A single-session feedback training modifies interpretation bias in individuals with high social anxiety: A randomized controlled trial

The ability to interpret facial expressions accurately is important to adaptive social functioning. Social anxiety disorder is associated with a biased interpretation of facial emotions. This study aimed to demonstrate the effects of feedback training on modifying interpretation bias in individuals with high social anxiety. A total of 451 university students were screened, and 69 participants with high social anxiety were randomly assigned to either a training (n = 37) or a control (n = 32) group. Participants completed pre-questionnaires on social anxiety and depression symptoms, then performed a single session of experiment, followed by post-questionnaires on social anxiety symptoms. In the experiment, participants viewed an ambiguous facial expression and rated the intensity on a continuous scale. The training group received feedback that presented their ratings alongside the actual intensity, allowing them to accurately assess their emotional perception bias through trial-by-trial feedback. The control group received no feedback. The training group showed a significant reduction in interpretation bias for happy and angry faces after the experiment, while the control group did not. However, although the training group's social anxiety symptoms decreased post-experiment, the difference was not statistically significant compared to the control group. These findings provide preliminary evidence that the feedback training targeting dimensional ratings of emotions may be a promising option for correcting interpretation bias in individuals with high social anxiety. Future research could implement multiple sessions of training to potentially reduce both interpretation bias and social anxiety symptoms and verify the long-term effects.