An examination of the cognitive and physiological mechanisms of interpretation bias modification

Research has demonstrated the role of cognitive biases, specifically negative interpretation bias, in the development and persistence of anxiety. An evolving area of work focuses on the advancement of cognitive bias modification for interpretation (CBM-I) techniques, aiming to effectively modify threat interpretations and subsequently reduce anxiety. This thesis seeks to extend this area of work by examining the cognitive and physiological factors that potentially underpin interpretation bias and its modification. The four key chapters that form the thesis are a published systematic review paper assessing the physiological correlates of interpretation bias (Chapter two) and three pre-registered online studies that investigated whether attentional control moderates the efficacy of CBM-I (Chapter three), whether a resonance frequency breathing manipulation, known to enhance heart rate variability (which itself has been linked to improved executive function), can be used to enhance attentional control (Chapter four), and whether resonance breathing can improve the efficacy of CBM-I (Chapter five). First, the systematic review highlighted a number of physiological markers related to interpretation bias and CBM-I training. Study one demonstrated the successful induction of positive interpretation bias in a high-worrying sample through CBM-I. However, the evidence did not support a relationship between attentional control and CBM-I efficacy. Moving on to study two, resonance frequency breathing was associated with reduced reported anxiety, but no significant improvement was observed in attentional control. Study three showed that both standard CBM-I and an RFB-adapted CBM-I variant induced a more positive interpretation bias, with no significant difference in their overall efficacy. The implications of these findings for theory and clinical practice are discussed in Chapter six.