This randomized, single-blind trial tests whether one session of interpretation bias modification reduces immediate social-evaluative anxiety and shifts interpretation bias in Pakistani university students aged 18 to 25 years with elevated social anxiety. Participants are assigned to either feedback-contingent interpretation bias modification or a structurally matched interpretation control condition. Primary and secondary outcomes are assessed before and after the intervention session using short-form state-trait anxiety measures and Word-Sentence Association Paradigm endorsement indices.
age 18 to 25 years
Social Phobia Inventory score greater than 19
at least moderate severity on the DSM-5-TR Severity Measure for Social Anxiety Disorder-Adult
able to read study materials
clinically elevated depressive symptoms on Beck Depression Inventory-II at or above prespecified cutoff [above 16]
clinically elevated general anxiety symptoms on the Beck Anxiety Inventory at or above prespecified cutoff [ above 20]
current medical or psychiatric condition likely to interfere with safe or valid participation
prior participation in this trial.
Parallel
WSAP-based interpretation bias modification
BehavioralSingle-session Word-Sentence Association Paradigm training with performance-contingent feedback across 220 trials in two 110-trial blocks; each block includes 70 social ambiguity trials and 40 non-social fillers. Correct feedback follows benign endorsement or threat rejection; incorrect feedback follows threat endorsement or benign rejection.
WSAP interpretation control condition
BehavioralMatched Word-Sentence Association Paradigm exposure with identical stimulus timing and response demands, feedback delivered on 50 percent of trials without contingency favoring benign over threat interpretations.
short version of the Spielberger State-Trait Anxiety Inventory
The primary outcome is within-participant change in state anxiety measured with the 5-item short-form State-Trait Anxiety Inventory state subscale (STAIS-5). Items are summed to a total score, with higher scores indicating greater state anxiety. The primary comparison is the between-group difference in change score (IBM versus ICC).
Spielberger short-form State-Trait Anxiety Inventory (S-STAI)
Difference between post-session and baseline STAIS-5 total score; higher scores indicate greater state anxiety.
Change in Word-Sentence Association Paradigm threat endorsement rate.
Proportion of threat word-sentence pairings endorsed as related; lower values indicate less threat-consistent interpretation. Used as interpretation bias metrices.
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Ather Mujitaba
Lead sponsor
University of Gujrat
Sponsor institution
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