Mental imagery abilities in different modalities moderate the efficacy of cognitive bias modification for interpretation bias in social anxiety

Cognitive bias modification for interpretation bias (CBM-I) is an effective low-intensity intervention that targets interpretation biases associated with the development and maintenance of social anxiety. Few studies to-date have examined the extent to which individual mental imagery ability affects the efficacy of CBM-I. A total of 666 individuals were screened. Seventy-two participants with high levels of social anxiety and elevated baseline interpretation bias were randomly assigned to either CBM-I (n = 36) or control groups (n = 36). They completed 5-day internet-delivered training in modifying their interpretation bias associated with ambiguous social scenarios (CBM-I) or reading neutral text passages (control). Intent-to-treat analyses revealed that participants in the CBM-I group had a significant reduction in their interpretation bias compared to the controls. They had a reduction of 11 %-18 % on the social anxiety measures. Participants' mental imagery ability was significantly associated with the reduction of interpretation bias and social anxiety symptoms in the CBM-I group. Specifically, participants with higher mental imagery ability in emotional feelings benefited the most from the intervention. CBM-I is an efficacious intervention for modulating social anxiety-related biases and symptoms. Mental imagery ability facilitated the efficacy of CBM-I.