Brief Interpretation Bias Modification for Social Anxiety Disorder in Pakistani Young Adults: An Experimental Evaluation

Social anxiety in young adults is maintained in part by a tendency to interpret ambiguous social information as threatening. The study evaluates a behavioral interpretation training procedure delivered with OpenSesame, using trial-by-trial responses to ambiguous social sentences preceded by threat or benign prime words. In the experimental arm, feedback contingently reinforces benign endorsements and threat rejections. In the control arm, exposure and timing are matched but feedback is noncontingent and presented on half of trials. The design is a parallel two-arm randomized pretest-posttest trial with participant masking to assignment. Assessment includes the 5-item state and 5-item trait short-form State-Trait Anxiety Inventory totals and Word-Sentence Association Paradigm threat and benign endorsement proportions. The mechanistic hypothesis is that feedback-consistent learning increases benign interpretations and reduces threat interpretations, which is associated with lower post-session state anxiety. The trial was conducted as part of a PhD thesis at the University of Gujrat under formal institutional approvals.

Inclusion criteria

• age 18 to 25 years
• Social Phobia Inventory score greater than 19
• at least moderate severity on the DSM-5-TR Severity Measure for Social Anxiety Disorder-Adult
• able to read study materials
• provides written informed consent.

Exclusion criteria

• clinically elevated depressive symptoms on Beck Depression Inventory-II at or above prespecified cutoff [above 16]
• clinically elevated general anxiety symptoms on the Beck Anxiety Inventory at or above prespecified cutoff [ above 20]
• current medical or psychiatric condition likely to interfere with safe or valid participation
• prior participation in this trial.