Transitioning to college: Testing cognitive bias modification for interpretations as an inoculation tool for social anxiety in college first-years

Sarah E Dreyer-Oren; Akanksha Das; Rachel B Geyer; Robert E Fite; Elizabeth J Kiel; Elise M Clerkin

doi:10.1016/j.jbtep.2024.101961

Transitioning to college: Testing cognitive bias modification for interpretations as an inoculation tool for social anxiety in college first-years

J Behav Ther Exp Psychiatry. 2024 Mar 11:84:101961. doi: 10.1016/j.jbtep.2024.101961. Online ahead of print.

Authors

Sarah E Dreyer-Oren¹, Akanksha Das², Rachel B Geyer², Robert E Fite³, Elizabeth J Kiel², Elise M Clerkin⁴

Affiliations

¹ Alpert Medical School of Brown University, Providence, RI, USA; Butler Hospital, Providence, RI, USA. Electronic address: sarah_dreyer-oren@brown.edu.
² Miami University, Oxford, OH, USA.
³ Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA.
⁴ University of Virginia, Charlottesville, VA, USA.

PMID: 38489952
DOI: 10.1016/j.jbtep.2024.101961

Abstract

Background and objectives: Reducing social anxiety development among incoming college students may improve college adjustment and mental health outcomes. This study tested whether cognitive bias modification for interpretations (CBM-I) reduces social anxiety and increases adjustment during the transition to college, and whether changes in outcomes would be mediated by changes in interpretation biases.

Methods: Participants (N = 73) were randomly assigned to a 3-session weekly CBM-I condition or symptom tracking (ST) control condition. Multilevel models were used to estimate within-person trajectories from baseline to one week post-intervention and to test whether trajectories differed by condition.

Results: Those in the CBM-I condition (vs. ST) reported higher increases in social adjustment across time. There were not significant differences between conditions for changes in social anxiety, academic adjustment, and personal adjustment. CBM-I was indirectly linked to improvements in outcome variables via more adaptive interpretation biases.

Limitations: CBM-I was administered in a laboratory setting, requiring more resources than some computerized interventions.

Conclusions: Data tentatively support CBM-I for first-year students to increase social adjustment. Further, mediation findings provide support for targeting interpretation biases to improve social anxiety and adjustment outcomes. Yet, CBM-I did not outperform ST in improving social anxiety symptoms or other areas of college adjustment, and effect sizes were small, suggesting that more work is needed to amplify the potential of CBM-I as a therapeutic tool.

Keywords: Cognitive bias modification; College; Interpretation bias; Social anxiety.