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Cognitive-behavior therapy resolves implicit fear associations in generalized anxiety disorder.
Andrea Reinecke1, Mike Rinck, Eni S Becker
1University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford, UK. andrea.reinecke@psych.ox.ac.uk
Behaviour Research and Therapy
|November 22, 2012
Summary
Cognitive-behavioral therapy (CBT) normalized biased implicit evaluations in generalized anxiety disorder (GAD) patients. Reduced bias during treatment predicted symptom improvement, suggesting bias normalization is key to CBT
Area of Science:
- Cognitive psychology
- Clinical psychology
- Neuroscience
Background:
- Cognitive schema theories link anxiety disorders to excessive fear associations.
- Generalized anxiety disorder (GAD) patients show biased implicit evaluations of negative and neutral worry words.
- This bias may indicate a pathologically broadened fear structure.
Purpose of the Study:
- To assess the impact of cognitive-behavioral therapy (CBT) on biased implicit evaluations in GAD.
- To determine if bias normalization predicts treatment outcomes.
- To investigate the relationship between pre-treatment bias and treatment response.
Main Methods:
- An Extrinsic Affective Simon task measured implicit associations in 23 GAD patients and 25 healthy controls.
- GAD patients were tested before and after CBT, with some tested during waiting periods.
- Clinical symptoms were assessed pre- and post-treatment and at 6-month follow-up.
Main Results:
- CBT normalized the bias for neutral words in GAD patients.
- Reduced bias during treatment predicted greater symptom improvement post-intervention.
- Pre-treatment bias amplitude predicted the speed of CBT response.
Conclusions:
- Biased implicit evaluation of neutral worry targets is linked to state worry, not enduring GAD vulnerability.
- Normalization of this bias may be a critical mechanism in CBT's therapeutic effect.
- CBT effectively targets and modifies these implicit biases.
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