(PS4-A14) Evaluation of an Interpretation Bias Modification Program Targeting Internalizing Symptoms in Secondary School Students

The current study evaluated an intervention that supports secondary school students with internalizing symptoms through a computerized Interpretation Bias Modification program. The program is defined by multiple training sessions that reinforce adopting more positive interpretations of ambiguous social scenarios. The program aims to increase the accuracy and speed with which students can judge the threat-based nature of events they are likely to encounter daily. As students progress through the training program, measurements were made regarding their ‘online’ and ‘offline’ processing biases and the association to cognitive and behavioral internalizing symptoms known to maintain depressive and anxious conditions. The study addresses the lack of school-based mental health service providers across the United States.

The randomized waitlist control trial design was conducted with students ages 11-18, drawn from school and community samples. Students who completed the intervention received three to eight ‘doses’ of the training program in a two-week window. The researchers compared internalizing behavior of the treatment group (N = 56) to the participant outcomes in the waitlist control group (N = 45). The sample includes a majority of racial-ethnic minority students (n = 71). The variables of interest were measures of anxiety, depression, and patterns of negative thought that embody both conditions.

Primary findings from t-tests, ANCOVA, growth curve analysis, and linear mixed-effects model regressions indicated significant differences between the training conditions and within the training condition as a function of training. Speed and accuracy metrics of positive interpretation were shown to have improved as a function of training. Paired differences t-tests showed that participants in the treatment condition experience significantly reduced depressive symptoms, negative automatic thoughts, and worry. Researchers identified a medium effect size on reductions in depressive symptoms within the treatment group (eta_p² = .066). Linear mixed model regressions showed individuals who were identified with greater symptom severity were more likely to benefit from the training program. A cross-level interaction was found that with each successive training session, youth in the ‘high internalizing symptom’ class were more likely to benefit from training than their ‘low internalizing symptom’ counterparts. There were positive findings regarding the acceptability of the interpretation bias training intervention from qualitative analysis of student narratives.