cognitive bias modification (cbm)



Still very much in its infancy, it’s fair to say that Cognitive Bias Modification (CBM) has caused somewhat of a stir.

Essentially, CBM is a cognitive training exercise whereby common distortions in thinking are modified using a series of basic computerised selection tasks (for example by attuning to positive images over negative ones). Despite their sounding so similar, CBM and cognitive behavioural therapy (CBT) are very different in practice (the latter being instead a traditional ‘talking therapy’).

The potential, it is argued, of CBM lies in its ability to be delivered anywhere, without the need for a psychological therapist. For this reason, some are even suggesting it can be used as a preventative tool to eliminate emotional distress. 

What we know already

CBM exists on the shoulders of extensive research in experimental psychology, particularly in the area of; unsurprisingly; cognitive biases. Fellow blogger Shirley Reynolds gives an excellent overview of cognitive biases.

In a nutshell, we know that when people are anxious, they selectively attenuate to anxiety-provoking stimuli. This is likely a survival thing. It helps to be aware of the bear, in order to run in the opposite direction. This is a cognitive bias. Likewise, we know that when people are depressed, they have a tendency to selectively attend to negative information regarding themselves, others and the world. This understanding led, in part, to the development of CBT. Evidence suggests that CBM does indeed modify these cognitive biases.

Areas of uncertainty

The difficulty with CBM, many argue, is that whilst it may remedy certain cognitive biases, the therapeutic value remains questionable. Essentially, despite modification in biases, evidence does not support that this necessarily leads to significant symptom improvement in clinical trials. Is it a classic case of association versus causality?

This uncertainty is further compounded by weak methodology. Often studies into CBM have suffered from small sample sizes and other forms of research bias.

Despite all of this, a number of CBM-inspired mobile Apps are freely available.

What’s in the pipeline?

It is early days. CBM research is still in a transition from laboratory to real-world clinical settings. Addressing questions such as ‘how can we translate training in a laboratory to real-world times of emotional distress?’ may give us a clearer idea of the efficacy of CBM in a clinical context.

Furthermore, as more rigorous studies are conducted, a clearer idea of the efficacy of CBM will hopefully begin to emerge.


Cristea, I. A., Kok, R. N., & Cuijpers, P. (2015). Efficacy of cognitive bias modification interventions in anxiety and depression: meta-analysis. The British Journal of Psychiatry, 206, 7-16. [Abstract]

Koster, E. H., Fox, E., & MacLeod, C. (2009). Introduction to the special section on cognitive bias modification in emotional disorders. Journal of Abnormal Psychology118, 1-4. [Abstract]


Written by: Patrick Kennedy-Williams
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Last updated: Sep 2015
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Our cognitive bias modification (cbm) Blogs

Learning to focus on smiles not frowns: challenging unhelpful attention and interpretation patterns #ActiveIngredientsMH


Jennifer Lau summarises a recent systematic review relating to her own Wellcome Trust funded research into promoting helpful attention and interpretation patterns to reduce anxiety and depression in young people.

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Cognitive bias modification for addiction: are we flogging a dead horse?


Matt Field considers a recent meta-analysis that explores the effectiveness of Cognitive Bias Modification interventions for substance addictions.

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Digital interventions for social anxiety disorder: new meta-analysis finds mixed results


Carla McEnery reports on a recent meta-analysis of technology-assisted interventions for Social Anxiety Disorder, which finds positive results from Internet-delivered CBT and Virtual Reality Exposure Therapy.

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Another negative trial of cognitive bias modification: a case for Occam’s razor

William of Ockham

Ioana Cristea reviews a recent RCT that found no effects of positive imagery-based cognitive bias modification, delivered as a web-based treatment for people with depression.

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Limited benefits of cognitive bias modification for adolescents: is it time to move on?


Ioana Cristea reviews a recent randomised controlled trial of cognitive bias modification to treat interpretation bias in adolescents. She argues that this new study adds weight to the ascertion that there are very limited, if any, mental health benefits for CBM interventions.

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Cognitive bias modification for anxiety and depression in children and adolescents


Shirley Reynolds writes her debut Mental Elf blog on a recent meta-analysis of cognitive bias modification (CBM) for anxiety and depression in children and adolescents. The review suggests that, on the face of it, we should not be investing in future CBM research, but is it that simple?

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Cognitive bias modification for anxiety and depression: is practice based on sound evidence?


Sarah McDonald reviews a recent meta-analysis on the efficacy of cognitive bias modification interventions in anxiety and depression, which finds a dearth of reliable research to support the use of this treatment.

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