The effects of computerised metacognitive cognitive bias modification training on the development of adaptive metacognitive beliefs and post-traumatic stress disorder symptoms

Background and objectives: Maladaptive metacognitive beliefs are associated with the development of post-traumatic stress disorder (PTSD) symptoms following trauma, however it remains unclear whether training people to adopt healthy metacognitive beliefs helps to protect against the development of PTSD symptoms. We developed and tested a new cognitive bias modification training protocol (CBM_Metacog) that aimed to prevent analogue PTSD by training people to adopt healthy metacognitive beliefs prior to watching a distressing film. Methods: Participants (N = 135) received CBM_Metacog or a control CBM training and then watched a trauma film. We assessed participants’ metacognitive appraisal style/beliefs, analogue PTSD symptoms, including intrusions and meta-awareness of their intrusions. Results: CBM_Metacog led participants to adopt healthier metacognitive beliefs relative to the control training. Importantly, CBM_Metacog participants reported fewer film intrusions over a 7-day period compared to the control group. CBM_Metacog did not increase participants’ meta-awareness of their intrusions. Limitations: As this was the first study to manipulate metacognitive beliefs related to an analogue trauma via CBM, we chose to use a healthy participant sample. Therefore, further research is needed before these results can be generalised to clinical samples. Conclusions: Overall, these results suggest that training people to adopt healthy metacognitive beliefs, prior to trauma exposure, may help reduce vulnerability to PTSD.