Utilising cognitive bias modification to remedy appearance and self-worth biases in eating disorder psychopathology: A systematic review

Background and objectives: This study systematically reviewed the impact of Cognitive Bias Modification (CBM) on biases related to attention (CBM-A) and interpretation (CBM-I) for appearance and self-worth stimuli and the subsequent impact on eating disorder (ED) psychopathology. Method: The current review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), with 12 studies meeting inclusion criteria (CBM-A n = 5; CBM-I n = 7). Results: The literature provides preliminary support for CBM-A and CBM-I efficacy in eliciting bias change in varying degrees of psychopathology (Cohen's d ranging between −1.67 and 1.34; 9 studies reflected improved bias, and 3 reflected no change or did not assess), while highlighting the less robust effects associated with improving ED psychopathology (d ranging between −1.30 and 0.61; 5 studies reflected symptom improvement, and 7 reflected no change or did not assess). Limitations: The review only considered peer reviewed research and did not report on the findings of unpublished data; thus, the current findings may not provide an accurate representation of CBM in EDs. Conclusions: The current findings highlight the potential of CBM as an adjunct intervention for EDs; however the limited number of investigations and high degree of heterogeneity across the included studies impedes on the generalisability of the findings.