were negatively associated with explicit evaluations of reward and dominance smiles. These findings support the assumptions of non-biased explicit information processing in social anxiety, and flattened emotional sensitivity in CU-traits. The importance of a multimethod approach to enhance the understanding of the effects of smile types on perceivers is discussed.

24 december 2021, Item does not contain fulltext, Research has identified three different types of smiles - the reward, affiliation and dominance smile - which serve expressions of happiness, connectedness, and superiority, respectively. Examining their explicit and implicit evaluations by considering a perceivers’ level of social anxiety and psychopathy may enhance our understanding of these smiles' theorised meanings, and their role in problematic social behaviour. Female participants (N=122) filled in questionnaires on social anxiety, psychopathic tendencies (i.e. the affective-interpersonal deficit and antisocial lifestyle) and callous-unemotional (CU) traits. In order to measure explicit and implicit evaluations of the three smiles, angry and neutral facial expressions, an Explicit Valence Rating Task and an Approach-Avoidance Task were administered. Results indicated that all smiles were explicitly evaluated as positive. No differences in implicit evaluations between the smile types were found. Social anxiety was not associated with either explicit or implicit smile evaluations. In contrast, CU-traits were negatively associated with explicit evaluations of reward and dominance smiles. These findings support the assumptions of non-biased explicit information processing in social anxiety, and flattened emotional sensitivity in CU-traits. The importance of a multimethod approach to enhance the understanding of the effects of smile types on perceivers is discussed.

Contains fulltext : 242772.pdf (Publisher’s version ) (Open Access), Many individuals with coronary heart disease (CHD) have maladaptive beliefs which might increase anxiety and depression. This study investigates the impact of using video information to convey facts and correct misconceptions about CHD in individuals. 150 individuals with CHD were assigned to either the control group or one of two experimental groups. The participants completed the York Cardiac Beliefs Questionnaire in the baseline measure immediately after first viewing the video (time 1), and after viewing the video for six times within two weeks (time 2). The Beck Anxiety Inventory and Beck Depression Inventory II were completed in the baseline and at time 2. Multiple repeated measures anova shows that after the intervention, participants' maladaptive beliefs, anxiety and depression were reduced in both experimental groups. Yet, it did not happen in the control group. It indicates that the video information corrects maladaptive beliefs, and reduces anxiety and depression levels in individuals with CHD.

Item does not contain fulltext, Cognitive behavioral therapy (CBT) is an established first-line intervention for psychological disorders. Numerous randomized controlled trials (RCTs) and meta-analyses indicate that CBT outperforms wait-list and placebo conditions and evidences comparable efficacy to other efficacious interventions such as pharmacotherapies. This chapter provides a narrative review of studies examining putative mechanisms of action of CBT for depression and anxiety disorders, and briefly addresses research in other mental health disorders. It focuses on core behavioral and cognitive mechanisms of action as tested by self-report measures or behavioral measures. Because sustainable treatment effects should be reflected by changes in the brain, specifically in areas related to proposed mechanisms of change, researchers have started relating brain activation in areas related to such processes with CBT outcome. The chapter illustrates how mechanistic research can guide treatment development and finish by offering some directions for research in this important area.

Radboud University, 24 november 2021, Promotores : Rinck, M., Hudson, J.L., Becker, E.S., Rapee, R.M. Co-promotor : Klein, A.M., Contains fulltext : 239921.pdf (Publisher’s version ) (Closed access)

Item does not contain fulltext, Basic research on emotional memory has given rise to important innovations in research on memory training in the context of psychopathology. In the special issue om memory training research is presented on (1) memory processes in psychopathology; (2) modification of emotional memories in psychotherapy; and (3) procedures to directly target memory processes. We review the key contributions of the special issue in these areas and describe the challenges for further research in this area.

Item does not contain fulltext, Background: There is a growing body of research supporting the potential therapeutic value of the Cognitive Control Training (CCT) for depression, even though more research including a control condition is necessary to investigate its working mechanisms. Methods: The aim of this randomized, double-blind, placebo-controlled trial was to investigate the adjunctive effects of CCT to treatment-as-usual, compared to a sham-training, in patients with Major Depressive Disorder. Hundred-and-fifteen inpatients were randomly assigned to complete ten sessions of either an active working-memory based CCT (n = 56) or a comparable sham-training (n = 59). Changes in depressive symptoms and rumination were assessed from baseline to post-training, and at 1 year follow-up. Secondary outcome measures included alternative indices of maladaptive emotion regulation strategies, state-rumination in response to a worry induction, a cognitive transfer task and self-reports of work-status and well-being at 1 year follow-up. Results: Our results show no evidence for short-term beneficial effects of CCT in depressed inpatients when added to TAU. Conclusion: Although other studies suggest that CCT may hold potential as an add-on intervention for depression, our findings point to the importance of investigating individual differences and conditions predicting training response.

