Return of Negative Interpretation Bias After Positive Interpretation Training as a Dynamic Predictor of Treatment Outcome in Fear of Public Speaking

Despite various efforts in the field, no consistent predictors of treatment outcome in anxiety disorders have been identified. Based on the Dynamic Systems Theory, this study proposes a novel, dynamic predictor of treatment outcome in those with public speaking anxiety. Using intensive assessments, it was assessed whether speed of recovery to one’s interpretation bias equilibrium after an experimentally-induced perturbation (i.e., interpretation training targeting negative interpretation bias as a critical maintaining factor for anxiety) predicts subsequent outcome to online exposure treatment. Women with subclinical public speaking anxiety completed a positive interpretation training (n = 50) or a neutral interpretation training (n = 50). Consistent with our central hypothesis, results showed that slower recovery to one’s interpretation bias equilibrium was associated with a greater decline in fear of public speaking after exposure treatment. These results show the potential of a dynamic approach in predicting treatment outcome in public speaking anxiety.