Interpretation Bias Across Body Dysmorphic, Social Anxiety and Generalized Anxiety Disorder—A Multilevel, Diffusion Model Account

• Published in: Cognitive therapy and research 2021-08, Vol.45 (4), p.715-729
• Main Authors: Dietel, Fanny Alexandra, Möllmann, Anne, Bürkner, Paul-Christian, Wilhelm, Sabine, Buhlmann, Ulrike
• Format: Article
• Language: English
• Subjects: Anxiety; Anxiety disorders; Bias; Body dysmorphic disorder; Clinical Psychology; Cognitive Psychology; Generalized anxiety disorder; Medicine; Medicine & Public Health; Original Article; Quality of Life Research; Social anxiety
• ISSN: 0147-5916; 1573-2819
• DOI: 10.1007/s10608-020-10180-7

Background Interpretation biases are suggested to be transdiagnostic phenomena, but have rarely been compared across different disorders and current concerns. Methods We investigated explicit, decision-based, and more implicit, reaction time-based interpretation bias in individuals with body dysmorphic disorder (BDD; N  = 29), social anxiety disorder (SAD; N  = 36), generalized anxiety disorder (GAD; N  = 22), and non-clinical controls (NC; N  = 32), using an adapted Word Sentence Association Paradigm (WSAP). Results Results indicated that interpretation bias occurred transdiagnostically, while content-specific bias patterns varied meaningfully across groups. BDD and SAD shared explicit and, more inconsistently, implicit interpretation biases for appearance-related and social situations. The GAD group exhibited an explicit and implicit negative interpretation bias for general situations, and an additional implicit lack of positive bias. Mechanistic Wiener diffusion model analyses revealed that interpretation bias patterns were mainly driven by speeded information uptake, potentially mirroring disorder-specific associative memory organization. Conclusions These findings have important implications for understanding interpretation biases as both etiological and treatment factors.