APPLIED COGNITIVE PSYCHOLOGY

Appl. Cognit. Psychol. 24: 312–325 (2010)

Published online in Wiley InterScience
(www.interscience.wiley.com) DOI: 10.1002/acp.1678

Cognitive Mechanisms Underlying the Emotional Effects

of Bias Modification

LAURA HOPPITT1,2*,y, ANDREW MATHEWS1z,

JENNY YIEND1x and BUNDY MACKINTOSH1,2
1
Medical Research Council Cognition and Brain Sciences Unit, Cambridge, England
2
The Open University, UK

SUMMARY
In this study we assessed the cognitive mechanisms underlying the affective consequences of
modifying emotional processing biases. During ‘active’ training participants selected either threa-
tening or non-threatening meanings of emotionally ambiguous words, in contrast to ‘passive’
conditions in which participants read unambiguous words with equivalent valenced meanings. Both
methods enhanced access to training-congruent primed emotional meanings, as assessed in a lexical
decision task, although neither method displayed evidence of an induced interpretive bias as it is
usually understood. However, consistent with previous research, the methods differed in their
emotional consequences: Active training had greater effects on anxiety while viewing an accident
video than did passive exposure. We interpret these results to suggest that both forms of training
enhance priming of a valenced category, but only active conditions induce an implicit production rule
to generate and/or select emotional meanings, and that it is this latter process that is critical to the
modification of emotionality. Copyright # 2010 John Wiley & Sons, Ltd.

A large body of evidence now supports the conclusion that anxiety-prone individuals are
characterised by perceiving threatening interpretations of ambiguous events (e.g. Richards
& French, 1992). Although this seems consistent with the hypothesis that interpretive (and
other) biases can cause anxiety, evidence for this hypothesis is based only on observed
associations, leaving open the possibility that emotional state causes bias (rather than the
reverse) or that cognitive biases and emotion are related only by being products of another
causal process (Mathews & MacLeod, 2002). One method that allows a direct test of the
causal hypothesis is to experimentally manipulate a cognitive bias and then assess the
emotional consequences; for example, the experience of anxiety in response to a stressful
event (Mathews & MacLeod, 2002). This method is often referred to as training a cognitive
bias or Cognitive Bias Modification (CBM). The results of such experiments have
suggested that modification/training of interpretive bias not only influences the cognitive

*Correspondence to: Laura Hoppitt, School of Social Work and Psychology, University of East Anglia, Norwich,
NR4 7TJ, UK. E-mail: l.hoppitt@uea.ac.uk
y
Present address: University of East Anglia, Norwich, UK.
z
Present address: University of California, Davis, CA, USA.
x
Present address: Institute of Psychiatry, King’s College London, London, England.
ô
Present address: University of East Anglia and Medical Research Council Cognition and Brain Sciences Unit.

Copyright # 2010 John Wiley & Sons, Ltd.

 Cognitive mechanisms underlying CBM 313

processing of novel emotional stimuli but can also modify subsequent anxiety vulnerability
(e.g. Wilson, MacLeod, Mathews, & Rutherford, 2006).
Grey and Mathews (2000) provided the first clear evidence of experimental
manipulation of interpretive bias using a method in which participants were required
to select threatening or non-threatening interpretations of emotionally ambiguous words
(threat/non-threat homographs such as sink or growth), they then assessed the subsequent
interpretation of novel emotionally ambiguous stimuli. In the initial (training) phase, a
homograph was presented on each trial, followed by a fragment to be completed as a word
that was related either to the threatening meaning of the homograph (threat training
condition, e.g. sink: drow-) or to its benign meaning (non-threat training condition, e.g.
sink: wa-h). This contingency therefore encouraged participants to interpret homographs in
a threatening or non-threatening way, depending on training group.
After completion of the training phase, Grey and Mathews (2000, experiment 2) tested
effects on interpretation using a lexical decision task. Threat/neutral homographs (half of
which were new to participants and half of which had been seen before) were presented as
primes, followed after 750 milliseconds by a word or non-word target, for which a lexical
(word/non-word) decision had to be made. Word targets were related to the threatening
meaning of the homograph prime on half the trials and the benign meaning on the other
half. Results suggested that interpretation of both old and new homographs had been
influenced, because participants in the threat trained group were faster when making
lexical decisions for threatening word targets and the non-threat trained group for benign
targets, regardless of whether or not the homograph had been seen before in training.
We refer to this induction method as ‘active’ training, because the task encourages
participants to actively generate emotional meanings and select training congruent
meanings from several possible interpretations. In contrast, we use the term ‘passive’ to
describe methods in which participants are repeatedly exposed to equivalently valenced
meanings, and thus do not have to generate and select training congruent meanings
themselves (this terminology was originally used by Grey & Mathews, 2000; Mathews &
Mackintosh, 2000). The key difference between active and passive training is whether or
not the training congruent valenced meanings are presented to participants (as in passive
training) or whether participants are presented with emotional ambiguity and (through the
constraints of the task) are encouraged to generate emotional meanings, and select training
congruent meanings (active training). Over time, due to the constraints of the task,
participants in active (but not passive) training conditions learn to generate training
congruent emotional meanings in the face of emotional ambiguity. For example, Grey and
Mathews (2000, experiment 3) used a passive condition in which unambiguous associates
were presented first, followed only later by the homograph. A relatedness judgement
between the words was then required in which active generation and selection among
meanings of the homograph was not necessary. Results from a lexical decision task
suggested that interpretive bias was induced just as effectively using either the active or
passive method.
Wilson et al. (2006) investigated the later effects on anxiety vulnerability of an active
training method similar to that of Grey and Mathews (2000). After training, in test trials
participants saw a cue (a homograph or non-ambiguous word) and then had to decide which
of two word targets was most related in meaning to that cue. Participants showed faster
selection of words related to meanings of the homograph prime that were consistent with
the valence of training. Although no differential mood effects were detected during
training, they were revealed following a final phase in which participants viewed a

