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CompletedNCT07753538SADUpdated Aug 7, 2026

Interpretation Bias Modification Training for Social Anxiety Disorder

An interventional study of Interpretation Bias Modification Training and Stress Management Psychoeducation in Social Anxiety Disorder (SAD), sponsored by University of Wisconsin, Milwaukee. Completed at 1 site in United States. Open to participants aged 18 Years to 60 Years. Per ClinicalTrials.gov, last updated 2026-08-07.

Sponsored by University of Wisconsin, Milwaukee · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
50
Allocation
Randomized
Ages
18 Years to 60 Years
Sex
All
01

Study summary

The overall goal of the current study is to develop and evaluate a computerized interpretation bias modification (IBM) training for treating social anxiety disorder (SAD). A key focus is placed on enhancing accessibility and efficacy of IBM for SAD by delivering it through a mobile platform, with three specific aims outlined.

First, the current study aims to examine the efficacy of the IBM training in reducing social anxiety symptoms by comparing the pre-, post-, and follow-up assessments of the IBM group with a control group.

Second, the current study aims to examine the effect of IBM on reducing participants' daily social anxiety symptoms using daily diary methodology.

Third, the investigators also aim to evaluate the feasibility and acceptability of the IBM training. The investigators expect that at least 70% of participants will complete 4 or more of the six training sessions.

02

Conditions studied

  • Social Anxiety Disorder (SAD)

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Keywords

  • interpretation bias
  • cognitive training
  • computerized intervention
  • social anxiety disorder
03

Who can participate

Ages eligible
18 Years to 60 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Diagnosis of SAD based on the DIAMOND screening interview
  • Moderate or severe symptoms of SAD as assessed by the Liebowitz Social Anxiety Scale (LSAS score of >= 30)
  • Ages 18-60
  • English as a primary language
  • Possession of a mobile device for access to training and text message for daily diary

Exclusion criteria

Exclusion Criteria:

  • Self-report visual impairment that cannot be adjusted and will prevent them from clearly recognizing words and pictures on mobile screen
  • Self-reported history of a bipolar disorder or psychotic disorder as measured by Diagnostic History Scale
  • Current psychotherapy for SAD
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Participant)
Enrollment
50 participants (actual)

Study arms

  • Experimental
    Cognitive Bias Modification for Interpretation Bias (CBM-I)

    CBM-I is designed to modify negative interpretation bias, a core cognitive characteristic of social anxiety disorder. During the training, participants will complete sentence fragments by filling in missing letters, guiding them to interpret ambiguous social scenarios in a benign way. Participants will complete the training three times per week for two weeks.

    Behavioral: Interpretation Bias Modification Training

  • Active comparator
    Stress Management Psychoeducation (SMP) Group

    The Stress Management Psychoeducation (SMP) group will also receive a cognitive training intervention involving the completion of sentence fragments by filling in missing letters. However, the training content will focus on stress management strategies, such as relaxation techniques and organizational skills, rather than interpretation bias modification. Participants in the SMP group will also complete the training three times per week for two weeks.

    Behavioral: Stress Management Psychoeducation

Interventions

  • BehavioralInterpretation Bias Modification Training

    Interpretation Bias Modification Training aims to help participants interpret ambiguous social scenarios in a benign way, with the goal of reducing social anxiety symptoms. Individuals with social anxiety disorder tend to interpret ambiguous social situations negatively or catastrophize mildly negative events. This intervention targets this core cognitive characteristic by repeatedly training more adaptive interpretation. Cognitive training is delivered through mobile devices, increasing accessibility and cost-effectiveness while allowing participants to complete the intervention remotely.

  • BehavioralStress Management Psychoeducation

    Stress Management Psychoeducation (SMP) is used as a credible comparison condition to evaluate whether CBM-I has specific therapeutic effects on reducing social anxiety symptoms. The SMP condition follows the same training format as CBM-I, in which participants complete fragmented sentences by filling in missing letters. However, the training content focuses on stress management strategies rather than modifying maladaptive interpretations of ambiguous social situations.

05

What researchers measure

Primary outcomes

  1. Brief Fear of Negative Evaluation (BFNE)

    The BFNE is a 12-item questionnaire, evaluating the level of apprehension and distress about expected negative evaluation. The BFNE was used to assess the cognitive symptoms of social anxiety disorder.

    Time frame: Pre-training (baseline); Post-training (approximately 1-2 days after completion of the 2-week intervention); 2-week follow-up (2 weeks after completion of the 2-week intervention)

  2. Liebowitz Social Anxiety Scale- Self-report Version (LSAS-SR)

    The LSAS-SR is a 24-item scale that assesses the severity of social anxiety symptoms across two subscales: the level of anxiety (emotional reaction) and the level of avoidance (behavioral reaction). In the current study, the two subscales will be analyzed separately to evaluate the effects of the intervention on the emotional and behavioral symptoms of social anxiety.

    Time frame: Pre-training (baseline); Post-training (approximately 1-2 days after completion of the 2-week intervention); 2-week follow-up (2 weeks after completion of the 2-week intervention)

  3. Diagnostic Interview for Anxiety, Mood, and OCD and Related Neuropsychiatric Disorders (DIAMOND)

    DIAMOND is a semi-structured diagnostic interview to assess DSM-5 psychiatric disorders and has demonstrated good reliability and validity. For the current study, only the social anxiety disorder module was administered at pre-training and follow-up assessments.

