Multi-session, Personalized Cognitive Bias Modification for Thought-Action-Fusion

Effects of Multi-session, Personalized Cognitive Bias Modification for Thought-Action-Fusion Among Adults With Obsessive-Compulsive Symptoms: A Randomized Controlled Trial

Thought-Action-Fusion (TAF) is a cognitive bias that posits (1) having unwanted thoughts is morally equivalent to acting upon the thoughts (TAF-Moral; e.g., "Thinking about harming a child is as immoral as actually harming a child") and (2) having unwanted thoughts will increase the likelihood of the thoughts happening in real life (TAF-Likelihood; e.g., "My mother will get into a car accident, because I thought about it"). Given its central role in the development and maintenance of OCD, TAF has emerged as a potential treatment target for obsessive-compulsive disorder (OCD). Previous research has demonstrated that TAF is indeed a malleable construct. This study aims to examine the effects of a multi-session, personalized cognitive bias modification (CBM) for thought-action-fusion (TAF) on improving obsessive-compulsive (OC) symptoms in a college sample.

All participants will be randomized into three groups: 1) CBM-TAF, 2) CBM-SMP (stress management psychoeducation), and 3) WL (waitlist). Participants randomized into either of the training groups (CBM-TAF or CBM-SMP) will complete a total of 6 training sessions (2x/week for 3 weeks), which employ the ambiguous-sentence completion task. To strengthen the training effect, participants will watch brief animated videos about TAF (CBM-TAF) or stress management (CBM-SMP) at the beginning of each session. Participants randomized into the WL group will only complete weekly assessments without any training sessions. All participants will complete pre-, post-training and 1-month follow-up assessments. All training sessions and assessments will be housed on a mobile-based web platform.

Inclusion Criteria:

• A score of 18 or higher on the Dimensional Obsessive-Compulsive Scale (DOCS)
• Aged 18 or higher
• Access to a mobile device (i.e., smartphone)

Exclusion Criteria:

• Self-reported visual impairment that cannot be adjusted and will prevent them from clearly recognizing words and pictures on mobile screen
• Self-reported history of a bipolar disorder or psychotic disorder on a Diagnostic History Scale (DHS)
• Inability to adequately understand the study procedure as determined by the responses to comprehension questions provided at the time of the consent