Elske Salemink

Utrecht University | UU

Previous research shows that automatic tendency to approach alcohol plays a causal role in problematic alcohol use and can be retrained by Approach Bias Modification (ApBM). ApBM has been shown to be effective for patients diagnosed with alcohol use disorder (AUD) in inpatient treatment. This study aimed to investigate the effectiveness of adding a...

An important question in mental healthcare for children is whether treatments are effective and safe in the long run. Here, we comment on a recent editorial perspective by Roest et al. (2022), who argue, based on an overview of systematic reviews, ‘that there is no convincing evidence that interventions for the most common childhood disorders are b...

BACKGROUND Fatigue is an important symptom for many patients, including kidney patients. Cognitive Bias Modification (CBM) training is a promising technique to counter fatigue symptoms. OBJECTIVE The current study aimed to evaluate a CBM training among kidney patients and health care professionals. Using an iterative design process, evaluating exp...

Background Fatigue is an important symptom for many patients, including patients with kidney disease. Cognitive biases, such as attentional bias and self-identity bias, are thought to influence fatigue. Cognitive bias modification (CBM) training is a promising technique to counter fatigue. Objective We aimed to evaluate a CBM training among patien...

Background and objectives Negative mental imagery appears to play a role in anxiety disorders and can involve aversive memories or anticipated future threats. Modulating aversive memories through imagery rescripting generally reduces negative memory appraisals and associated anxiety. This pre-registered two-day analog study investigated whether ima...

Background This preregistered study compares adolescents with mild-to-borderline intellectual disability (MBID) and typically developing (TD) adolescents on their susceptibility to peer influence. To understand why adolescents with MBID are susceptible to peer influence, links with inhibition, Theory of Mind (ToM) and negative interpretation bias a...

Distressing mental images are common in anxiety disorders and can make it difficult for patients to confront feared situations. This study examined whether imagery rescripting focused on a feared social situation prepares participants to engage in a feared situation. Sixty healthy individuals were asked to formulate a behavioral experiment to test...

The Abbreviated Math Anxiety Scale (AMAS) is commonly used to compare groups on math anxiety. Group comparisons should however be preceded by a demonstration of metric and scalar measurement invariance, which is currently only available for undergraduate students in the USA. This study tested for metric and scalar measurement invariance of AMAS sco...

Attention biases (AB) are a core component of cognitive models of depression yet it is unclear what role they play in the transgenerational transmission of depression. 44 children (9–14 years) with a high familial risk of depression (HR) were compared on multiple measures of AB with 36 children with a low familial risk of depression (LR). Their par...

Background and objectives Interpretation bias plays a crucial role in anxiety. To test the causal role and potential clinical benefits, training procedures were developed to experimentally change interpretation bias. However, these procedures are monotonous and plain, which could negatively affect motivation and adherence. The aim of this study was...

Introduction Emerging adulthood is a phase in life that is associated with an increased risk to develop a variety of mental health disorders including anxiety and depression. However, less than 25% of university students receive professional help for their mental health reports. Internet-based cognitive behavioural therapy (iCBT) may entail useful...

Background: Adolescents with mild-to-borderline intellectual disability (MBID) may be more susceptible to peer influence than typically developing (TD) adolescents.Aims: This preregistered study compares adolescents with MBID and TD adolescents on their susceptibility to peer influence and investigates links with three potential underlying mechanis...

The role of negative attention biases (AB), central to cognitive models of adult depression, is yet unclear in youth depression. We investigated negative AB in depressed compared to healthy youth and tested whether AB are more pronounced in depressed than at-risk youth. Negative AB was assessed for sad and angry faces with an eye-tracking paradigm...

Psychological problems like procrastination, perfectionism, low self-esteem, test anxiety and stress are common among college students. There are evidence-based interventions available for these problems that not only have direct effects on these problems, but also indirect effects on mental disorders such as depression and anxiety disorders. Targe...

Background While taxonomy segregates anxiety symptoms into diagnoses, patients typically present with multiple diagnoses; this poses major challenges, particularly for youth, where mixed presentation is particularly common. Anxiety comorbidity could reflect multivariate, cross-domain interactions insufficiently emphasized in current taxonomy. We ut...

