Date Published: 13 July 2011

Cognitive bias modification of interpretations (CBM-I) to help teenagers with Anxiety Issues

Training teenagers to view social situations in a positive way could help those with anxiety symptoms and may help prevent problems continuing into adult life, according to recent research from Oxford University, England.

The researchers found that tasks designed to prompt either positive or negative interpretations of unclear situations can shift how healthy teenagers think about such events.

This approach is called 'cognitive bias modification of interpretations' or CBM-I.

Having shown in the lab that positive or negative styles of thinking can be induced in adolescents without any anxiety symptoms, the research team are now investigating if it is possible to change the negative thoughts that can drive problems in teenagers with high anxiety. The researchers from Oxford University, along with a colleague at the Institute of Psychiatry, have published their findings in the journal Child Psychiatry and Human Development.

" It's thought that some people may tend to draw negative interpretations of ambiguous situations," explained Dr Jennifer Lau, who led the work at the Department of Experimental Psychology at Oxford University.

" For example, I might wave at someone I recently met on the other side of the street. If they don't wave back, I might think they didn't remember me ? or alternatively, I might think they're snubbing me.
_ People with anxiety are more likely to assume the latter interpretation. These negative thoughts are believed to drive and maintain their feelings of low mood and anxiety. If you can change that negative style of thinking, perhaps you can change mood in anxious teenagers."

Adolescence appears to be a general period of vulnerability when problems with anxiety and depression can first emerge, and new treatments are needed. Cognitive behaviour therapy, for example, doesn't work for everyone and it may not be available everywhere. Estimation about prevalence of anxiety among teenagers vary. Some suggest that it could be around 10?15%. The teenage years are a period when biological changes coincide with the development of areas of the brain involved in emotional control and with big social changes, such as changing schools and friendship groups, and first romantic interests. Despite this, anxiety and depression in adolescents has remained a rather neglected area of study compared with adults.

" Of course it's normal for teenagers to be worried about exams, friends, social acceptance, and about the future generally," said Dr Lau.

" But anxiety can become a problem when it becomes persistent or is out of proportion to the situation. For example when someone is doing well at school but still worries all the time and can't control the worry. In some extreme cases kids avoid going to school because they are anxious. This is not being just a little bit worried."

Study method and processes:
Dr Lau and her colleagues investigated if simple training tasks carried out at a computer screen could change the reactions teenagers have to imagined social situations, leading them to take either more positive interpretations of the situations or more negative. Thirty-six healthy teenagers from schools in Oxfordshire and Buckinghamshire took part in the study and were randomly allocated to receive training designed to boost positive readings of scenarios or negative readings. The training consisted of working through a set of short scenarios involving familar social situations such as reading a comment about your photo on facebook, but ambiguous in terms of how one might respond emotionally. The volunteers then had to complete these ambiguous stories, being prompted to give answers which tended to resolve the situation in either a positive way or a negative way ? depending on what type of training they were allocated to in the study. Following this period of training, the researchers assessed if there was any difference in how likely participants were to rate further scenarios as positive or negative. Volunteers' mood was also assessed throughout the study.

Conclusions:
The training task induced different interpretation biases in the teenagers. Those who received positive training tended to endorse positive readings of the ambiguous scenarios, while those who received the negative training were more likely to view the scenarios more negatively. This suggests that the approach is able to shift teenager's interpretations of situations, at least in this laboratory setting.

Dr Lau said that "although these results are early, and among a limited number of healthy teenagers, we hope this approach to encourage positive interpretations of events will prove to be a powerful tool. If we are able to intervene early and effectively in teenagers with anxiety, we may be able to prevent later adult problems.The next steps are to give people with high levels of anxiety these training tasks to see if it helps change their mood over significant periods of time."

Reference to Paper:
"The plasticity of adolescent cognitions: Data from a novel cognitive bias modification training task" by Jennifer Y F Lau and colleagues is published online in the journal Child Psychiatry and Human Development with the DOI (Digital Object Identifier) 10.1007/s10578-011-0244-3.

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