Social Anxiety DisorderBIBM-SAD-PYANCT07406321
Brief Interpretation Bias Modification for Social Anxiety Disorder in Pakistani Young Adults: An Experimental Evaluation
A study testing WSAP-based interpretation bias modification in people with Social Anxiety Disorder and Interpretation Bias, run by Ather Mujitaba at 1 site in Pakistan.
Trial summary
This randomized, single-blind trial tests whether one session of interpretation bias modification reduces immediate social-evaluative anxiety and shifts interpretation bias in Pakistani university students aged 18 to 25 years with elevated social anxiety. Read more about this study
- Who is it for?
- Ages 18 to 25 years
- Conditions the study is for
- Social Anxiety Disorder, Interpretation Bias
- What is being tested?
- WSAP-based interpretation bias modification
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 130 participants
- Where
- 1 sitePakistan
- Study dates
- Feb 2026to Apr 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 25 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- age 18 to 25 years
- Social Phobia Inventory score greater than 19
- at least moderate severity on the DSM-5-TR Severity Measure for Social Anxiety Disorder-Adult
- able to read study materials
- provides written informed consent.
Who cannot join
- clinically elevated depressive symptoms on Beck Depression Inventory-II at or above prespecified cutoff [above 16]
- clinically elevated general anxiety symptoms on the Beck Anxiety Inventory at or above prespecified cutoff [ above 20]
- current medical or psychiatric condition likely to interfere with safe or valid participation
- prior participation in this trial.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Pakistan1 site
University of Gujrat
Dhok Gujra, Punjab Province, 51700
Dr Saima Riaz, PhD, +(92) 92532260000 ext. +92 (53) 22600, saim.riaz@uog.edu.pk
About this study
Official title: Efficacy of Cognitive Bias Modification Itervention in Young Adult With Social Anxiety
This randomized, single-blind trial tests whether one session of interpretation bias modification reduces immediate social-evaluative anxiety and shifts interpretation bias in Pakistani university students aged 18 to 25 years with elevated social anxiety. Participants are assigned to either feedback-contingent interpretation bias modification or a structurally matched interpretation control condition. Primary and secondary outcomes are assessed before and after the intervention session using short-form state-trait anxiety measures and Word-Sentence Association Paradigm endorsement indices.
Read the detailed description
Social anxiety in young adults is maintained in part by a tendency to interpret ambiguous social information as threatening. The study evaluates a behavioral interpretation training procedure delivered with OpenSesame, using trial-by-trial responses to ambiguous social sentences preceded by threat or benign prime words. In the experimental arm, feedback contingently reinforces benign endorsements and threat rejections. In the control arm, exposure and timing are matched but feedback is noncontingent and presented on half of trials. The design is a parallel two-arm randomized pretest-posttest trial with participant masking to assignment. Assessment includes the 5-item state and 5-item trait short-form State-Trait Anxiety Inventory totals and Word-Sentence Association Paradigm threat and benign endorsement proportions. The mechanistic hypothesis is that feedback-consistent learning increases benign interpretations and reduces threat interpretations, which is associated with lower post-session state anxiety. The trial was conducted as part of a PhD thesis at the University of Gujrat under formal institutional approvals.
- Conditions
- Social Anxiety Disorder, Interpretation Bias
- Being tested
- WSAP-based interpretation bias modification, WSAP interpretation control condition
- Keywords
- interpretation bias modification, Word-Sentence Association Paradigm, Social Anxiety Disorder, Pakistan Young Adult, Cogntive Bias Modification
- Medical subject headings
- Phobia, Social
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
WSAP-based interpretation bias modificationBehavioural
Single-session Word-Sentence Association Paradigm training with performance-contingent feedback across 220 trials in two 110-trial blocks; each block includes 70 social ambiguity trials and 40 non-social fillers. Correct feedback follows benign endorsement or threat rejection; incorrect feedback follows threat endorsement or benign rejection.
