This study investigates the potential of rumination-focused cognitive behavioural therapy (RFCBT) to address core issues in adolescents with social anxiety disorder (SAD). Specifically, it examines RFCBT’s effectiveness in reducing internalized shame, negative interpretation biases, and rumination, which contribute significantly to their social anxiety. The present study employed a quasi-experimental design with a pre-test, post-test, and follow-up phase. The population of the study included all adolescents with SAD in Ahvaz, Iran, in 2023. The sample consisted of 48 adolescents with SAD who were selected using convenience sampling and then randomly assigned to either the RFCBT group or the control group (24 participants per group). The research instruments included the Social Anxiety Questionnaire, the Child Internalized Shame Scale, the Interpretation Bias Questionnaire, and the Rumination Response Scale (RRS). Repeated measures analysis of variance (ANOVA) was used to analyse the data. The findings indicate that RFCBT had a significant effect on reducing internalized shame, interpretation bias, and rumination (p<0.01) in adolescents with SAD, with results maintained at follow-up. This study adds to the evidence that RFCBT can be helpful for anxiety disorders in adolescents. RFCBT seems to work by addressing negative self-views, biased interpretations, and repetitive negative thinking patterns. More research is needed to determine if these benefits are sustained long-term and if RFCBT can improve social skills and overall well-being for adolescents with social anxiety.

Interpretation bias (i.e. the selective negative interpretation of ambiguous stimuli) may contribute to the development and maintenance of health anxiety. However, the strength of the empirical evidence for this association remains a topic of debate. This study aimed to estimate the association between health anxiety and interpretation bias and to identify potential moderators of this association. Chinese-language databases (CNKI, VIP, and Wanfang), English-language databases (Web of Science, PubMed, PsycINFO, and Scopus), and German-language databases (Psyndex and PubPsych) were searched for relevant studies. There were 36 articles (39 studies) identified by this search (N = 8984), of which 32 articles (34 studies) were included in the meta-analysis (N = 8602). Results revealed a medium overall effect size (g = 0.67). Statistically equivalent effect sizes were observed for patients diagnosed with clinical health anxiety (g = 0.58) and subclinical health anxiety (g = 0.72). The effect sizes for threat stimuli that were health related (g = 0.68) and not health related (g = 0.63) did not differ significantly. The effect size for studies using an offline paradigm (g = 0.75) was significantly higher than that for studies using an online paradigm (g = 0.50). It is concluded that health anxiety is significantly and robustly associated with interpretation bias. These findings are of central importance for the advancement of models and treatment of health anxiety.

Experimental studies applying cognitive bias modification of attention (CBM-A) and interpretation (CBM-I) to reduce aggression have examined the effect of modifying each cognitive bias in isolation. In order to maximise the potential impact on both biases and symptom reduction, we examined whether a combined bias training procedure targeting both attention and interpretation biases (CBM-AI) in combination would be more effective than targeting interpretation bias (CBM-I) alone. University students (17–35 years) were randomly assigned to either a single session of CBM-AI training (n = 40), CBM-I training (n = 40), or a control condition (n = 40). Contrary to our expectations, participants showed an increase in adaptive attention and pro-social interpretation bias in all training conditions. Additionally, in none of the conditions, we found a significant change on self-reported or behavioural aggression. These findings suggest: (1) that the combined training did not have added effect over single interpretation bias training, (2) that training interpretation bias may lead to changes in attention bias, (3) that elements of the control condition unexpectedly, but interestingly, also affected attention and interpretation biases, and (4) single-session CBM procedures do not produce robust effects on self-report or behavioural measures of aggression in unselected samples.

Background: Previous research suggests that computerized interpretation bias modification (IBM) techniques may be useful for modifying thoughts and behaviours relevant to eating pathology; however, little is known about the utility of IBM for decreasing specific eating disorder (ED) symptoms (e.g. bulimia, drive for thinness). Aims: The current study sought to further examine the utility of IBM for ED symptoms via secondary analyses of an examination of IBM for individuals with elevated body dysmorphic disorder (BDD) symptoms (see Summers and Cougle, 2016), as these disorders are both characterized by threat interpretation biases of ambiguous appearance-related information. Method: We recruited 41 participants for a randomized trial comparing four sessions of IBM aimed at modifying problematic social and appearance-related threat interpretation biases with a placebo control training (PC). Results: At 1-week post-treatment, and relative to the PC, the IBM group reported greater reductions in negative/threat interpretations of ambiguous information in favour of positive/benign biases. Furthermore, among individuals with high pre-treatment bulimia symptoms, IBM yielded greater reductions in bulimia symptoms compared with PC at post-treatment. No treatment effects were observed on drive for thinness symptoms. Conclusions: The current study suggests that cognitive interventions for individuals with primary BDD symptoms may improve co-occurring ED symptoms such as bulimia.