Exposure therapy is the recommended treatment for anxiety disorders, but many anxious individuals are unwilling to expose themselves to feared situations. Episodic simulation of future situations contributes to adaptive emotion regulation and motivates behavior. This study investigated whether future-oriented positive mental imagery reduces anticip...

Objective: Approach bias modification (ApBM) is a promising new add-on training intervention for patients with alcohol use disorder (AUD). Given that comorbid anxiety and major depressive disorders are very common in AUD, and that such comorbidity affects psychological treatments negatively, the primary aim of the present study was investigating wh...

Contemporary cognitive models of depression propose that cognitive biases for negative information at the level of attention (attention biases; AB) and interpretation (interpretation biases; IB) increase depression risk by promoting maladaptive emotion regulation (ER). So far, empirical support testing interactions between these variables is restri...

Dual process models posit that combinations of impulsive and reflective processes drive behaviour, and that the capacity to engage in effortful cognitive processing moderates the relation between measures of impulsive or reflective processes and actual behaviour. When cognitive resources are low, impulsive processes are more likely to drive behavio...

BACKGROUND Alcohol use and anxiety disorders commonly co-occur, resulting in a more severe clinical presentation and poorer response to single-disorder treatments. Research has shown that Approach Bias Modification (ApBM) and Interpretation Bias Modification (IBM) cognitive re-training interventions can be efficacious adjunctive treatments that imp...

Background Alcohol use and anxiety disorders commonly co-occur, resulting in a more severe clinical presentation and poorer response to treatment. Research has shown that approach bias modification (ApBM) and interpretation bias modification (IBM) cognitive retraining interventions can be efficacious adjunctive treatments that improve outcomes for...

UNSTRUCTURED While there has been increasing interest in the use of gamification in mental healthcare, there is a lack of design knowledge on how elements from games could be integrated into existing therapeutic treatment activities in a manner which is balanced and effective. To help address this issue, we propose a design process framework to sup...

While there has been increasing interest in the use of gamification in mental health care, there is a lack of design knowledge on how elements from games could be integrated into existing therapeutic treatment activities in a manner that is balanced and effective. To help address this issue, we propose a design process framework to support the deve...

Background Given findings showing that emotion regulation may be enhanced through prefrontal neurostimulation, the present study examined whether the effect of transcranial direct current stimulation on emotional reactivity is mediated via biased interpretation, and whether emotion regulation goals further moderate this relationship.Methods Healthy...

More than half of university students have high levels of stress. Stress management programs can help students improve coping skills and prevent psychological distress. However, studies have generally targeted all university students regardless of whether they experience high levels of stress or not, and thus more studies are needed to examine the...

Background and Objectives In dual-tasking, individuals recall a threat-related memory while performing a demanding dual-task. This is a fruitful approach to reduce the unpleasantness and vividness of aversive memories and to reduce conditioned fear responses. Crucially, it remains unclear whether dual-tasking can also reduce conditioned fear respon...

Background Cognitive behavioral therapy (CBT) is the treatment of choice for pediatric obsessive-compulsive disorder (OCD), but not all patients profit sufficiently. Long waitlists and wide variations in improvement rates ask for new interventions. We examined the effectiveness of a Cognitive Bias modification–Interpretation (CBM-I) training that w...

Background Approach bias modification (ApBM) and interpretation bias modification (IBM) are two promising adjunct treatments for alcohol use and social anxiety, respectively. However, the acceptability of combining ApBM and IBM into one program for people who experience both of these disorders is unknown. The present study describes the codevelopme...

BACKGROUND More than half of university students have high levels of stress. Stress management programs can help students improve coping skills and prevent psychological distress. However, studies have generally targeted all university students regardless of whether they experience high levels of stress or not, and thus more studies are needed to e...

Negative interpretation biases have been found to characterize adults with depression and to be involved in the development and maintenance of the disorder. However, less is known about their role in youth depression. The present study investigated i) whether negative interpretation biases characterize children and adolescents with depression and i...

Fear is an adaptive response in the presence of danger. However, when threat is uncertain and continuous, as in the current coronavirus disease (COVID-19) pandemic, fear can become chronic and burdensome. To identify predictors of fear of the coronavirus, we conducted an online survey (N = 439) three days after the World Health Organization declare...

