Does Cognitive Bias Modification for Appraisals Change Symptom-Cognition Relations in PTSD? Preliminary Evidence from
Pascal Schlechter1, Thole H Hoppen1,2, Simon E Blackwell3
1Institute of Psychology, University of Münster, Germany.
Clinical Psychology & Psychotherapy
|July 18, 2026
Summary
Cognitive Bias Modification for Appraisals (CBM-APP) may alter the connections between post-traumatic stress disorder (PTSD) symptoms and cognitive appraisals. This training potentially weakens automatic negative self-associations linked to symptom activation in PTSD patients.
Area of Science:
- Psychology
- Neuroscience
- Clinical Psychology
Background:
- Post-traumatic stress disorder (PTSD) is often maintained by maladaptive appraisals of traumatic events.
- Cognitive Bias Modification for Appraisals (CBM-APP) is an intervention designed to foster more adaptive appraisals and reduce PTSD symptoms.
- The impact of CBM-APP on the interrelationships between PTSD symptoms and cognitive appraisals remains underexplored.
Purpose of the Study:
- To investigate how CBM-APP affects the network structure and centrality of associations among PTSD symptom clusters and cognitive appraisals.
- To examine changes in both explicit and implicit cognitive measures following CBM-APP.
- To compare these changes in a CBM-APP group versus a control training group.
Main Methods:
- A secondary analysis of a randomized controlled trial involving 77 adult PTSD patients.
- Repeated cross-sectional network analysis was employed to map symptom and cognition associations at pre- and post-training.
- Gaussian Graphical Models were used to estimate network structures, assessing symptom clusters (PTSD Checklist for DSM-5) and various cognitive measures (scenario task appraisals, Implicit Association Test).
Main Results:
- No significant differences in overall network connectivity were observed between groups.
- The 'Alterations in Cognition and Mood' symptom cluster emerged as the most central node post-training in both CBM-APP and control groups.
- In the CBM-APP group, a decrease in the centrality of implicit trauma-related associations was noted, suggesting a potential reduction in the link between automatic negative self-associations and symptom activation.
Conclusions:
- Preliminary findings suggest CBM-APP may influence the relational dynamics between PTSD symptoms and cognitive appraisals.
- The observed reduction in implicit association centrality warrants further investigation.
- Larger sample sizes and network stability analyses are recommended for future research.
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