Augmenting interpretative cognitive bias modification using memory reconsolidation updating

Abstract

Research suggests that interpretative cognitive biases can be attenuated by cognitive bias modification for interpretation (CBM-I). However, small effect sizes and a lack of follow-up data highlight a need to increase the potency and durability of CBM-I. Recent findings have suggested that reactivating a fear memory briefly before behavioral intervention may suppress later return of fear, through utilization of a process known as reconsolidation updating. The current experiment investigated the efficacy of a CBM-I augmentation that involved administering a brief fear reactivation procedure prior to CBM-I. 74 adults with clinical social anxiety were randomly assigned to give an impromptu speech either 10 minutes prior to interpretation bias training (CBM+FRT), 24 hours prior to training (CBM), or 24 hours prior to placebo training (CONTROL). Social anxiety symptomology and interpretation bias were assessed using self-report questionnaires and a behavioral task at baseline (BL), post-training (POST), 1-week follow-up (FU1), and 2-week (FU2) follow-up. Mixed effects regression models revealed that as hypothesized, the CBM+FRT group had significantly lower interpretation bias than the CBM group at FU2, but not at POST or FU1. However, there were no significant between-group differences in self-reported anxiety symptoms at any assessment. Additionally, no difference in interpretation bias between CBM and CONTROL was found at POST. Findings provide support for continued investigation of brief fear network reactivation as a means of enhancing anxiety treatment. However, a failure to find effects of non-augmented CBM-I suggests that further scrutiny is necessary to determine CBM’s clinical utility.