Copyright # 2010 John Wiley & Sons, Ltd. Appl. Cognit. Psychol. 24: 312–325 (2010)
DOI: 10.1002/acp
314 L. Hoppitt et al.

potentially distressing video of accident scenes. Those trained with fragments that
corresponded to threatening meanings of homographs reported greater increases in
negative mood following the video than did those in the groups trained with benign
meanings.
This finding has a number of important implications. Because no mood changes were
observed during training itself, it is hard to argue that the subsequent anxiety response was
due to carryover of differences in emotional state produced in training. Instead, it was
argued that the emotional effects of training were achieved because active training induced
an implicit production rule to generate and select positive (or negative) meanings when
processing new ambiguous events (Mathews & MacLeod, 2002; Wilson et al., 2006). If so,
emotional effects presumably depend specifically on practice in active generation and
selection of valenced meanings during training. Of course, on some active training trials
the first word that comes to mind will be a training congruent interpretation that fits the
word fragment. In such a case participants would not need to generate alternative meanings
and select among them, but this will not occur on every trial at the beginning of training, so
generation and selection will still be required. As training progresses however (and the
implicit production rule is learnt), training congruent meanings will tend to be generated
preferentially in favour of training incongruent meanings.
Confirming the hypothesis that it is the induced production rule that affects later
emotionality requires evidence that passive training does not affect later emotionality.
Hoppitt, Mathews, Yiend, and Mackintosh (2010) investigated this issue by directly
comparing the effects of active and passive threat training in modifying emotionality pre to
post-training. The training utilised emotionally ambiguous scenarios related to a potential
physical threat (similar to those used by Mackintosh, Mathews, Ridgeway, & Cook, 2006
and Yiend, Mackintosh, & Mathews, 2005). All of the scenarios were emotionally
ambiguous until the final word which resolved the ambiguity negatively. In the active threat
condition, this final word was presented as an incomplete word, such that participants had
to generate the negative meaning of the scenario themselves in order to fill out the word
correctly. In the passive threat condition this final word was presented intact, meaning that
equivalently threatening material was presented but there was no requirement for active
generation and selection of meaning. Pre- and post-training, all participants were presented
with emotionally ambiguous event scenarios to read. Their task was to create an image of
the event outcome (cf. Hertel, Mathews, Peterson, & Kintner, 2003; Holmes & Mathews,
2005; Holmes, Mathews, Dalgleish, & Mackintosh, 2006) and rate the emotionality of this
image. Results suggested that passive threat training did not affect emotionality of images,
whereas active threat training caused post-training images to be reported as more
unpleasant than pre-training images.
If passive training can induce an interpretive bias (e.g. Grey & Mathews, 2000,
experiment 3) then why should it not have any effect on emotionality? We propose that this
is because passive training merely facilitates some kind of training-congruent generic
emotional priming (as originally suggested by Grey & Mathews, 2000). The effects of this
generic priming could resemble an interpretive bias but the underlying learning might not
involve differential generation and selection of valenced meanings in the presence of
ambiguity. The result is a tendency to differentially endorse negative or positive
information when it was presented (Grey & Mathews, 2000; Hoppitt et al., 2010).
However, as yet no study has directly investigated the cognitive processes underlying
active and passive training to ascertain whether or not this is the case. As Cognitive Bias
Modification for interpretation (CBM-I) starts to be used to erode negative biases and thus

