# Effectiveness of interpretation training to reduce anxiety: Evaluating technology-based delivery models and methods to reduce attrition

> **NIH NIH R01** · UNIVERSITY OF VIRGINIA · 2020 · $470,828

## Abstract

Project Summary/Abstract
Approximately 25-30% of the U.S. population will experience anxiety pathology severe enough to qualify for an
anxiety disorder diagnosis during their lifetime. Critically, the majority will not receive treatment, creating a
serious need to consider alternative approaches to delivering mental health services that can meet needs on a
larger scale. Cognitive Bias Modification (CBM) interventions for anxiety hold considerable promise as a way to
meet these needs. These programs alter biased ways of thinking, such as selective assignment of threat
interpretations, which are known to cause and maintain anxiety. CBM for interpretation bias (CBM-I) has
established efficacy when administered via computer in the laboratory, and there is clear evidence for target
engagement (i.e., change in interpretations, the identified mechanism). Now, effectiveness needs to be tested
in the community, using sufficiently large samples to evaluate key moderators of its effects, including delivery
method (computer vs. mobile phone) and the addition of minimal human contact (for those at risk of attrition).
Addressing attrition is critical given high rates of drop out for web-based interventions. The PI's lab is ideally
positioned to test moderators of CBM-I. Specifically, via the PI's MindTrails web site (established with the lab's
prior NIMH R34MH106770 award), the lab already has the infrastructure to deliver CBM to the public and
recruit large anxious samples. Moreover, the PI and Co-I have established infrastructure to do mobile sensing
of mood and CBM-I delivery via mobile phones. Thus, the project can respond to NIMH's request for
“Effectiveness trials that can contribute to advancing the personalization of mental health care.” The current
proposal aims to compare effectiveness and target engagement of CBM-I delivered via computer vs. mobile
phone, and test if adding minimal human contact for participants at risk of dropout improves retention and
outcomes. Study 1 will provide a pilot feasibility and user experience test of the CBM-I program on mobile
phones. Study 2 will examine the lab's current online, computer-based CBM-I data to help determine
empirical indicators of attrition. Study 3 will provide the primary test of moderators of effectiveness. Namely, in
Study 3, N=840 high anxious participants will be randomized to one of 3 conditions: 1) CBM-I training delivered
by computer (at existing MindTrails site); 2) CBM-I training delivered by mobile phone; 3) Control group-
Psychoeducation only. CBM-I conditions include 5 weekly training sessions. Based on theoretically- and
empirically-derived predictors of attrition, participants identified as high-risk for dropout in conditions 1 and 2
will then be randomly assigned to add minimal human contact (using the TeleCoach protocol) or no change.
Using this adaptive intervention, known as Sequential, Multiple Assignment, Randomized Trial (SMART), the
project can test both the effects of CBM-I de...

## Key facts

- **NIH application ID:** 9900865
- **Project number:** 5R01MH113752-04
- **Recipient organization:** UNIVERSITY OF VIRGINIA
- **Principal Investigator:** BETHANY A TEACHMAN
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $470,828
- **Award type:** 5
- **Project period:** 2017-07-01 → 2023-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9900865

## Citation

> US National Institutes of Health, RePORTER application 9900865, Effectiveness of interpretation training to reduce anxiety: Evaluating technology-based delivery models and methods to reduce attrition (5R01MH113752-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9900865. Licensed CC0.

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