Contains fulltext : 235092.pdf (Publisher’s version ) (Closed access)

Contains fulltext : 233300.pdf (Publisher’s version ) (Open Access), This study examined the transactional longitudinal association between social status (likeability and popularity) and social anxiety symptoms (fear of negative evaluation and social avoidance and distress), and explored gender differences in this association. Participants included 274 adolescents (136 boys, Mage = 12.55). Data were collected at two waves with a 6-month interval. Likeability and popularity were measured with peer nominations and social anxiety symptoms with self-reports. Autoregressive cross-lagged path models showed relative stability of social status and social anxiety. Girls who were seen as less popular by their classmates avoided social situations more frequently and experienced more distress during such situations over time. These results highlight the importance of distinguishing between different social status components and social anxiety symptoms and to take gender into account. Early support for less popular girls seems important to prevent more severe consequences of avoidance and distress, such as social exclusion and victimization.

10 juni 2021, Item does not contain fulltext, Objective: Approach bias modification (ApBM) is a promising new add-on training intervention for patients with alcohol use disorder (AUD). Given that comorbid anxiety and major depressive disorders are very common in AUD, and that such comorbidity affects psychological treatments negatively, the primary aim of the present study was investigating whether ApBM training is moderated by anxiety/major depressive disorder comorbidity. The secondary aim was to examine whether ApBM's relapse-preventive effect can be replicated. Method: We conducted a large-scale randomized controlled trial (RCT) in a clinical sample of AUD inpatients (n = 729) with a follow-up assessment after 1 year. All patients received 12 weeks of inpatient treatment as usual (TAU). On top of that, patients were randomized to a 12-session ApBM (TAU + ApBM), and a no-training control condition (TAU-only). Treatment success was defined as either no relapse or a single lapse shorter than 3 days in duration, ended by the patient and followed by at least 4 weeks of abstinence. Failure was defined as relapse, passed away, no contact, or refusal to provide information. Results: We found that TAU + ApBM had significantly higher success rates than TAU-only at 1-year follow-up. Importantly, anxiety/depressive comorbidity moderated ApBM's effects: Adding ApBM to TAU increased success rates more for patients with a comorbid anxiety and/or depressive disorder than for patients without such comorbidity. Conclusions: Our data suggest that adding ApBM to TAU works better in patients with a comorbid anxiety and/or depressive disorder; a promising finding gave the high rates of comorbidity in clinical practice.

Item does not contain fulltext, Objective: Perseverative cognition (PC) is the repeated or long-term activation of the cognitive representation of psychological stressors and is associated with prolonged stress including somatic and mental consequences. Hence, PC might represent a cognitive process linking mental and somatic pathology, but current research on this link is limited by investigating healthy samples, markers of somatic disease, and single disorders. The present study explored the importance of PC for different mental and somatic disorders in psychiatric patients. Methods: Data from 260 naturalistic psychiatric outpatients were used. Psychiatric diagnoses were based on structured clinical interviews. Somatic diseases were assessed using a well-validated questionnaire and were clustered into (cardio)vascular and immune-/endocrine diseases. PC was operationalized using the perseverative thinking questionnaire (PTQ). Results: Multiple regression complemented with relative importance analyses showed that the PTQ total and subscale scores were associated with the presence of mood disorders, addiction, and anxiety. Unexpectedly, no relatively important associations were found between the PTQ and autism spectrum disorder, attention-deficit/hyperactivity disorder, or somatic disease. Conclusions: Our data complement previous work linking PC to stress-related mental disorders but question its immediate role in neurodevelopmental- and somatic disorders. Targeting PC in the treatment of mood disorders and perhaps also in addiction appears promising.

Item does not contain fulltext, This chapter covers the topics and research questions of "Experimental Psychopathology" (EP) and the experimental tasks used to answer them. We describe historical roots and current models of EP, and we characterize its relevance for Clinical Psychology. The methods of EP are described in detail, illustrating the tasks which are used to study attention, associations, approach-avoidance tendencies, interpretation, memory, cognitive control, and learning processes. We also illustrate the path that EP research has taken from the experimental assessment of clinically relevant phenomena, via the induction of potentially causal processes and their therapeutic modification, to clinical applications.

Radboud University, 22 oktober 2021, Promotores : Becker, E.S., Rinck, M., Contains fulltext : 237844.pdf (Publisher’s version ) (Open Access)

Contains fulltext : 233751.pdf (Publisher’s version ) (Open Access), Attentional deficits as well as attentional biases towards negative material are related to major depression and might maintain chronicity. However, studies investigating attentional deficits and attentional biases in chronic, treatment-resistant depressed are lacking. The aim of the current study was to compare measures of attentional deficits and attentional bias between chronic, treatment-resistant depressed outpatients and never-depressed control participants. Attentional deficits were assessed with the attentional control scale (ACS) and the Stroop Color naming task. Attentional bias was measured with the exogenous cueing task (ECT) and an emotional Stroop task. Chronic, treatment-resistant depressed patients (n=80) showed significantly more attentional deficits than never-depressed controls (n=113) on the ACS and Stroop color-naming task. However, in contrast with hypotheses, no differences were found between chronic, treatment-resistant depressed patients and never-depressed individuals on the ECT or emotional Stroop task. The current findings indicate that chronic, treatment-resistant depressed patients present attentional deficits. The results however question whether this patient group shows attentional biases for negative material. Future research should include comparisons of chronic, treatment-resistant and non-chronically depressed patients. If replicated, these current results might indicate that focusing on improving attentional deficits could be a more promising target for treatment than addressing attentional biases.