Copyright # 2010 John Wiley & Sons, Ltd. Appl. Cognit. Psychol. 24: 312–325 (2010)
DOI: 10.1002/acp
 Cognitive mechanisms underlying CBM 315

alleviate anxiety states (e.g. Hirsch, Hayes, & Mathews, 2009; Mathews, Ridgeway, Cook,
& Yiend, 2007; Murphy, Hirsch, Mathews, Smith, & Clark, 2007) it seems critical to have a
clear understanding of the cognitive processes that must be changed in order to reduce
subsequent emotional vulnerability most effectively. Indeed, understanding the cognitive
mechanisms of change for CBM has been outlined as a key enterprise for future research
(MacLeod, Koster, & Fox, 2009).
The main aim of this study was therefore to investigate these underlying cognitive
processes in CBM. In order to do this, active and passive single word training, similar to
that used by Grey and Mathews (2000) was utilised. A post-training lexical decision task
was used to test the cognitive processes that had changed as a result of training. In
particular we wanted to differentiate between a true interpretive bias, as opposed to some
form of facilitated emotional priming (i.e. enhanced priming with training congruent
valenced words). To differentiate between these possibilities, in the post-training lexical
decision test some target words were immediately preceded by a related ambiguous or
unambiguously valenced cue. If training induced a selective interpretive bias, this should
be evident on trials in which the cue was an emotionally ambiguous word. If training
enhanced the effects of any current emotional prime then this should be evident on trials in
which the cue was either emotionally ambiguous or unambiguous. Interestingly, Wilson
et al. (2006) reported training-congruent speeding in a test phase involving relationship
judgements, only when using emotionally ambiguous primes following active training. We
were therefore particularly interested in assessing any difference between these two types
of cued trials following both active and passive methods in the post-training lexical
decision task. Finally, it is possible that training might facilitate access to an entire
valenced category of words even in the absence of any current priming cue. Given the
evidence that individuals with anxiety do not show differential facilitation to an entire
valenced category in this way it was considered unlikely that CBM would facilitate access
in this way (MacLeod & Mathews, 1991). However, in order to assess this, non-cued trials
were added to the lexical decision task.
To test our prediction that active training has greater effects on emotional response to a
later stress task than equivalently valenced passive training, the lexical decision task was
followed by a video depicting individuals in real life-threatening situations. We predicted
that the active trained groups would show greater training-congruent changes in anxiety
during the distressing film (due to the induction of an implicit learned production rule to
generate and select emotional meanings in the training phase) than the passive trained
groups.

METHOD

Participants
A total of 112 participants aged between 18 and 60 (44 males and 68 females, mean age
42.21 years, SD ¼ 12.99) were recruited from the panel of community volunteers at the
MRC Cognition and Brain Sciences Unit. Participants were randomly allocated to one of
four training conditions: Active threat (n ¼ 29), passive threat (n ¼ 29), active non-threat
(n ¼ 27) and passive non-threat (n ¼ 27). The random allocation was subject to the
restrictions of keeping state and trait anxiety levels, gender ratio and cell size
approximately equal in all groups. All participants had English as their first language, were

Copyright # 2010 John Wiley & Sons, Ltd. Appl. Cognit. Psychol. 24: 312–325 (2010)
DOI: 10.1002/acp
316 L. Hoppitt et al.

paid £5 per hour for their time and had trait anxiety scores in the normal range. In order to
ensure that the accident video was an appropriate stressor for all participants, individuals
reporting that they are not generally emotionally affected by watching such films on
television or that they had been in similar situations themselves (and thus might be
sensitised to such events) were excluded from the final analysis. This exclusion was
determined by a judge who was blind to training allocation.

Materials
Most of the training and test homographs were selected from the word association norms
reported by French and Richards (1992), supplemented by others developed by Wilson
et al. (2006) and by the present authors. A final pool of 96 homographs was split into three
sets of 32, such that for any one participants two sets were used in the training phase and the
remaining set was used in the test phase. These sets were approximately counterbalanced
across participants within groups so that all sets were used in training and test contexts.

Active training
On each trial, participants were presented with a homograph cue (e.g. growth) followed by
a related word fragment (word with missing letters) 750 milliseconds later. In threat
training the fragmented target was related to the threatening meaning of the homograph cue
(e.g. tumour), in non-threat training it was related to the non-threatening meaning (e.g.
height). Each homograph cue was presented four times during training, each time paired
with a different threat or non-threat word fragment. This produced a total of 256 trials,
presented in random order.

