We investigate how biases in cognitive processes contribute to the onset and persistence of anxiety problems and whether it is important to change these processes in order to ameliorate anxiety. Our lab approaches these questions with theoretical and experimental psychopathology approaches. These approaches fall into five general areas (outlined below):
B. A., Joormann, J., Steinman, S. A., & Gotlib, I. H. (2012).
Automaticity in anxiety disorders and major depressive disorder.
Clinical Psychology Review, 32, 575-603.
Magee, J. C., Harden, K. P., & Teachman, B. A. (2012). Psychopathology and thought suppression: A quantitative review. Clinical Psychology Review, 32, 189-201.
We study how automatic fear associations and other information processing biases change over the course of treatment. We have examined this question by looking at change in automatic cognitive processes following cognitive behavioral therapy for specific phobia, and have extended this question to panic disorder to determine whether the trajectories of change in cognitive processes predict symptom reduction as hypothesized in cognitive models of anxiety. In this work, we use intensive, repeated assessments and advanced growth curve modeling techniques. By administering a battery of cognitive bias measures throughout treatment, we can ask new questions about the time course of change so that we can determine whether cognitive change really precedes and predicts symptom reduction. These questions are important because currently we are able to help many people with anxiety treatments, but numerous individuals still do not benefit, and we do not know why some people improve while others continue to struggle. The goal of this work is to determine if change in cognitive processing can help explain why the treatments work, and perhaps more importantly, why the treatments sometimes fail. For instance, we have shown that change in automatic panic associations and in catastrophic misinterpretations of bodily sensations predicts later reductions in panic symptoms, including measures of the severity and frequency of panic attacks, as well as avoidance of panic triggers.
Teachman, B. A., Marker, C. D., & Clerkin, E. M. (2010). Catastrophic misinterpretations as a predictor of symptom change during treatment for panic disorder. Journal of Consulting and Clinical Psychology, 78, 964-973.
Teachman, B. A., Marker, C. D., & Smith-Janik, S. B. (2008). Automatic associations and panic disorder: Trajectories of change over the course of treatment. Journal of Consulting and Clinical Psychology, 76 , 988-1002.
Clerkin, E. M., Teachman, B. A., & Smith-Janik, S. B. (2008). Sudden gains in group cognitive-behavioral therapy for panic disorder. Behaviour Research and Therapy, 46 , 1244-1250.
Finally, we are examining the causal link between changes in cognitive biases and fear reduction. With the advent of new techniques in cognitive science and cognitive bias modification paradigms, we can test information-processing models of etiology more directly. For instance, we have trained interpretation biases away from threat cues to decrease fear responding among obsessional, high fear and phobic samples, and used a conditioning paradigm to modify implicit associations among individuals high in social anxiety symptoms. We have also used experimental manipulations to increase or decrease cognitive biases to determine their impact on anxiety symptoms (e.g., in OCD, we shifted beliefs about the importance and immorality of intrusive thoughts). These demonstrations are significant because they permit evaluation of the causal (rather than simply correlational) claims that underlie cognitive theories of anxiety, and also because they offer promise for new interventions to help the many people who do not respond to currently available treatments.
Green, J. S., & Teachman, B. A. (in press). Is 'cootie' in the eye of the beholder? An experimental attempt to modify implicit associations tied to contamination fears. Journal of Experimental Psychopathology.
Clerkin, E. M., & Teachman, B. A. (2011). Training interpretation biases among individuals with symptoms of obsessive compulsive disorder. Journal of Behavior Therapy and Experimental Psychiatry, 42, 337-343.
Clerkin, E. M., & Teachman, B. A. (2010). Training implicit social anxiety associations: An experimental intervention. Journal of Anxiety Disorders, 24, 300-308.
Steinman, S. A. & Teachman, B. A. (2010). Modifying interpretations among individuals high in anxiety sensitivity. Journal of Anxiety Disorders, 24, 71-78.
Teachman, B. A., & Addison, L. M. (2008). Training interpretation biases away from threat in spider fear. Cognitive Therapy and Research, 32, 448-459.
These research endeavors are all designed to help address the fundamental question of why individuals with anxiety disorders interpret their environment in such a threatening way, and test approaches to reduce these maladaptive interpretations. Our lab integrates tools and perspectives from other fields, such as social cognition and perception, to investigate clinical phenomena in unique and externally valid ways. Further, the work is designed to be translational in terms of using basic science experimental approaches in applied ways. We are driven by a desire to understand how and why people think differently when they are anxious so that we can help change this biased thinking to relieve the suffering associated with anxiety disorders.
