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      Effects of Training Body-Related Interpretations on Panic-Related Cognitions and Symptoms

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          Abstract

          Background

          Interpretation biases (IBs) are central in panic disorder, and there is rich evidence showing that these are correlated with and predictive of panic-relevant symptomatology. However, experimental studies are needed to examine the potential causal effects of IBs, as predicted by cognitive models.

          Methods

          Panic-related IBs were manipulated via a sentence-completion Cognitive Bias Modification-Interpretation (CBM-I) training. The sample included N = 112 healthy participants reporting moderate levels of fear of bodily sensations. Participants were randomly allocated to a positive, negative, or control CBM-I condition. To test the trainings’ effect on panic-relevant cognitive processing, IBs were assessed via proximal and distal measures. Symptom provocation tasks were applied to test transfer to panic-relevant symptomatology.

          Results

          Results on the proximal measure showed that positive CBM-I led to more positive IBs compared to negative, and control training. Further, positive CBM-I led to more positive IBs on the distal measure as compared to negative CBM-I. However, there were no differential training effects on panic-related symptomatology triggered via the provocation tasks.

          Conclusion

          The findings indicate a limited generalization of the effects of CBM-I on IBs and panic-related symptoms. Potential means to improve generalization, such as applying more nuanced measures and combining CBM-I with psychoeducation are discussed.

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          Most cited references50

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          effectsize: Estimation of Effect Size Indices and Standardized Parameters

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            Robust dimensions of anxiety sensitivity: development and initial validation of the Anxiety Sensitivity Index-3.

            Accumulating evidence suggests that anxiety sensitivity (fear of arousal-related sensations) plays an important role in many clinical conditions, particularly anxiety disorders. Research has increasingly focused on how the basic dimensions of anxiety sensitivity are related to various forms of psychopathology. Such work has been hampered because the original measure--the Anxiety Sensitivity Index (ASI)--was not designed to be multidimensional. Subsequently developed multidimensional measures have unstable factor structures or measure only a subset of the most widely replicated factors. Therefore, the authors developed, via factor analysis of responses from U.S. and Canadian nonclinical participants (n=2,361), an 18-item measure, the ASI-3, which assesses the 3 factors best replicated in previous research: Physical, Cognitive, and Social Concerns. Factorial validity of the ASI-3 was supported by confirmatory factor analyses of 6 replication samples, including nonclinical samples from the United States and Canada, France, Mexico, the Netherlands, and Spain (n=4,494) and a clinical sample from the United States and Canada (n=390). The ASI-3 displayed generally good performance on other indices of reliability and validity, along with evidence of improved psychometric properties over the original ASI. (c) 2007 APA, all rights reserved
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              Coming to terms with the terms of risk.

              Terms such as risk, risk factors, and especially the term cause are inconsistently and imprecisely used, fostering scientific miscommunication and misleading research and policy. Clarifying such terms is the essential first step. We define risk and a risk factor (protective factor) and their potency, set out the conceptual basis of the methods by which risk factors are identified and potency demonstrated, and propose criteria for establishing the status of a risk factor as a fixed or variable marker or a causal risk factor. All definitions are based on the state of scientific knowledge (empirical documentation), rather than on hypotheses, speculations, or beliefs. We discuss common approaches and pitfalls and give a psychiatric research example. Imprecise reports can impede the search for understanding the cause and course of any disease and also may be a basis of inadequate clinical or policy decision-making. The issues in risk research are much too important to tolerate less than precise terminology or the less than rigorous research reporting that results from imprecise and inconsistent terminology.
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                Author and article information

                Contributors
                felix.wuertz@rub.de
                shari.steinman@mail.wvu.edu
                simon.blackwell@rub.de
                frank.wilhelm@plus.ac.at
                andrea.reinecke@psych.ox.ac.uk
                dirk.adolph@rub.de
                juergen.margraf@rub.de
                marcella.woud@rub.de
                Journal
                Cognit Ther Res
                Cognit Ther Res
                Cognitive Therapy and Research
                Springer US (New York )
                0147-5916
                1573-2819
                9 February 2023
                9 February 2023
                : 1-16
                Affiliations
                [1 ]GRID grid.5570.7, ISNI 0000 0004 0490 981X, Mental Health Treatment and Research Center, Faculty of Psychology, , Ruhr-University Bochum, ; Massenbergstraße 9-13, D-44787 Bochum, Germany
                [2 ]GRID grid.268154.c, ISNI 0000 0001 2156 6140, Psychology Department, , West Virginia University, ; Morgantown, USA
                [3 ]GRID grid.7039.d, ISNI 0000000110156330, Division of Clinical Psychology and Psychopathology, Department of Psychology, , Paris- Lodron University Salzburg, ; Hellbrunner Straße 34, 5020 Salzburg, Austria
                [4 ]GRID grid.4991.5, ISNI 0000 0004 1936 8948, Department of Psychiatry, , University of Oxford, ; Oxford , UK
                [5 ]GRID grid.451190.8, ISNI 0000 0004 0573 576X, Oxford Health NHS Foundation Trust, ; Oxford , UK
                Author information
                http://orcid.org/0000-0003-1627-9432
                http://orcid.org/0000-0002-0068-206X
                http://orcid.org/0000-0002-3313-7084
                http://orcid.org/0000-0001-5130-7318
                http://orcid.org/0000-0001-5207-7016
                http://orcid.org/0000-0002-4974-505X
                Article
                10358
                10.1007/s10608-023-10358-9
                9910773
                107a41f0-c3e7-4218-a060-8b5a7fa6be59
                © The Author(s) 2023

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 24 January 2023
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001659, Deutsche Forschungsgemeinschaft;
                Award ID: WO2018/2-1, WO 2018/3-1, 316803389, 442163275, 314131517
                Award ID: MA1116/13- 1, 314131517
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100004350, Studienstiftung des Deutschen Volkes;
                Award ID: Studienstiftung des Deutschen Volkes
                Funded by: MQ Mental Health Research
                Award ID: MQ14F192
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100013373, NIHR Oxford Biomedical Research Centre;
                Award ID: NIHR Oxford Biomedical Research Centre
                Award Recipient :
                Funded by: Ruhr-Universität Bochum (1007)
                Categories
                Original Article

                Clinical Psychology & Psychiatry
                cognitive bias modification,interpretation bias,panic disorder,symptom provocation,experimental psychopathology

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