2 - (SYM 31) Looking on the Bright Side: A Key Role for Interpretations in the Maintenance and Treatment of Emotional Problems

Our daily lives are full of ambiguity and uncertainty. People with anxiety and depression have a tendency to generate negative interpretations.  After exploring the evidence for transdiagnostic negative interpretation bias, we will consider how cognitive behaviour therapy (CBT) targets negative interpretations. Cognitive bias modification of interpretations (CBM-I) was developed to test the causal role of interpretation bias in maintaining emotional distress. Using a programmatic approach, we developed an effective transdiagnostic form of CBM-I that promotes a more positive interpretation bias and reduces anxiety, depression and repetitive negative thinking (RNT). Furthermore, effects were mediated by changes in interpretation bias.

Our CBM-I approach was recently adapted to form a perinatal tailored digital early intervention. We worked with people with lived experience of perinatal anxiety to tailor the CBM-I intervention to the day-to-day lives of pregnant people. It was designed to prevent escalating perinatal anxiety in those at risk due to high levels of RNT (a known risk factor for anxiety). A parallel two-arm randomised controlled trial assessed efficacy of adding twelve sessions of CBM-I to usual maternity care. Pregnant women/birthing people with high levels of RNT, but not high anxiety, (N = 268) were randomised to CBM-I plus usual care, or usual care alone. Participants in the CBM-I arm had lower anxiety later in pregnancy and post-birth. Furthermore, participants in the usual care arm had greater risk of clinically meaningful deterioration in anxiety, compared to participants in the CBM-I arm. Our lived experience experts, clinicians and community-based organisation that support pregnant people, are keen to enable this early intervention to be made available to those who could benefit.