title: Effects of cognitive bias modification on social anxiety: A meta-analysis.
abstract: BACKGROUND
  Cognitive bias modification (CBM), a set of techniques for modifying bias in information processing-is considered a novel intervention for social anxiety disorder (SAD), which has drawn considerable interest from researchers. However, the effects of CBM on SAD are not consistent. Some studies have demonstrated significant positive effects compared to control groups, while others have found no such effects.
  
  
  OBJECTIVE
  We conducted a meta-analysis aimed at quantitatively assessing the effects of CBM on SAD at post-test.
  
  
  METHODS
  Through a systematic literature search by two independent raters, 34 articles (36 randomized studies) including 2,550 participants were identified. A multilevel modeling approach was employed to assess the effects of CBM on SAD, and to explore the potentially crucial procedures and sample characteristics that enhance the effectiveness of benign training.
  
  
  RESULTS
  In general, there were small but significant effects of CBM on the primary symptoms of SAD (g = 0.17), cognitive bias (CB) toward threat (g = 0.32), and reactivity in stressful situations (g = 0.25), but non-significant effects on secondary symptoms. However, the interpretation modification program was more effective than was attentional bias modification in reducing SAD primary symptoms and negative CB. Laboratory training procedures produced larger primary symptom reductions compared to Internet-based training, whereas the percentage of contingency and feedback about training performance boosted cognitive effects only. Finally, the following groups were more likely to benefit from CBM: younger participants (primary symptoms and cognitive effects), women (primary symptom effects), and samples with stronger CB (stressor effects). The quality of the randomized controlled trials was less than desirable, as there was some indication of publication bias in our study.
  
  
  CONCLUSIONS
  Current findings broadly supported cognitive theories of SAD that consider a bidirectional or mutually reinforcing relationship between symptoms and CBs. However, the small therapeutic effect observed here indicates that it is necessary to develop more reliable and efficient CBM interventions that are specific to SAD.
authors.affiliation: Key Lab of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.|Psychology Department of Chengde Medical University, Chengde, China.|University of Chinese Academy of Sciences, Beijing, China.
authors.forename: Haining
authors.initials: H
authors.lastname: Liu
authors.affiliation: School of Nursing, Nanjing Medical University, Nanjing, China.
authors.forename: Xianwen
authors.initials: X
authors.lastname: Li
authors.affiliation: Key Lab of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.|University of Chinese Academy of Sciences, Beijing, China.
authors.forename: Buxin
authors.initials: B
authors.lastname: Han
authors.affiliation: Key Lab of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.|University of Chinese Academy of Sciences, Beijing, China.
authors.forename: Xiaoqian
authors.initials: X
authors.lastname: Liu
mesh_terms: D003071:Cognition; D006801:Humans; D000072861:Phobia, Social; D016032:Randomized Controlled Trials as Topic