Reciprocal influences of interpretation and attentional biases to health-related information

Abstract

Sa/u{g}l/i{}kla alakal/i{} bilgiler /`{u}zerine bili/c{s}sel s/`{u}re/c{c} yanl/i{}l/i{}klar/i{}n/i{}n, t/i{}bbi bir hastal/i{}k sahibi olan ki/c{s}ilerde bulundu/u{g}u onaylanm/i{}/c{s}t/i{}r. Dikkat yanl/i{}l/i{}/u{g}/i{}n/i{}n da bu bili/c{s}sel s/`{u}re/c{c}lerden biri olarak, sa/u{g}l/i{}k tehdidi i/c{c}eren bilgilerin tespitini kolayla/c{s}t/i{}rd/i{}/u{g}/i{} g/`{o}r/`{u}lm/`{u}/c{s}t/`{u}r. Yorumlama yanl/i{}l/i{}/u{g}/i{} ise mu/u{g}lak bedensel alg/i{}lara felaket anlamlar/i{} y/`{u}klemeye neden olan bir di/u{g}er bili/c{s}sel mekanizmad/i{}r. Literat/`{u}rde, dikkat ve yorumlama yanl/i{}l/i{}klar/i{}n/i{}n olumsuz duygular/i{} artt/i{}rd/i{}klar/i{} ve hastalar/i{}n sa/u{g}l/i{}k durumlar/i{}na al/i{}/c{s}malar/i{}n/i{} zorla/c{s}t/i{}rd/i{}klar/i{} kan/i{}tlanm/i{}/c{s} olmas/i{}na ragmen, bu iki yanl/i{}l/i{}k aras/i{}ndaki ba/u{g} a/c{c}/i{}k de/u{g}ildir. Baz/i{} teoriler dikkat ve yorumlama yanl/i{}l/i{}klar/i{}n/i{}n birbirleriyle alakal/i{} oldu/u{g}unu savunurken, baz/i{}lar/i{} ise bu yanl/i{}l/i{}klar/i{}n bili/c{s}sel s/`{u}re/c{c}lerin paralel bile/c{s}enleri olduklar/i{}n/i{} belirtmi/c{s}lerdir. Bu nedenle, s/`{o}zkonusu tez sa/u{g}l/i{}kla ilgili bilgilere kar/c{s}/i{} yorumlama ve dikkat yanl/i{}l/i{}klar/i{}n/i{}n aras/i{}ndaki ili/c{s}kiyi, yorumlama yanl/i{}l/i{}/u{g}/i{}n/i{} de/u{g}i/c{s}tirip bu s/`{u}recin dikkat yanl/i{}l/i{}/u{g}/i{}na etkisini inceleyerek anlamay/i{} hedeflemi/c{s}tir. Herhangi sa/u{g}l/i{}k veya psikolojik problemi olmayan 100 lisans /`{o}/u{g}rencisi, Ana-de/u{g}i/c{s}iklik veya Placebo-de/u{g}i/c{s}iklik gruplar/i{}na rastgele payla/c{s}t/i{}r/i{}lm/i{}/c{s}t/i{}r. Gruplar aras/i{} farkl/i{}l/i{}klar/i{} kontrol etmek amac/i{}yla b/`{u}t/`{u}n kat/i{}l/i{}mc/i{}lardan, sa/u{g}l/i{}k anksiyete duyarl/i{}l/i{}/u{g}/i{} /`{o}lce/u{g}i, Beck Depresyon Tarama /`{O}l/c{c}e/u{g}i ve Beck Anksiyete Duyarl/i{}l/i{}/u{g}/i{} /. {I}ndeksin i/c{c}eren bir dizi anketi doldurmalar/i{} istenmi/c{s}tir. De/u{g}i/c{s}iklik /`{o}ncesi /`{o}l/c{c}/`{u}m olarak, kat/i{}l/i{}mc/i{}lar/i{}n sa/u{g}l/i{}kla alakal/i{} bilgilere kar/c{s}/i{} yorumlama ve dikkat yanl/i{}l/i{}klar/i{} On-line Yorumlama Yanl/i{}l/i{}/u{g}/i{} ve G/`{o}rsel nokta izleme g/`{o}revlerinin de/u{g}i/c{s}tirilmi/c{s} versiyonlar/i{} kullan/i{}larak /`{o}l/c{c}/`{u}lm/`{u}/c{s}t/`{u}r. Daha sonra, Ana-de/u{g}i/c{s}iklik grubu sa/u{g}l/i{}kla alakal/i{} mu/u{g}lak senaryolar/i{}n g/`{u}vensiz ve tehtid edici anla/c{s}/i{}lmas/i{}n/i{} ama/c{c}layan Ana On-line Negatif Yorumlama Yanl/i{}l/i{}/u{g}/i{} De/u{g}i/c{s}imi g/`{o}revini tamamlam/i{}/c{s}lard/i{}r. Placebo-de/u{g}i/c{s}im grubu ise Placebo On-line Negatif Yorumlama Yanl/i{}l/i{}/u{g}/i{} De/u{g}i/c{s}imi g/`{o}revini tamamlam/i{}/c{s}lard/i{}r. De/u{g}i/c{s}iklik safhas/i{}n/i{} de/u{g}i/c{s}iklik sonras/i{} /`{o}l/c{c}/`{u}mler takip etmi/c{s}tir. Sonu/c{c}lar Ana-De/u{g}i/c{s}im grubundaki kat/i{}l/i{}mc/i{}lar/i{}n Placebo grubundakilerle kar/c{s}/i{}la/c{s}t/i{}r/i{}ld/i{}/u{g}/i{}nda sa/u{g}l/i{}kla alakal/i{} mu/u{g}lak durumlarda g/`{u}vensiz yorum de/u{g}erlendi-~rmelerinin g/`{o}sterdi/u{g}i /`{u}zere daha y/`{u}ksek test sonras/i{} yorumlama yanl/i{}l/i{}/u{g}/i{} g/`{o}stermi/c{s}lerdir. Yorumlama yanl/i{}l/i{}/u{g}/i{} i/c{c}in test sonras/i{} grup farkl/i{}l/i{}klar/i{} tepki s/`{u}resi dikkate al/i{}nd/i{}/u{g}/i{}nda ise istatistiksel olarak anlaml/i{} bir sonu/c{c} /c{c}/i{}kmam/i{}/c{s}t/i{}r. Ana olumsuz yorumlama yanl/i{}l/i{}/u{g}/i{} y/`{o}netimi mu/u{g}lak g/`{o}rsellere kar/c{s}/i{} dikkat yanl/i{}l/i{}/u{g}/i{}n/i{} artt/i{}rmakta ba/c{s}ar/i{}l/i{} olurken, Placebo grubu y/`{o}netimi ba/c{s}ar/i{}l/i{} olamam/i{}/c{s}t/i{}r. Placebo de/u{g}i/c{s}ikli/u{g}inin tersine, Ana- de/u{g}i/c{s}ilik uygulamasu sa/u{g}l/i{}kla alakal/i{} g/`{o}rsellere kar/c{s}/i{} dikkat yanl/i{}l/i{}/u{g}/i{}n/i{} da artt/i{}rm/i{}/c{s}t/i{}r. Bu sonu/c{c}lar yorumlama ve dikkat yanl/i{}l/i{}klar/i{}n/i{}n bili/c{s}el s/`{u}re/c{c}lerin birbirleriyle alakal/i{} taraflar/i{} olduklar/i{}na dair kan/i{}t olarak d/`{u}/c{s}/`{u}n/`{u}lebilir. Sa/u{g}l/i{}kla alakal/i{} durumlar/i{}n yinelenen bir /c{s}ekilde olumsuz yorumlanmas/i{}, hastalar/i{}n sa/u{g}l/i{}kla ilgili di/u{g}er mu/u{g}lak durumlar/i{} da olumsuz anlamland/i{}rmalar/i{}na imkan sa/u{g}lamaktad/i{}r. B/`{o}ylece, yeni olumsuz anlamland/i{}rmalar v/`{u}cuttaki mu/u{g}lak duyumar/i{}n ve sa/u{g}l/i{}kla alakal/i{} bilgilerin farkedilmesini kolayla/c{s}t/i{}rarak dikkat yanl/i{}l/i{}/u{g}/i{}n/i{} ortaya /c{c}/i{}karacakt/i{}r.