Passive training
Grey and Mathews (2000, experiment 3) presented an unambiguous associate prior to the
homograph during training to obviate the need to select emotional meaning. However,
because this method does not ensure that participants do not spontaneously generate and
select alternative meanings, we entirely removed the possibility of actively selecting from
among alternate meanings in the passive training condition by replacing the homograph
cues with unambiguous synonyms having the valenced meaning appropriate for each
group. Importantly, although participants were still required to complete a word fragment
in order to equate response requirements, doing so did not involve selecting the meaning of
emotional ambiguity (as was the case in active training) but rather merely exposed them
repeatedly to valenced meanings (thus maintaining the crucial differences between active
and passive training). Hence, the homograph cue (e.g. growth) was replaced by an
unambiguous word matching either its threatening or non-threatening meaning, depending
on group assignment (e.g. cancer or expansion). In all other respects training was the same
as the corresponding active selection groups.

Lexical decision task

There were 96 real word trials in the lexical decision task, of which 32 had homograph
prime cues followed by target words corresponding to their threatening or non-threatening
meanings (taken from one of the three counterbalanced sets). Another 32 trials had
unambiguous threat or non-threat prime cues, and in the remaining 32 the cue word was
replaced with xxxx, in each case followed by threatening or non-threatening target words.
All words presented in the test phase were new to participants and had never been seen in

Copyright # 2010 John Wiley & Sons, Ltd. Appl. Cognit. Psychol. 24: 312–325 (2010)
DOI: 10.1002/acp
 Cognitive mechanisms underlying CBM 317

training. Furthermore, 96 trials were added in which the lexical decision target word was
not a real word. In a similar way to the word trials, these non-words were also preceded by
other emotional homographs, unambiguous threatening or non-threatening primes or xxxx.
There were thus a total of 192 trials, presented in random order, all with an SOA of
750 milliseconds (following Grey & Mathews, 2000).

Accident video
The final phase involved viewing a video in four segments taken from television broadcasts
(as used by Wilson et al., 2006). Scenes included a man being saved from drowning, people
escaping from fires and a helicopter crash. The film clips can be considered emotionally
ambiguous to the extent that viewers can focus on the horror of the accident scene itself or
the heroism involved in the rescue and relatively positive outcome.

Assessment of anxiety
Both trait and state anxiety were assessed using the State-Trait Anxiety Inventory
(Spielberger, Gorsuch, Lushene, Vagg, & Jacobs, 1983). The trait anxiety scale contains 20
items to be rated according to how participants feel generally and the state scale contains
the same number of items to be rated according to how they are feeling right at that moment
(e.g. ‘I feel at ease’). All items are rated on four point scales, so that the minimum score is
20 and the maximum 80.

Procedure
After signing consent forms, participants filled out the state and trait parts of the STAI.
They then sat in front of a PC where the instructions for the first task were displayed. They
were informed that the study would require them to find missing letters from words and that
just before the word fragment they would see a clue that would help them to find the right
word. They were instructed to press a ‘stop’ key when they felt they knew what the word
was, and then to press the key corresponding to the first missing letter. This double response
was used to ensure that the time taken to respond to the word was not contaminated by
variance in the time taken to locate the correct letter key. Participants completed two
practice trials to ensure that they understood the task, before moving on to the main training
phase. On each trial, a single cue word appeared on the screen, followed after
750 milliseconds by a fragment that was displayed below the cue with dashes in the gaps
indicating where the missing letters were. If the stop key was not pressed within 20 seconds
the computer automatically moved onto the next frame asking for the correct letter to be
entered. If this was not entered the computer displayed the correct word and moved onto
the next trial. The training phase lasted for approximately 30 minutes. The training and
testing phases were programmed using MEL version 2.0 software (Micro Experimental
Laboratory; Schneider, 1988).
Participants were then instructed that for the next task they would have to decide as
quickly as possible if a string of letters made up a real English word or not. On each trial
they were shown a plus sign (for 1 second) to warn them a word was about to appear, and
then either a cue word or a string of crosses, appeared for 750 milliseconds. Participants
were instructed to read but not otherwise respond to the cue. A second set of letters then
appeared in capitals, half of the time making up a real word. Participants were asked to
press a ‘yes’ button as quickly as possible if the letters made up a real word and a ‘no’

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DOI: 10.1002/acp
318 L. Hoppitt et al.

button if they did not. The testing phase lasted approximately 15 minutes with a short break
half way through.
Immediately after finishing the lexical decision task participants were asked to fill in
another state anxiety questionnaire and were then shown the video (lasting approximately
6 minutes). The nature of the video was explained to them beforehand and it was
emphasised that they did not have to watch it if they did not want to (all participants did
choose to watch the entire video). Immediately after the video they were given another state
anxiety questionnaire to fill out, and were then asked about their thoughts as to the purpose
of the experiment. The experimenter checked that their mood had returned to normal
levels, after which they were thanked and paid. The whole experiment took approximately
1 hour and 15 minutes to complete.

