Imagine the bright side of life: A randomized controlled trial of two types of interpretation bias modification procedure targeting adolescent anxiety and depression

• Published in: PloS one 2017-07, Vol.12 (7), p.e0181147-e0181147
• Main Authors: de Voogd, E L, de Hullu, E, Burnett Heyes, S, Blackwell, S E, Wiers, R W, Salemink, E
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescent depression; Adolescents; Affect; Anxiety; Anxiety - pathology; Anxiety - psychology; Attentional bias; Bias; Biology and Life Sciences; Care and treatment; Child; Cognition; Cognitive ability; Depression - pathology; Depression - psychology; Diagnosis; Emotions; Feasibility studies; Female; Humans; Imagery; Imagery (Psychotherapy) - methods; Internet; Long-term effects; Male; Medicine and Health Sciences; Mental depression; People and Places; Psychological aspects; Randomization; Research and Analysis Methods; Self Concept; Social Sciences; Studies; Surveys and Questionnaires; Teenagers; Training; Treatment Outcome
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0181147

Anxiety and depression are highly prevalent during adolescence and characterized by negative interpretation biases. Cognitive bias modification of interpretations (CBM-I) may reduce such biases and improve emotional functioning. However, as findings have been mixed and the traditional scenario training is experienced as relatively boring, a picture-based type of training might be more engaging and effective. The current study investigated short- and long-term effects (up to 6 months) and users' experience of two types of CBM-I procedure in adolescents with heightened symptoms of anxiety or depression (N = 119, aged 12-18 year). Participants were randomized to eight online sessions of text-based scenario training, picture-word imagery training, or neutral control training. No significant group differences were observed on primary or secondary emotional outcomes. A decrease in anxiety and depressive symptoms, and improvements in emotional resilience were observed, irrespective of condition. Scenario training marginally reduced negative interpretation bias on a closely matched assessment task, while no such effects were found on a different task, nor for the picture-word or control group. Subjective evaluations of all training paradigms were relatively negative and the imagery component appeared particularly difficult for adolescents with higher symptom levels. The current results question the preventive efficacy and feasibility of both CBM-I procedures as implemented here in adolescents.