Interpretation Biases in Anxiety – A Three-Level Meta-Analysis

Interpretation biases (IBs) play a central role in cognitive models of anxiety disorders and are considered a transdiagnostic feature operating across anxiety disorder categories and lev-els of severity. Despite decades of research, the magnitude of this bias in anxiety as well as the factors modulating its magnitude are largely unknown. This article presents a three-level meta-analysis investigating the strength of the association between IBs and symptoms of anxiety. Databases (PsycINFO, PubMed, ProQuest Dissertations) were searched resulting in the inclusion of 295 samples with 1450 contrasts. An overall medium effect size (g = 0.48, 95% CI [0.43, 0.52]) was found. Equivalent effect sizes were found for minors and adults as well as different disorder categories (Generalized Anxiety, Panic/Agoraphobia/Anxiety Sen-sitivity, Specific Phobia, Separation Anxiety, Multiple Symptom Clusters) and clinical sta-tuses (clinical, sub-clinical). Moreover, effect sizes were larger for studies using direct measures, and verbal and disorder-specific stimuli. Interestingly, the effect size was stronger for negative than for positive stimuli. To conclude, the present results are consistent with the view that anxiety is associated with IBs that operate across different categories and severity levels. These findings have implications for cognitive theories of anxiety as well as clinical interventions.