RESULTS

Participant characteristics
There were neither any significant differences between active and passive groups in trait
anxiety, F (1, 108) ¼ 1.75, p ¼ 0.19 or initial state anxiety,1 F < 1, as assessed at the
beginning of the session; nor between threat and non-threat groups in trait anxiety, F (1,
108) ¼ 1.92, p ¼ 0.17 or initial state anxiety, F < 1.

Lexical decision latencies

Lexical decision responses longer than 1400 milliseconds and shorter than 100 milli-
seconds made up 2% of all responses and were excluded from the analysis as outliers,
together with errors (another 3%). Due to computer error, lexical decision data was lost for
some participants and this left the groups sizes in the analyses as follows: 25 in active
threat, 25 in passive threat, 23 in active non-threat and 22 in passive non-threat. The means
of the remaining lexical decision latencies were analysed using a mixed-model ANOVA,
with training method (active or passive) and training valence (threat or non-threat) as
between-subjects factors and cue type (homograph, unambiguous word or none) and target
valence (threat or non-threat) as within-subjects factors.
There were significant main effects of cue type, F (2, 182) ¼ 67.82, p < 0.001, h2p ¼ 0.43
and target valence, F (1, 91) ¼ 60.01, p < 0.001, h2p ¼ 0.40, which were qualified by a
significant interaction among training valence, target valence and cue type, F (2,
182) ¼ 6.55, p ¼ 0.002, h2p ¼ 0.07.
Given previous findings (e.g. Wilson et al., 2006) we expected that any significant
training effects would occur on cued rather than non-cued trials. Therefore, this three-way
interaction was decomposed using separate ANOVAs for cued and non-cued trials. In the
analysis of non-cued trials alone there were no significant interactions, (all p values
0.1).
For cued trials, the interaction between target valence and training valence was significant,
F (1, 91) ¼ 12.16, p ¼ 0.001, h2p ¼ 0.12, and inspection of Table 1 suggests that although
responses to non-threat targets were generally faster than responses to threat targets, this
difference was less in the threat-trained groups (see Table 1). This two-way interaction was
1
Data for pre-training state anxiety in the active threat group deviated from a normal distribution. All analysis
involving this data set were re-run with non-parametric tests. At no point did this affect the significance of the
results and therefore all are reported as parametric tests.

Copyright # 2010 John Wiley & Sons, Ltd. Appl. Cognit. Psychol. 24: 312–325 (2010)
DOI: 10.1002/acp
 Table 1. Mean lexical decision latencies (milliseconds) to a negative or neutral target, depending on type of cue and training condition
Threat training Non-threat Training

Copyright # 2010 John Wiley & Sons, Ltd.

Cue type Target valence Active n ¼ 25 Passive n ¼ 25 Active n ¼ 23 Passive n ¼ 22
Ambiguous Negative target 636.38 (105.81) 632.39 (123.23) 669.64 (91.32) 695.75 (89.04)
Neutral target 625.81 (102.94) 613.50 (118.09) 643.29 (86.68) 661.86 (94.66)
Unambiguous Negative target 633.46 (101.11) 626.16 (119.04) 680.19 (78.51) 672.09 (89.91)
Neutral target 624.09 (106.07) 616.50 (121.50) 633.34 (71.03) 639.73 (84.16)
No cue Negative target 690.06 (105.97) 689.13 (138.33) 704.61 (98.62) 739.85 (111.39)
Neutral target 644.27 (115.55) 660.71 (142.78) 681.09 (88.90) 729.57 (123.53)
Note: Standard deviations are shown in parentheses.
Cognitive mechanisms underlying CBM
319

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320 L. Hoppitt et al.

not qualified by any further interaction between target valence, cue type (ambiguous or
unambiguous) and training valence, F (1, 91) ¼ 1.22, p ¼ 0.272, h2p ¼ 0.13 or between
target valence, cue type, training valence and training method, F < 1.
In summary, therefore, the results are consistent with a relative speeding of responses to
word targets that were congruent with the valence used in training. Although this effect
depended on a priming cue being present in the lexical decision test, there was no apparent
difference between trials using homograph or unambiguous cues of the same valence as the
target word. This suggests that non-threat and threat training conditions speeded access to
targets of the trained valence, regardless of whether the current priming cue was ambiguous
or non-ambiguous or of whether training involved active selection of meaning or passive
exposure, but only in the presence of a current priming cue.

