Effects of Training Body-Related Interpretations on Panic-Related Cognitions and Symptoms

Felix Würtz; Shari Steinman; Simon E Blackwell; Frank H Wilhelm; Andrea Reinecke; Dirk Adolph; Jürgen Margraf; Marcella L Woud

doi:10.1007/s10608-023-10358-9

Effects of Training Body-Related Interpretations on Panic-Related Cognitions and Symptoms

Cognit Ther Res. 2023;47(3):494-509. doi: 10.1007/s10608-023-10358-9. Epub 2023 Feb 9.

Authors

Felix Würtz¹, Shari Steinman², Simon E Blackwell¹, Frank H Wilhelm³, Andrea Reinecke^{4

5}, Dirk Adolph¹, Jürgen Margraf¹, Marcella L Woud¹

Affiliations

¹ Mental Health Treatment and Research Center, Faculty of Psychology, Ruhr-University Bochum, Massenbergstraße 9-13, D-44787 Bochum, Germany.
² Psychology Department, West Virginia University, Morgantown, USA.
³ Division of Clinical Psychology and Psychopathology, Department of Psychology, Paris- Lodron University Salzburg, Hellbrunner Straße 34, 5020 Salzburg, Austria.
⁴ Department of Psychiatry, University of Oxford, Oxford , UK.
⁵ Oxford Health NHS Foundation Trust, Oxford , UK.

Abstract

Background: Interpretation biases (IBs) are central in panic disorder, and there is rich evidence showing that these are correlated with and predictive of panic-relevant symptomatology. However, experimental studies are needed to examine the potential causal effects of IBs, as predicted by cognitive models.

Methods: Panic-related IBs were manipulated via a sentence-completion Cognitive Bias Modification-Interpretation (CBM-I) training. The sample included N = 112 healthy participants reporting moderate levels of fear of bodily sensations. Participants were randomly allocated to a positive, negative, or control CBM-I condition. To test the trainings' effect on panic-relevant cognitive processing, IBs were assessed via proximal and distal measures. Symptom provocation tasks were applied to test transfer to panic-relevant symptomatology.

Results: Results on the proximal measure showed that positive CBM-I led to more positive IBs compared to negative, and control training. Further, positive CBM-I led to more positive IBs on the distal measure as compared to negative CBM-I. However, there were no differential training effects on panic-related symptomatology triggered via the provocation tasks.

Conclusion: The findings indicate a limited generalization of the effects of CBM-I on IBs and panic-related symptoms. Potential means to improve generalization, such as applying more nuanced measures and combining CBM-I with psychoeducation are discussed.

Keywords: Cognitive bias modification; Experimental psychopathology; Interpretation bias; Panic disorder; Symptom provocation.