An online game-based cognitive bias modification for interpretation (CBM-I) program to reduce fear during the COVID-19 pandemic: resilience as a moderator.

Introduction: This study examined the training effects of an online game-based cognitive bias modification for interpretation (CBM-I) program in reducing fear during the COVID-19 pandemic in Hong Kong. In addition to investigating the changes in both proximal (i.e. negative and positive interpretations) and distal outcomes (i.e. fear of COVID-19), we examined whether individuals with higher baseline resilience levels would benefit more from the CBM-I program.

Methods: A total of 68 Hong Kong undergraduate students were randomized into either the CBM-I group or a control group, among which 66 participants completed the pretest, post-test, and follow-up on negative and positive interpretations, fear of COVID-19, and resilience.

Results: Compared to the control group, the CBM-I training group showed a significantly greater decrease in negative interpretations, a significantly greater increase in positive interpretations of COVID-19-related ambiguous scenarios, and a trend toward a greater reduction in fear of COVID-19. The CBM-I training was more effective at reducing fear among those with higher levels of resilience at baseline, whereas the control group showed the opposite effect, albeit to a lesser extent.

Conclusion: This online game-based CBM-I training shows the potential to modify the negative interpretation bias toward fear-inducing scenarios and contributes to the reduction of fear. Baseline screening of resilient individuals may optimize the training effects.