How Anxious Are You Right Now? Using Ecological Momentary Assessment to Evaluate the Effects of Cognitive Bias Modification for Social Threat Interpretations

This study examines the effectiveness of a one-week period of online Cognitive Bias Modification for Interpretations (CBM-I) for socially anxious individuals. In addition to measuring intervention effectiveness through traditional trait measures, this study investigates whether associated state measures are sensitive to intervention effects in daily life. One-hundred and six participants scoring high on a measure of trait social anxiety completed two in-lab sessions separated by five weeks of ecological momentary assessment, with n = 51 participants randomly assigned to receive the online CBM-I intervention half-way through the five-week monitoring period. In addition to examining change on traditional trait questionnaire outcomes, state outcomes were assessed by comparing participants’ responses to randomly-timed and nightly surveys delivered to their mobile phones prior to and following the online intervention. Results indicate that the CBM-I training was more effective than monitoring alone in reducing trait negative interpretation bias, indicating target engagement. However, this change was not reliably accompanied by changes on other cognitive processing style outcomes, at either trait or state levels. Further, while trait and state social anxiety symptoms and fear of negative evaluation improved, these changes were not unique to the CBM-I intervention group. This study demonstrates the challenges and opportunities associated with investigating intervention effects in daily life.

Any published paper that follows from this thesis will credit the following authors, in order: Katharine E. Daniel, Alexander R. Daros, Miranda L. Beltzer, Mehdi Boukhechba, Laura E. Barnes, & Bethany A. Teachman