WSAP interpretation control conditionBehavioural
Matched Word-Sentence Association Paradigm exposure with identical stimulus timing and response demands, feedback delivered on 50 percent of trials without contingency favoring benign over threat interpretations.
| Study group | Role | What they receive |
|---|---|---|
| Interpretation Bias Modification | Experimental | Single-session Word-Sentence Association Paradigm training with performance-contingent feedback across 220 trials in two 110-trial blocks; each block includes 70 social ambiguity trials and 40 non-social fillers. Correct feedback follows benign endorsement or threat rejection; incorrect feedback follows threat endorsement or benign rejection. Receives: Behavioral: WSAP-based interpretation bias modification |
| Interpretation Control Condition | Active comparator | Matched Word-Sentence Association Paradigm exposure with identical stimulus timing and response demands, feedback delivered on 50 percent of trials without contingency, favoring benign over threat interpretations. Receives: Behavioral: WSAP interpretation control condition |
What is being measured
The primary outcome is the main question the study is designed to answer.
short version of the Spielberger State-Trait Anxiety Inventory
The primary outcome is within-participant change in state anxiety measured with the 5-item short-form State-Trait Anxiety Inventory state subscale (STAIS-5). Items are summed to a total score, with higher scores indicating greater state anxiety. The primary comparison is the between-group difference in change score (IBM versus ICC).
Measured: Baseline (pre-intervention, same visit) and immediate post-intervention after the single-session training (same visit, approximately 30 to 60 minutes after intervention)
Spielberger short-form State-Trait Anxiety Inventory (S-STAI)
Difference between post-session and baseline STAIS-5 total score; higher scores indicate greater state anxiety.
Measured: Baseline pre-intervention and immediate post-intervention in the same visit (approximately 30 to 60 minutes after training starts).
Secondary outcomes (1)
Change in Word-Sentence Association Paradigm threat endorsement rate.
Proportion of threat word-sentence pairings endorsed as related; lower values indicate less threat-consistent interpretation. Used as interpretation bias metrices.
Measured: Baseline pre-intervention and immediate post-intervention in the same visit.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 Feb 2026
- Study startFeb 2026 (estimated)
- Primary completionApr 2026 (estimated)
- Study completionApr 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Social Anxiety DisorderStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Parallel Assignment.
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 130 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Ather Mujitaba
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor-investigator, Ather Mujitaba, University of Gujrat
- Investigators
- Saima Riaz Riaz, PhD, Principal investigator, University of Gujrat
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07406321
- Sponsor's protocol ID
- UOG/ORIC/2025/342
- Acronym
- BIBM-SAD-PYA
- Status last verified
- Feb 2026
- First submitted
- 5 Feb 2026
- Last updated
- 12 Feb 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: Individual participant data are not available at this stage because the trial is ongoing and data collection is not complete. After study completion, data cleaning, and primary reporting, the team will determine whether de-identified individual participant data can be shared in line with institutional approvals, participant consent, and applicable regulations.
Publications
1. Hofmann SG. Cognitive factors that maintain social anxiety disorder: a comprehensive model and its treatment implications. Cogn Behav Ther. 2007;36(4):193-209. doi:10.1080/16506070701421313. 2. Ejaz B, Muazzam A, Anjum A, Pollock G, Nawaz R. Measuring the scale and scope of social anxiety among students in Pakistani higher education institutions: an alternative social anxiety scale. Sustainability. 2020;12(6):2164. doi:10.3390/su12062164. 3. Rapee RM, Heimberg RG. A cognitive-behavioral model of anxiety in social phobia. Behav Res Ther. 1997;35(8):741-756. doi:10.1016/S0005-7967(97)00022-3. 4. Spielberger CD, Gorsuch RL, Lushene R, Vagg PR, Jacobs GA. Manual for the State-Trait Anxiety Inventory (Form Y). Palo Alto (CA): Consulting Psychologists Press; 1983. 5. Beard C, Amir N. Negative interpretation bias mediates the effect of social anxiety on state anxiety. Cognit Ther Res. 2010;34(3):292-296. doi:10.1007/s10608-009-9258-6. 6. Hallion LS, Ruscio AM. A meta-analysis of the effect of cognitive bias modification on anxiety and depression. Psychol Bull. 2011;137(6):940-958. doi:10.1037/a0024355. 