Background: Alcohol use is associated with an automatic tendency to approach alcohol, and the retraining of this tendency (cognitive bias modification [CBM]) shows therapeutic promise in clinical settings. To improve access to training and to enhance participant engagement, a mobile version of alcohol avoidance training was developed. Objective:...

Fear is an adaptive response in the presence of danger. However, when threat is uncertain and continuous, as in the current coronavirus disease (COVID-19) pandemic, fear can become chronic and burdensome. To better understand predictors of fear of the coronavirus, we conducted an online survey (N = 439) between March 14 and 17, 2020, which started...

Background and objectives: Interpretation bias modification can affect stress reactivity, yet results have not been consistent. This inconsistency may be partly due to variability in the degree to which training procedures alter interpretation at a more automatic, rather than strategic, level of processing, and a mismatch in available resources be...

Aggressive individuals more readily interpret others' motives and intentions in ambiguous situations as hostile. This hostile attribution bias has been argued to be causally involved in the development and maintenance of aggression, making it a target for interventions. In our current study, adolescents selected for high levels of aggression (N = 3...

Adolescents with mild to borderline intellectual disability (MBID) show more daily life risk taking than typically developing adolescents. To obtain insight in when these “risk-taking adolescents” especially take risks, we investigated main and interaction effects of (a) MBID, (b) sex, and (c) type of peer influence on risk taking. The Balloon Anal...

Background While taxonomy segregates anxiety symptoms into diagnoses, patients typically present with multiple diagnoses; this poses major challenges, particularly for youth, where mixed presentation is particularly common. Anxiety comorbidity could reflect multivariate, cross-domain interactions insufficiently emphasized in current taxonomy. We ut...

Social anxiety is characterised by a bias to recall negative social autobiographical memories as well as anxious expectations about future social interactions. Neuroscientific research shows that a shared neural network underlies both temporal directions of autobiographical recall and future self-projections. Inspired by these findings, the current...

Background and objectives Attentional Bias Modification (ABM) paradigms targeting anxiety aim to reduce attentional biases for threatening stimuli and thereby reduce anxiety. Based on cognitive theories of performance and learning, elevated levels of arousal during ABM might enhance its effectiveness by making training more engaging and activating...

Aims Research suggests that self-reports on inferred motives for engaging in behavior may be biased by limited introspective access into such processes. Self-reports on observable behavior, on the other hand, may generate more accurate responses with which to predict behavior. The aim was to determine whether drinking alcohol in response to negativ...

Background and objectives. Research on the social effects of intranasal oxytocin in children is scarce. Oxytocin has been proposed to have clearer beneficial effects when added to social learning paradigms. The current study tested this proposition in middle childhood by assessing effects of cognitive bias modification (CBM) training and oxytocin o...

BACKGROUND Alcohol use is associated with the automatic tendency to approach alcohol, with the retraining of this tendency (cognitive bias modification, CBM) showing therapeutic promise in clinical settings. To improve access to the training and to enhance participants’ engagement, a mobile version of the Alcohol Avoidance Training was developed....

Introduction: The reclassification of gambling disorder as an addictive disorder in the latest DSM-5 has yielded the question which innovations in addiction treatment can benefit the treatment of problem gambling (PG). One particular innovation that has shown promise in other addictive behaviors, is the use of cognitive bias modification (CBM) tech...

The current study examined the role of implicitly measured associations (henceforth referred to as associations) between math and anxiety in adolescents' math anxiety. Previous research has shown that associations predicted behavior independent of explicit measures. In this study, it was investigated whether math-anxiety associations would be relat...

Although attentional bias (AB) is considered a key characteristic of anxiety problems, the psychometric properties of most AB measures are either problematic or unknown. We conducted two experiments in which we addressed the reliability, convergent validity, and concurrent validity of different AB measures in unselected student samples. In Experime...

Innovations in CBT for Childhood Anxiety, OCD, and PTSD - edited by Lara J. Farrell April 2019

Background and objectives: Although induced changes in interpretation bias can lead to reduced levels of stress reactivity, results are often inconsistent. One possible cause of the inconsistencies in the effects of interpretation bias modification (IBM) on stress reactivity is the degree to which participants engaged in emotion regulation while b...

