Anxiety & Depression Association of America

Multi-session, Personalized Cognitive Bias Modification for Thought-Action-Fusion

Purpose

Thought-Action-Fusion (TAF) is a cognitive bias that posits (1) having unwanted thoughts is morally equivalent to acting upon the thoughts (TAF-Moral; e.g., "Thinking about harming a child is as immoral as actually harming a child") and (2) having unwanted thoughts will increase the likelihood of the thoughts happening in real life (TAF-Likelihood; e.g., "My mother will get into a car accident, because I thought about it"). Given its central role in the development and maintenance of OCD, TAF has emerged as a potential treatment target for obsessive-compulsive disorder (OCD). Previous research has demonstrated that TAF is indeed a malleable construct. This study aims to examine the effects of a multi-session, personalized cognitive bias modification (CBM) for thought-action-fusion (TAF) on improving obsessive-compulsive (OC) symptoms in a college sample.

Condition

Eligibility

Eligible Ages: Over 18 Years
Eligible Genders: All
Accepts Healthy Volunteers: No

Inclusion Criteria

A score of 18 or higher on the Dimensional Obsessive-Compulsive Scale (DOCS) - Aged 18 or higher - Access to a mobile device (i.e., smartphone)

Exclusion Criteria

Self-reported 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 on a Diagnostic History Scale (DHS) - Inability to adequately understand the study procedure as determined by the responses to comprehension questions provided at the time of the consent

Study Design

Phase: N/A
Study Type: Interventional
Allocation: Randomized
Intervention Model: Parallel Assignment
Primary Purpose: Treatment
Masking: Single (Participant)

Arm Groups

Arm	Description	Assigned Intervention
Experimental Cognitive Bias Modification for Thought-Action-Fusion (CBM-TAF)	CBM-TAF will employ an ambiguous sentence-completion task, where participants have to fill in a missing letter in a fragmented word and resolve emotional ambiguity of a given scenario. At the beginning of each training session, participants will watch a brief animated video about TAF, OCD, and modifying TAF. Each training session will consist of 40 scenarios, which will take about 20 minutes to complete. There will be a total of 6 sessions (2x/week for 3 weeks).	Behavioral: CBM-TAF CBM-TAF aims to modify TAF by training participants to adopt an interpretation style that is inconsistent with TAF (i.e., having unwanted thoughts is not morally equivalent to acting upon them and/or having unwanted thoughts does not increase the likelihood of feared events happening in real life). To personalize the training, CBM-TAF is designed to address 4 subtypes of OCD (as defined by Dimensional Obsessive-Compulsive Scale; Abramowitz et al., 2010), each of which targets either TAF-moral or TAF-likelihood. Participants will indicate two OCD subtypes that are most relevant to their experiences and only complete scenarios that correspond to their chosen subtypes. For each scenario, participants are instructed to enter a missing letter in a fragmented word and resolve its emotional ambiguity. After then, participants will answer a True/False question related to the given scenario to verify their comprehension and consolidate their acquisition of healthier interpretation style.
Active Comparator Cognitive Bias Modification for Stress Management Psychoeducation (CBM-SMP)	Similar to CBM-TAF, CBM-SMP will employ an ambiguous sentence-completion task, where participants have to fill in a missing letter in a fragmented word. However, the content of scenarios in CBM-SMP will focus on general stress management techniques. At the beginning of each training session, participants will watch a brief animated video about OCD and stress management techniques. Each training session will consist of 40 scenarios, which will take about 20 minutes to complete. There will be a total of 6 sessions (2x/week for 3 weeks).	Behavioral: CBM-SMP CBM-SMP is a comparable intervention to CBM-TAF (Siwiec et al., 2023), which aims to provide general education about stress and stress management techniques. It is identical to CBM-TAF in terms of its administration, except for the content of scenarios included in training sessions. For each scenario, participants are instructed to enter a missing letter in a fragmented word. After then, participants will answer a True/False question related to the given scenario in order to verify their comprehension.
No Intervention Waitlist (WL)	Participants in WL group will only complete weekly assessment measures without engaging in any training sessions.

Recruiting Locations

More Details

Status: Recruiting
Sponsor: Han Joo Lee

Study Contact

Hanjoo Lee, PhD
(414) 229-5858
leehj@uwm.edu

Detailed Description

All participants will be randomized into three groups: 1) CBM-TAF, 2) CBM-SMP (stress management psychoeducation), and 3) WL (waitlist). Participants randomized into either of the training groups (CBM-TAF or CBM-SMP) will complete a total of 6 training sessions (2x/week for 3 weeks), which employ the ambiguous-sentence completion task. To strengthen the training effect, participants will watch brief animated videos about TAF (CBM-TAF) or stress management (CBM-SMP) at the beginning of each session. Participants randomized into the WL group will only complete weekly assessments without any training sessions. All participants will complete pre-, post-training and 1-month follow-up assessments. All training sessions and assessments will be housed on a mobile-based web platform.