State anxiety
Following previous research, participants who reported initial state anxiety as being at floor
level of the scale on all three consecutive occasions (i.e. three consecutive scores of the
lowest possible score on the state part of the STAI) were excluded from the analysis (cf.
Mackintosh et al., 2006). Four participants were excluded from this analysis on that basis
(two in the active threat condition, one in the passive threat condition and one in the active
non-threat condition). In addition, as discussed in the Method section, participants were
only included if the film was an appropriate stressor (five were excluded from the active
threat group, five from passive threat, one from active non-threat and one from passive non-
threat on this basis). To check that no differences in state anxiety had occurred due to the
training phase and lexical decision task (before viewing the video), state anxiety scores
were analysed using a mixed model ANOVA with training method (active or passive) and
training valence (threat or non-threat) as the between-subjects factors, and time of
completing the state anxiety questionnaire (pre-CBM and post lexical decision task) as the
within-subjects factor. There was a significant main effect of time, indicating that mean
state anxiety increased in all groups over the training and test session, F (1, 92) ¼ 5.34,
p ¼ 0.02, h2p ¼ 0.06. Importantly there were no significant interactions with training method
and training valence, all F’s < 1 (see Table 2).
State anxiety scores taken before and after the video were then analysed in the same way.
There was a large main effect of time, F (1, 92) ¼ 43.02, p < 0.001, h2p ¼ 0.32, qualified by
an interaction between time and training method, F (1, 92) ¼ 6.09, p ¼ 0.015, h2p ¼ 0.06,
that was further qualified by a three-way interaction involving training valence, F (1,
92) ¼ 4.00, p ¼ 0.048, h2p ¼ 0.04. Planned comparisons were carried out using change in
state anxiety pre to post-film as the dependent variable. Mean state anxiety increased
significantly more in the active threat training condition than in the passive threat training

Table 2. Mean state anxiety before training, before the video and after the video, depending on
training method (active or passive) and training valence (threat or non-threat)
Condition Pre-training Pre-video Post-video
Active threat n ¼ 22 27.09 (6.68) 27.82 (4.62) 36.32 (10.70)
Passive threat n ¼ 23 28.04 (6.29) 29.96 (7.26) 32.04 (8.91)
Active non-threat n ¼ 25 28.44 (6.55) 29.44 (8.17) 34.28 (9.19)
Passive non-threat n ¼ 26 27.50 (7.34) 29.31 (6.80) 33.46 (8.86)
Note: Standard deviations are shown in parentheses beside each value.

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DOI: 10.1002/acp
 Cognitive mechanisms underlying CBM 321

condition, t (43) ¼ 2.84, p ¼ 0.004, d ¼ 0.87, the difference between active non-threat and
passive non-threat training did not approach significance, t (49) ¼ 0.36, p ¼ 0.37, (for
means see Table 2).