tive processing biases to health-related information have been endorsed to be present in patients who are suffering from medical diseases. Attentional bias is one of the cognitive processes which facilitates the detection of health-threatening information. Interpretation bias is the other cognitive mechanism that makes patients attribute catastrophic meanings to ambiguous bodily sensations. Despite the literature demonstrating that attentional and interpretation biases increase negative emotions and challenge patients for adaptation to their health condition, the link between these two biases has remained unclear. While some theories claim that attentional and interpretation biases are interrelated, some state that they might be orthogonal components of cognitive processing. Therefore, this thesis aimed to investigate the relationship between interpretation and attentional biases to health-related information by modifying interpretation bias and studying its effect on attentional bias.One hundred undergraduate students who lack any medical or psychological problems were randomly allocated to Main-Modification or Placebo-Modification groups. All participants were asked to complete a battery of questionnaire including health anxiety inventory, Beck depression inventory, and Beck anxiety inventory in order to control between-group differences regarding these constructs. As the pre-modification assessment, participants' interpretation and attentional biases to health-related information were respectively measured using the Modified Version of Online Interpretation Bias and Dot-probe tasks. Then, the Main-Modification group underwent Main On-line Negative Interpretation Bias Modification Task aimed to impose unsafe and threatening interpretations for ambiguous health-related scenarios. the Placebo-modification group completed Placebo On-line Negative Interpretation Bias Modification Task. The modification phase was followed by post-modification measurements.Results revealed that the participants in the Main-Modification group experienced more post-test interpretation bias indexed by Unsafe valence of interpretations for ambiguous health-related situations compared to the Placebo group. The Post-test between-group difference, however, was not significant for interpretation bias indexed by reaction time. Main negative interpretation bias modification succeeded to amplify attentional bias toward Ambiguous images in the Main group but Placebo modification did not do so. Unlike Placebo modification, Main modification increased attentional bias to Health-Related images as well. However, this increase was not statistically significant. These results can be considered as the pieces of evidence endorsing the idea that interpretation and attentional biases are interrelated aspects of cognitive processing. Repeated exposure to negative interpretations for health-related situations might increase patients' accessibility to negative meanings for interpreting further ambiguous health-related situations. In turn, the new negative meanings might facilitate detection of ambiguous bodily sensations or another health-related information known as attentional bias