7. MacLeod C, Mathews A. Cognitive bias modification approaches to anxiety. Annu Rev Clin Psychol. 2012;8:189-217. doi:10.1146/annurev-clinpsy-032511-143052. 8. Amir N, Bomyea J, Beard C. The effect of a single-session interpretation modification on attention bias in socially anxious individuals. J Anxiety Disord. 2010;24(2):178-182. doi:10.1016/j.janxdis.2009.10.005. 9. Beard C, Amir N. Interpretation in social anxiety: when meaning precedes ambiguity. Cognit Ther Res. 2009;33(4):406-415. doi:10.1007/s10608-009-9235-0. 10. Gonsalves M, Whittles RL, Weisberg RB, Beard C. A systematic review of the word sentence association paradigm (WSAP). J Behav Ther Exp Psychiatry. 2019;64:133-148. doi:10.1016/j.jbtep.2019.04.003. 11. Connor KM, Davidson JRT, Churchill LE, Sherwood A, Foa E, Weisler RH. Psychometric properties of the Social Phobia Inventory (SPIN). Br J Psychiatry. 200
Study at a glance
From the registry record, last updated by the sponsor on 12 Feb 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Efficacy of Cognitive Bias Modification Itervention in Young Adult With Social Anxiety
- ClinicalTrials.gov ID
- NCT07406321
- Acronym / sponsor ID
- BIBM-SAD-PYA / UOG/ORIC/2025/342
- Conditions
- Social Anxiety Disorder, Interpretation Bias
- Keywords
- interpretation bias modification, Word-Sentence Association Paradigm, Social Anxiety Disorder, Pakistan Young Adult, Cogntive Bias Modification
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 130 participants (estimated)
- Lead sponsor
- Ather MujitabaUniversity, hospital or other
- Study start
- Feb 2026 (estimated)
- Primary completion
- Apr 2026 (estimated)
- Study completion
- Apr 2026 (estimated)
- First posted
- 12 Feb 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This randomized, single-blind trial tests whether one session of interpretation bias modification reduces immediate social-evaluative anxiety and shifts interpretation bias in Pakistani university students aged 18 to 25 years with elevated social anxiety. Participants are assigned to either feedback-contingent interpretation bias modification or a structurally matched interpretation control condition. Primary and secondary outcomes are assessed before and after the intervention session using short-form state-trait anxiety measures and Word-Sentence Association Paradigm endorsement indices.
Detailed description
Social anxiety in young adults is maintained in part by a tendency to interpret ambiguous social information as threatening. The study evaluates a behavioral interpretation training procedure delivered with OpenSesame, using trial-by-trial responses to ambiguous social sentences preceded by threat or benign prime words. In the experimental arm, feedback contingently reinforces benign endorsements and threat rejections. In the control arm, exposure and timing are matched but feedback is noncontingent and presented on half of trials. The design is a parallel two-arm randomized pretest-posttest trial with participant masking to assignment. Assessment includes the 5-item state and 5-item trait short-form State-Trait Anxiety Inventory totals and Word-Sentence Association Paradigm threat and benign endorsement proportions. The mechanistic hypothesis is that feedback-consistent learning increases benign interpretations and reduces threat interpretations, which is associated with lower post-session state anxiety. The trial was conducted as part of a PhD thesis at the University of Gujrat under formal institutional approvals.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
- Model description
- Parallel Assignment.
| Arm | Type | Receives |
|---|---|---|
| Interpretation Bias Modification | Experimental | Behavioral: WSAP-based interpretation bias modificationSingle-session Word-Sentence Association Paradigm training with performance-contingent feedback across 220 trials in two 110-trial blocks; each block includes 70 social ambiguity trials and 40 non-social fillers. Correct feedback follows benign endorsement or threat rejection; incorrect feedback follows threat endorsement or benign rejection. |
| Interpretation Control Condition | Active comparator | Behavioral: WSAP interpretation control conditionMatched Word-Sentence Association Paradigm exposure with identical stimulus timing and response demands, feedback delivered on 50 percent of trials without contingency, favoring benign over threat interpretations. |
Who may qualify
- Ages
- 18 to 25 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (5 listed)
- age 18 to 25 years
- Social Phobia Inventory score greater than 19
- at least moderate severity on the DSM-5-TR Severity Measure for Social Anxiety Disorder-Adult
- able to read study materials
- provides written informed consent.