DISCUSSION

The lexical decision results suggest that, regardless of whether training was active or
passive, those in threat training conditions were relatively faster to identify (cued) threat
versus non-threat target words, than were those in the non-threat training conditions. This
was true whether or not the priming cues were ambiguous but not when no cues were
present at all. In other words, the results of the lexical decision task indicate that both active
and passive training enhanced training-congruent emotional priming effects. However,
rather than simply enhancing access to all words of the trained valence, it seems that a
current priming cue is required before training effects can be observed. These effects may
thus be better described as a directional enhancement of priming in the presence of a
valenced cue, rather than interpretive bias as it is usually understood.
These results are not entirely consistent with the findings of Wilson et al. (2006), who
reported training-congruent speeding in a different test (involving relationship
judgements), only when using emotionally ambiguous primes following active training.
Given the difference in test methods across studies, it is possible that procedural variations
account for this difference. For example, the fact that selection was required between two
target words in the judgement test task used by Wilson et al. (2006) could account for the
greater importance of a homograph prime in that study. Re-enactment of a selective
production rule acquired during training may thus depend on the current task context such
as anticipation of the need to select among alternatives.
In contrast to the effects seen in the present lexical decision test, subsequent exposure to
a mild (and perhaps ambiguous) stressor elicited different emotional responses according
to whether or not training had involved active selection among emotional meanings.
Specifically, participants trained to actively generate and select the threatening meanings of
homographs became more anxious than did those trained without active selection of
threatening meanings, when later exposed to videos depicting accidents. These emotional
effects of training cannot be explained solely by the enhancement of emotional priming, as
this occurred equally in both the active and passive conditions. If the increase in anxiety
attributable to training in the active selection of threatening meanings cannot be accounted
for by enhanced emotional priming alone, what could explain this additional emotional
effect, seen only in the active condition?
We suggest that the most parsimonious explanation is based on the principle of transfer
of processing (consistent with that proposed by Wilson et al., 2006): That is, the transfer of
a previously practiced method of processing to a subsequent event (referred to here as an
implicit production rule). Specifically, we suggest that participants assigned to active threat
training learned to generate and select threatening meanings, and then (unintentionally)
continued to do so when later encountering new and potentially threatening events. A
tendency to actively select threatening meanings—even in the absence of being required to
do so by any accompanying task—may provide a plausible explanation for the increased
anxiety experienced while viewing the video. For example, the film stressor showed clips
of real-life accident scenes, but often these scenes were emotionally ambiguous (for

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322 L. Hoppitt et al.

example, although there was a scene of a man drowning, it finished with his rescue by a
heroic police officer). It is possible that in the active threat condition, the induced
production rule to generate and select negative meanings led participants to select negative
aspects of the film to focus upon (i.e. the terrible predicaments as opposed to the heroic
rescues). This would explain the increased anxiety in this condition as compared to the
passive threat group, who presumably did not have any tendency to select either negative or
positive emotional meanings.
Our original hypotheses can thus be restated as follows: Enhanced emotional priming of
an emotional semantic category can be induced by practice that involves repeated access to
examples within that category, irrespective of whether active selection of ambiguous
meaning or passive exposure is involved. This enhanced priming then speeds access to new
meanings within this category when in the presence of relevant cues (e.g. emotionally
ambiguous or unambiguous threat/non-threat words). Importantly however, this enhanced
emotional priming on its own does not necessarily lead to any modification of emotional
vulnerability. These results are consistent with and extend the findings of Hoppitt et al.
(2010) in which it was found that active threat training modified the emotionality of images
in a post-training task whereas passive training did not.
This is not to say that enhanced priming plays no role at all in modifying emotional
vulnerability; on the contrary, we think it may well be that such priming predisposes the
direction of processing towards one valenced meaning or the other. However, our data
suggest that the active generation and/or selection of emotional meanings during training
appears to be necessary for congruent changes in emotional reactivity to occur, even if it
may not be sufficient in the absence of directional priming. The findings from the current
study thus provide further evidence that active generation and selection of affective
meanings of ambiguous events is critical for later emotional effects, but leave open the
possibility that enhanced priming may serve to influence the valenced direction of this
subsequent emotional processing.
Alternative explanations that need to be ruled out include carry-over effects of anxiety,
experimental demand and response bias. Importantly, no differential anxiety effects
between groups were detected from before to after training and test. Therefore, it seems
unlikely that carry-over effects of anxiety from training might provide an explanation. This
finding is consistent with the results reported by Wilson et al. (2006). Although text based
training has been shown to modify anxiety at the time of training (e.g. Mathews &
Mackintosh, 2000), such an effect is typically absent with single words. One possible
explanation is that single words do not sufficiently activate a threat representation system,
unlike self-related images generated by completing ambiguous scenarios (Mathews &
MacLeod, 2002).
Although demand effects are difficult to rule out completely, we have found no evidence
to support this possibility in this or previous experiments. Debriefing was carried out
following the experiment to assess how aware participants were of the purpose of the study
and no participants were fully aware of the experimental purpose. Furthermore, because
the critical comparison was between groups who were equally primed with threatening
meanings, it does not seem that repeated exposure to negative valence alone or a
consequent negative response bias, can account for the active-passive difference in state
anxiety. There seems to be no reason why a response bias would only follow active training
when exposure to negative meanings was the same in both methods (if not greater in the
passive condition, as words had unambiguously negative meanings). In the lexical decision
task, a response bias account would predict an effect of training valence on all trial types

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DOI: 10.1002/acp
 Cognitive mechanisms underlying CBM 323

