What Do People Really Think of Me? Evaluating Bias in Interpersonal Predictions Over the Course of Cognitive-Behavioral Therapy of Depression

• Published in: Behavior therapy 2021-09, Vol.52 (5), p.1286-1295
• Main Authors: Ezawa, Iony D., Plate, Andre J., Strunk, Daniel R.
• Format: Article
• Language: English
• Subjects: cognitive behavioral therapy; cognitive bias; depression; interpersonal
• ISSN: 0005-7894; 1878-1888
• DOI: 10.1016/j.beth.2021.02.007

•This study evaluated whether interpersonal biases change in CBT of depression.•Interpersonal biases became less negative and more realistic throughout CBT.•Some of these bias changes were associated with faster rates of symptom reduction. Cognitive behavioral therapy (CBT) of depression is hypothesized to achieve its effects by correcting negative biases. However, little research has tested how biases change over the course of CBT. We focus on biases in interpersonal judgments and examine whether changes in biases occur in CBT and are associated with symptom improvements. A sample of 126 adults (60% women, mean age 31.7, 83% White) participated in CBT of depression. Observers provided ratings of patients participating in two interpersonal tasks on three occasions. Patients were asked to predict observers’ ratings. In a thin slice (TS) task, observers evaluated how patients came across in a brief segment in which patients talked about themselves. In a Standard Interaction Task (SIT), observers rated the social skills patients displayed in challenging role plays. The difference between patient predictions and observer ratings provided measures of bias in these interpersonal judgments. TS and SIT bias became significantly less pessimistic and more realistic over the course of CBT. Improvements in TS bias were associated with a faster reduction in symptoms, whereas there was a non-significant trend for improvement in SIT bias being associated with faster symptom reduction. Consistent with the CBT model, negative interpersonal biases became more realistic throughout a course of CBT for depression and at least some of the changes in bias were related to therapeutic outcomes. We encourage future researchers to continue examining for whom and under which conditions correcting such biases produces the greatest benefits.