Do attentional and interpretive biases interact or work independently in vulnerability to emotional stress?

Current psychological theories emphasise the role that the way in which people think plays in the development of common psychological conditions like anxiety, depression and elation. It is thought that people with anxiety or depression have biased thinking styles which mean that they tend to automatically process information in a threat-related or negative way compared with the general population. Those with elation react differently from those that are normal and those with anxiety and depression. Two kinds of biased thinking have been identified in emotional disorders: attention bias, where attention is automatically diverted towards items associated with danger or unhappiness, and interpretation bias, where the individual automatically perceives emotionally aversive meanings in ambiguous information. Computer-based interventions which have been designed to reverse these biases (known as cognitive bias modification (CBM)) have been shown to significantly alleviate anxiety and low mood, demonstrating the causal role of biased thinking in mental ill health, whilst providing a potential platform for developing non-specialist interventions which individuals can access on their own home computer. All the research to date, has, however, focussed on a single thinking bias at a time (either attention or interpretation). In addition, testing of participants tends to be conducted with groups of either highly socially anxious participants, or those who experience no difficulty in their everyday living due to anxiety. Interpretation bias modification programs typically train individuals to interpret information in a more positive way, and the effect of interpretation bias from pre to post training is assessed, along with any changes in mood. Similarly, attention bias modification programs train participants to attend away from unpleasant stimuli and the difference between pre and post attention bias is measured, along with mood changes. Very little work has considered whether reduction in one bias also results in a reduction in the other bias and how different mood states might interact with different levels of bias. For further progress to be made in understanding the mechanisms underpinning emotional problems, work needs to be done to find out how the identified attentional and interpretive processes interact with one another and with different levels of distress to induce and subsequently maintain differing levels of anxiety in individuals. The aim of the proposed research is to find out first of all whether or not the biases operate conjointly or independently. Based on these findings, the second aim will be to examine the optimal conditions for training delivery for individuals with elevated anxiety and/or depression levels, and exuberant individuals. The findings from this research will inform the development of current theories of affective conditions in cognitive psychology. With improved understanding of the conditions in which the mind generates biased thinking more precise cognitive bias modification interventions can be developed to target problematic thinking in anxiety, depression and elation.

The proposed research is anticipated to advance theoretical knowledge regarding the cognitive processes involved in attentional and interpretive biases associated with anxiety, and propagate further research regarding the most efficacious presentation of Cognitive Bias Modification (CBM) treatment programmes. The CBM paradigm is currently receiving a plethora of research attention, both nationally and internationally, some of which is investigating the efficacy of computerised CBM programmes, which have the potential for users to access at their convenience - for example, on their home computer: a cost effective solution in the treatment of anxiety. In contrast to the currently favoured 'talking therapies' such as CBT, CBM utilises implicit, unconscious processes, and thus may render itself more suitable to anxious individuals with conditions such as stuttering and aphasia. Although future research is required to investigate this fully, in the long term CBM may have the potential for wide application in the treatment of anxiety, particularly in health service settings, where cost effectiveness is a priority. It is therefore anticipated that the proposed research will directly underpin future CBM treatment designs, which will in turn, indirectly, be of benefit to any organisation with a requirement to provide cost effective anxiety treatment packages to a wide audience, including both national and international organisations. Within the UK, this may include public health service providers - the NHS and private sector, third party organisations, such as charities. Providing a potentially efficacious, easily accessible, cost effective solution to health care providers in the treatment of anxiety has clear additional benefits to society at large. Directly, many work hours are lost within the UK each year to sufferers of anxiety conditions. Indirectly the family and friends of those with anxiety disorders are also at increased risk of experiencing some kind of mental health difficulty. Thus in the long term and indirectly, CBM has the potential to assist in the reduction of long term health costs, improving the mental wellbeing of the nation, and reducing man hours lost at work.

Staff working on this project will develop a range of competencies which could be applied to other work sectors, including use of IT and advanced software, presenting to seminar groups and conferences, journal article writing, working with the general public as well as skills in planning and running a comprehensive project. They will also be well versed in CBM methodologies, which, as the methodology develops, will become increasingly applicable in contexts outside the laboratory.