(i.e. both those that were cued and those that were not), so the effects on cued trials alone
are difficult to account for in terms of response bias.
It could be argued that there is no obvious reason why passive methods should be able to
enhance primed access to an valenced semantic category, yet not cause similar changes in
emotional vulnerability as were seen with active training. However, the distinction between
‘cold’ semantic or propositional meaning, and ‘hot’ or emotional meaning, has been made
previously within a number of cognitive models (e.g. Teasdale, 1993). Similarly, other
research using cognitive bias modification has shown that valenced semantic
interpretations encoded in verbal form may not be accompanied by any emotional
response, whereas the same information encoded in other ways (such as an image) is much
more likely to elicit emotion (Holmes & Mathews, 2005; Holmes et al., 2006).
There are several possible reasons for the apparent lack of emotional differences due to
active selection in non-threat training. First, the homograph training method may be less
effective at training in a ‘positive’ than in a negative direction because of constraints
imposed by the available meanings of the homographs. The homographs were chosen to
have one negative/threat meaning and an alternative non-threat meaning. By design,
therefore, the threat meanings of the homographs form a fairly coherent category of threat,
mostly involving physical harm or danger of attack (e.g. sink/drown, stalk/pursue, batter/
assault). In contrast the non-threat meanings are ‘anything except threat’, are not
necessarily positive and do not form a coherent category (e.g. sink/basin, stalk/leaves,
batter/pancake). The more coherent threat category may thus induce more powerful
training effects.
Second, our participants were non-anxious volunteers. It has previously been argued that
most healthy people are characterised by mildly positive biases that protect them from
negative emotions to some extent (e.g. Hirsch & Mathews, 2000). For both of these
reasons, it may be difficult to further increase the already positive bias in this group using
homograph training. In other related work, more explicitly positive materials have been
developed for use with participants having elevated trait anxiety levels. Results suggest that
positive adaptations of active text-based training (similar to that used by Mathews &
Mackintosh, 2000) can indeed reduce negative interpretation bias and decrease elevated
trait anxiety levels (e.g. Mathews et al., 2007). According to clinical intuition, if people
suffering from emotional disorders generate and select alternative and more positive
interpretations of everyday emotionally ambiguous events for themselves, effects will be
superior to simply offering advice about alternative ways of seeing their situation. A
Socratic method of questioning is therefore often used to try to produce a lasting change in
beliefs or mood (e.g. Beck, 1995). Comparisons of active versus passive methods of non-
threat training using highly anxious individuals could offer new routes to testing
hypotheses about the optimal ways of reducing emotional vulnerability. Ideally, active
CBM-I would create a cascade effect resulting in more and more training congruent
interpretations being made in everyday life.
It is important to note some limitations with the present study. First, 16 participants were
excluded from the analysis of state anxiety pre and post the film stressor (due to floor
effects and/or being either desensitised or sensitised to the film). Reducing sample sizes in
this way could reduce generalisability of the findings; however, sample sizes remained
comparable to (or exceeded) those used in previous CBM research (e.g. Mackintosh et al.,
2006; Wilson et al. 2006). Second, there is no baseline to assess change in anxiety to the
film stressor in the absence of CBM. It is therefore not possible to know whether
participants in the passive threat trained group (or indeed the active non-threat and passive

Copyright # 2010 John Wiley & Sons, Ltd. Appl. Cognit. Psychol. 24: 312–325 (2010)
DOI: 10.1002/acp
324 L. Hoppitt et al.

non-threat groups) increased in anxiety in a comparable way to participants who had not
received any training. Inclusion of baseline conditions in further research could answer this
question.
In conclusion, this study is the first to investigate the different cognitive mechanisms
underlying active versus passive training of cognitive processing bias whilst also assessing
the later emotional impact of these two training methods. The results suggest that both
active and passive methods enhance access to primed emotional meanings congruent with
those used in training, as assessed in a lexical decision task. Interestingly, neither training
method appeared to display an interpretive bias that could not be explained by enhanced
emotional priming. In addition to enhancing access to primed meanings, we have
suggested that only active threat training also induced an implicit learned production rule
to generate and select emotional meaning (in the form outlined by Mathews & MacLeod,
2002; Wilson et al., 2006). Our data show that it is the deployment of such a learned rule
when processing later potentially threatening events that is the critical causal factor for
subsequent changes in emotional reactivity.

ACKNOWLEDGEMENTS

This research was funded by Medical Research Council Studentship to the first author and
Wellcome Trust Project Grant No 074073 to the final author. The authors thank Colin
MacLeod for his helpful comments on an earlier version of this manuscript.

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Copyright # 2010 John Wiley & Sons, Ltd. Appl. Cognit. Psychol. 24: 312–325 (2010)
DOI: 10.1002/acp