Cognitive Biases in Social Anxiety Disorder: Examining Interpretation and Attention Biases and Their Relation to Anxious Behavior

Information processing biases, such as interpretation bias and attention bias, play a significant role in social anxiety disorder (Williams et al., 1997). Interpretation bias refers to the tendency to interpret both negative and neutral stimuli as more negative than they are objectively. Attention bias refers to the tendency to attend preferentially to threatening stimuli. Socially anxious individuals display a negative interpretation bias for ambiguous social stimuli (e.g., social scenarios) (for review see, Amir & Bomyea, 2010). In addition, socially anxious individuals exhibit a bias to orient attention either towards or away from threatening social stimuli (e.g., facial expressions; see Bar-Haim et al., 2007). Whereas an extensive body of research focuses on both interpretation bias and attention bias in social anxiety in isolation, very few studies have concurrently examined the associations between these two biases and social anxiety symptoms and evaluated their distinct predictive power. Further, no studies have examined their relation to behavioral avoidance, which is a key symptom of social anxiety that directly contributes to clinical severity (Kazdin, 1999). The current study examined how interpretation and attention biases independently relate to symptomology, situational anxiety, and behavior in adults diagnosed with social anxiety disorder. Thirty-four participants diagnosed with social anxiety completed computerized interpretation bias and attention bias tasks, a behavioral avoidance speech task, and self-report measures of state and trait social anxiety and general state anxiety. Results indicated that a negative interpretation bias was significantly related to state and trait social anxiety and a lack of benign interpretation bias was related to general state anxiety. There were no associations between attention bias and anxiety or behavior. Findings highlight the unique importance of both negative and benign interpretation biases in social phobia. Suggestions for future research include incorporating benign interpretation training, particularly under stress, into treatment programs such as cognitive modification or exposure therapy for social phobia. INDEX WORDS: Social anxiety, Interpretation bias, Attention bias, Behavior, COGNITIVE BIASES IN SOCIAL ANXIETY DISORDER: EXAMINING INTERPRETATION AND ATTENTION BIAS AND THEIR RELATION TO ANXIOUS BEHAVIOR