    Time frame: Pre-training (baseline); 2-week follow-up (2 weeks after completion of the 2-week intervention)

Secondary outcomes

  1. Word Sentence Association Paradigm (WSAP)

    The WSAP task was used to evaluate interpretation bias in response to ambiguous situations. During the task, participants indicate whether a presented word (either negative or benign) is related or unrelated to a subsequently presented ambiguous sentence. The scenarios included both social and general situations. The percentage of endorsement responses was calculated separately for each trial type: social-threat, social-benign, general-threat, and general benign.

    Time frame: Pre-training (baseline); Post-training (approximately 1-2 days after completion of the 2-week intervention); 2-week follow-up (2 weeks after completion of the 2-week intervention)

  2. Daily Diary

    Daily diary was used to evaluate participants' daily social interactions and changes in social anxiety symptoms. Participants in both groups received a text message to complete the daily diary survey each evening over the 2-week period of training. The survey first asked participants to report the social interactions they had experienced that day, followed by questions assessing anxiety, avoidance, negative self-perception, fear of negative judgment, and satisfaction related to the most stressful social interaction.

    Time frame: 2 weeks of training period

  3. Credibility and Expectancy Questionnaire (CEQ)

    The CEQ is a self-report measure that assesses participants' perceptions of the credibility of an intervention their expectations regarding its outcomes. This measure was used to evaluate the feasibility of the CBM-I intervention.

    Time frame: After the 1st training session

  4. Treatment Acceptability Questionnaire (TAQ)

    The TAQ is a 5-item self-report measures that evaluates participants' perceptions of an intervention's acceptability, ethicality, acceptability of side effects, pleasantness and comfort of the intervention.

    Time frame: 2-week follow-up (2 weeks after completion of the 2-week intervention)

06

Study locations

1 site
  • University of Wisconsin-Milwaukee
    Milwaukee, Wisconsin 53211, United States
07

References and documents

Publications

  • Mobini S, Mackintosh B, Illingworth J, Gega L, Langdon P, Hoppitt L. Effects of standard and explicit cognitive bias modification and computer-administered cognitive-behaviour therapy on cognitive biases and social anxiety. J Behav Ther Exp Psychiatry. 2014 Jun;45(2):272-9. doi: 10.1016/j.jbtep.2013.12.002. Epub 2013 Dec 31. PubMed 24412966 ↗
  • Beard C, Amir N. A multi-session interpretation modification program: changes in interpretation and social anxiety symptoms. Behav Res Ther. 2008 Oct;46(10):1135-41. doi: 10.1016/j.brat.2008.05.012. Epub 2008 Jun 27. PubMed 18675400 ↗
  • Beard C. Cognitive bias modification for anxiety: current evidence and future directions. Expert Rev Neurother. 2011 Feb;11(2):299-311. doi: 10.1586/ern.10.194. PubMed 21306216 ↗
  • Amir N, Prouvost C, Kuckertz JM. Lack of a benign interpretation bias in social anxiety disorder. Cogn Behav Ther. 2012;41(2):119-29. doi: 10.1080/16506073.2012.662655. Epub 2012 Apr 30. PubMed 22545788 ↗
  • Patel TA, Schubert FT, Hom MA, Cougle JR. Correlates of treatment seeking in individuals with social anxiety disorder: Findings from a nationally representative sample. J Anxiety Disord. 2022 Oct;91:102616. doi: 10.1016/j.janxdis.2022.102616. Epub 2022 Aug 6. PubMed 36007388 ↗
  • Liu H, Li X, Han B, Liu X. Effects of cognitive bias modification on social anxiety: A meta-analysis. PLoS One. 2017 Apr 6;12(4):e0175107. doi: 10.1371/journal.pone.0175107. eCollection 2017. PubMed 28384301 ↗
  • Heinrichs N, Hofmann SG. Information processing in social phobia: a critical review. Clin Psychol Rev. 2001 Jul;21(5):751-70. doi: 10.1016/s0272-7358(00)00067-2. PubMed 11434229 ↗
  • Cougle JR, Wilver NL, Day TN, Summers BJ, Okey SA, Carlton CN. Interpretation Bias Modification Versus Progressive Muscle Relaxation for Social Anxiety Disorder: A Web-Based Controlled Trial. Behav Ther. 2020 Jan;51(1):99-112. doi: 10.1016/j.beth.2019.05.009. Epub 2019 May 24. PubMed 32005343 ↗
  • Clark DM, McManus F. Information processing in social phobia. Biol Psychiatry. 2002 Jan 1;51(1):92-100. doi: 10.1016/s0006-3223(01)01296-3. PubMed 11801234 ↗
  • Amir N, Taylor CT. Interpretation training in individuals with generalized social anxiety disorder: a randomized controlled trial. J Consult Clin Psychol. 2012 Jun;80(3):497-511. doi: 10.1037/a0026928. Epub 2012 Jan 16. PubMed 22250851 ↗

Individual participant data

Plan to share: Undecided

08

Registry details

Key details

Study ID
NCT07753538
Lead sponsor
University of Wisconsin, Milwaukee
Responsible party
Sponsor
First posted
Aug 7, 2026
Start date
Sep 26, 2024
Primary completion
Dec 8, 2025
Completion
Dec 8, 2025
Last update
Aug 7, 2026

Oversight

FDA-regulated drug
No
FDA-regulated device
No
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