Background: Cognitive Bias Modification of Interpretations (CBM-I) is a computerized intervention designed to change negatively biased interpretations of ambiguous information, which underlie and reinforce anxiety. The repetitive and monotonous features of CBM-I can negatively impact on training adherence and learning processes. Objectives: This p...

Children of parents with a history of depression have an increased risk of developing depression themselves. The present study investigated the role of interpretation biases (that have been found in adults and adolescents with depression but have rarely been examined in at-risk youth) in the transgenerational transmission of depression risk. Interp...

Background: In two studies, the present research examined whether being high in both social anxiety and alcohol use disorder symptoms is associated with a comorbid interpretation and expectancy bias that reflects their bidirectional relationship. Design: Cross-sectional, quantitative surveys. Methods: Measures of social anxiety and alcohol use diso...

The goal of this study was to examine the effects of Cognitive Bias Modification training for Interpretation (CBM-I) in socially anxious adolescents with Mild Intellectual Disabilities (MID). A total of 69 socially anxious adolescents with MID were randomly assigned to either a positive or a neutral control-CMB-I-training. Training included five se...

Problematic alcohol use is associated with drinking alcohol to reduce negative mood states (negative reinforcement motive). Further, heavy drinking individuals tend to interpret ambiguous situations as alcohol-related (interpretive bias). The current experimental study aimed to examine the role of alcohol-related interpretive biases in negative-aff...

Background and objectives: In two experiments, we investigated the effects of Attentional Bias Modification (ABM) on emotion regulation, i.e. the manner in which people influence emotional experiences. We hypothesized that decreases in attentional bias to threat would impair upregulation and improve downregulation of negative emotions, while incre...

BACKGROUND Cognitive Bias Modification of Interpretations (CBM-I) is a computerized intervention designed to change negatively biased interpretations of ambiguous information, which underlie and reinforce anxiety. The repetitive and monotonous features of CBM-I can negatively impact training adherence and learning processes. OBJECTIVE This proof-o...

Background: Baclofen has shown promise in the treatment of alcohol dependence. However, its precise (neuro-) psychological working mechanism is still under debate. Aims: This study aimed to get a better understanding of baclofen's working mechanism by examining the effect of baclofen on cognitive biases. It was hypothesized that baclofen, compar...

Background: Social anxiety and depressive symptoms are relatively common in adolescents with Mild to Borderline Intellectual Disabilities (MBID). Unfortunately, there are only a few studies that focus on examining processes underlying social anxiety and depression in these adolescents. Aims: The aim was to examine the differences between self- a...

Dysfunctional beliefs are assumed to play an important role in OCD. A new type of treatment is the Cognitive Bias Modification of Interpretation (CBM-I) training: a computerized paradigm developed to modify dysfunctional interpretations in for example OCD, anxiety, and depression. A meta-analysis focusing on adult samples revealed that CBM-I traini...

Authors’ reply - Volume 212 Issue 4 - Ben Grafton, Colin MacLeod, Daniel Rudaizky, Elske Salemink, Elaine Fox, Lies Notebaert

Introduction Negatively biased interpretations play an important role in anxiety and depression, which are highly prevalent in adolescence, and changing such biases might thus reduce or prevent emotional disorders. We investigated the short- and long-term effects of an online interpretation bias modification training in unselected adolescents to ex...

Trial protocol translation. (DOCX)

Information letters. (PDF)

Additional manipulations and measures. (DOCX)

CONSORT checklist. (DOCX)

Additional documentation trial protocol. (DOCX)

Background: Recent theoretical models emphasize the role of impulsive processes in alcohol addiction, which can be retrained with computerized Cognitive Bias Modification (CBM) training. In this study, the focus is on action tendencies that are activated relatively automatically. Objective: The aim of the study is to examine the effectiveness of...

Background: Considerable research links threat-related attention biases to anxiety symptoms in adults, whereas extant findings on threat biases in youth are limited and mixed. Inconsistent findings may arise due to substantial methodological variability and limited sample sizes, emphasizing the need for systematic research on large samples. The ai...

This ECNP meeting was designed to build bridges between different constituencies of mental illness treatment researchers from a range of backgrounds with a specific focus on enhancing the development of novel, evidence based, psychological treatments. In particular we wished to explore the potential for basic neuroscience to support the development...