In addition to looking at change processes, we examine how cognitive biases are activated, and differentially predict fear, avoidance and other biases. For instance, in obsessive-compulsive disorder (OCD) we have examined how beliefs about thought suppression and thought-action fusion exacerbate obsessional symptoms. Among individuals with specific fears and with social phobia, we are investigating implicit and explicit memory biases in the context of state anxiety and disgust provocations, and have also applied these paradigms to better understand biases in body dysmorphic disorder.
Most recently, we are investigating how cognitive biases are related to other biases associated with fear. In collaboration with Drs. Dennis Proffitt and Jeanine Stefanucci, we are evaluating how fear is related to perceptual biases (e.g., how acrophobia is associated with overestimating heights while looking off a balcony), and the relationship of perceptual biases to cognitive biases. This line of work is important to establish the real-world implications of biased cognitive processing - to show that it predicts the symptoms, such as avoidance, that impair anxious individuals. Moreover, by distinguishing perceptual and cognitive biases, we can determine whether fear is associated with distortions in the ways people actually see, as well as interpret, their world.
Cody, M. W., & Teachman, B. A. (2010). Post-event processing and memory bias for performance feedback in social anxiety. Journal of Anxiety Disorders, 24, 468–479.
Teachman, B. A., Stefanucci, J. K., Clerkin, E. M., Cody, M. W., & Proffitt, D. R. (2008). A new mode of fear expression: Perceptual bias in height fear. Emotion, 8, 296-301.
Teachman, B. A., & Saporito, J. (2009). I am going to gag: Disgust cognitions in spider and blood-injury-injection fears. Cognition and Emotion, 23 , 399-414.
Clerkin, E. M., & Teachman, B. A. (2008). Perceptual and cognitive biases in individuals with body dysmorphic disorder symptoms. Cognition and Emotion, 22, 1327-1339 .
Magee, J. C., & Teachman, B. A. (2007). Why did the white bear return? Obsessive-compulsive symptoms and attributions for unsuccessful thought suppression. Behaviour Research and Therapy, 45 , 2884-2898.
We also integrate developmental approaches to better understand how cognitive processes relate to trajectories of anxiety symptoms across the lifespan. For instance, in younger samples, we have worked on the longitudinal prediction (by implicit fear associations) of social anxiety symptoms in adolescents, and information-processing biases in children with spider fears. In addition, we are evaluating the fit of cognitive models of anxiety in older adulthood, including trying to understand how age-related changes in cognitive processing and worry (e.g., worries about cognitive decline) influence the expression and regulation of anxiety . Further, we are currently working on a line of studies to evaluate the nature of intrusive thoughts and their link to anxiety problems in older adults. At both ends of the age spectrum, understanding how cognitive processing and anxiety function differently as a result of developmental differences is critical to prevent the onset of anxiety problems in young persons, promote successful aging and reduce the morbidity and mortality associated with anxiety in older persons.
Steinman, S. A., Smyth, F. L., Bucks, R., MacLeod, C., & Teachman, B. A. (in press). Anxiety-linked expectancy bias across the adult lifespan. Cognition and Emotion.
Magee, J. C., & Teachman, B. A. (2012). Distress and recurrence of intrusive thoughts in younger and older adults. Psychology and Aging, 199-210.
Teachman, B. A., & Gordon, T. L. (2009). Age differences in anxious responding: Older and calmer, unless the trigger is physical. Psychology and Aging, 24, 703-714.
Teachman, B. A., & Allen, J. P. (2007). Development of social anxiety: Social interaction predictors of implicit and explicit fear of negative evaluation. Journal of Abnormal Child Psychology, 35, 63-78.
Building from the social cognition literature and our understanding of how to modify negative beliefs and attitudes about stigmatized groups, we are examining how automatic biases affect clinical populations. Related investigations include implicit biases against persons with mental illness from the perspective of both healthy populations and persons with severe mental illness, interventions to reduce these biases, and consideration of how these biases prevent clinical populations from seeking treatment.
Menatti, A., Smyth, F. L., Nosek, B. A., & Teachman, B. A. (in press). Reducing stigma toward individuals with mental illnesses: A brief, online intervention. Stigma, Research and Action.
Saporito, J., Ryan, C., & Teachman, B. A. (2011). Reducing stigma toward seeking mental health treatment among adolescents. Stigma Research and Action, 1, 9-21.
Peris, T. S., Teachman, B. A., & Nosek, B. A. (2008). Implicit and explicit stigma of mental illness: Links to clinical care. Journal of Nervous and Mental Disease, 196, 752-760.
Teachman, B. A., Wilson, J., & Komarovskaya, I. (2006). Implicit and explicit stigma of mental illness in diagnosed and healthy samples. Journal of Social and Clinical Psychology, 25, 75-95.
updated July 2012