Key exclusion criteria (4 listed)
- clinically elevated depressive symptoms on Beck Depression Inventory-II at or above prespecified cutoff [above 16]
- clinically elevated general anxiety symptoms on the Beck Anxiety Inventory at or above prespecified cutoff [ above 20]
- current medical or psychiatric condition likely to interfere with safe or valid participation
- prior participation in this trial.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| WSAP-based interpretation bias modificationSingle-session Word-Sentence Association Paradigm training with performance-contingent feedback across 220 trials in two 110-trial blocks; each block includes 70 social ambiguity trials and 40 non-social fillers. Correct feedback follows benign endorsement or threat rejection; incorrect feedback follows threat endorsement or benign rejection. | Behavioural | Interpretation Bias Modification |
| WSAP interpretation control conditionMatched Word-Sentence Association Paradigm exposure with identical stimulus timing and response demands, feedback delivered on 50 percent of trials without contingency favoring benign over threat interpretations. | Behavioural | Interpretation Control Condition |
Primary outcome
short version of the Spielberger State-Trait Anxiety Inventory
Time frame: Baseline (pre-intervention, same visit) and immediate post-intervention after the single-session training (same visit, approximately 30 to 60 minutes after intervention)
The primary outcome is within-participant change in state anxiety measured with the 5-item short-form State-Trait Anxiety Inventory state subscale (STAIS-5). Items are summed to a total score, with higher scores indicating greater state anxiety. The primary comparison is the between-group difference in change score (IBM versus ICC).
Spielberger short-form State-Trait Anxiety Inventory (S-STAI)
Time frame: Baseline pre-intervention and immediate post-intervention in the same visit (approximately 30 to 60 minutes after training starts).
Difference between post-session and baseline STAIS-5 total score; higher scores indicate greater state anxiety.
1 secondary outcome
Change in Word-Sentence Association Paradigm threat endorsement rate.
Time frame: Baseline pre-intervention and immediate post-intervention in the same visit.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 12 Feb 2026.
- Results publication1. Hofmann SG. Cognitive factors that maintain social anxiety disorder: a comprehensive model and its treatment implications. Cogn Behav Ther. 2007;36(4):193-209. doi:10.1080/16506070701421313. 2. Ejaz B, Muazzam A, Anjum A, Pollock G, Nawaz R. Measuring the scale and scope of social anxiety among students in Pakistani higher education institutions: an alternative social anxiety scale. Sustainability. 2020;12(6):2164. doi:10.3390/su12062164. 3. Rapee RM, Heimberg RG. A cognitive-behavioral model of anxiety in social phobia. Behav Res Ther. 1997;35(8):741-756. doi:10.1016/S0005-7967(97)00022-3. 4. Spielberger CD, Gorsuch RL, Lushene R, Vagg PR, Jacobs GA. Manual for the State-Trait Anxiety Inventory (Form Y). Palo Alto (CA): Consulting Psychologists Press; 1983. 5. Beard C, Amir N. Negative interpretation bias mediates the effect of social anxiety on state anxiety. Cognit Ther Res. 2010;34(3):292-296. doi:10.1007/s10608-009-9258-6. 6. Hallion LS, Ruscio AM. A meta-analysis of the effect of cognitive bias modification on anxiety and depression. Psychol Bull. 2011;137(6):940-958. doi:10.1037/a0024355. 7. MacLeod C, Mathews A. Cognitive bias modification approaches to anxiety. Annu Rev Clin Psychol. 2012;8:189-217. doi:10.1146/annurev-clinpsy-032511-143052. 8. Amir N, Bomyea J, Beard C. The effect of a single-session interpretation modification on attention bias in socially anxious individuals. J Anxiety Disord. 2010;24(2):178-182. doi:10.1016/j.janxdis.2009.10.005. 9. Beard C, Amir N. Interpretation in social anxiety: when meaning precedes ambiguity. Cognit Ther Res. 2009;33(4):406-415. doi:10.1007/s10608-009-9235-0. 10. Gonsalves M, Whittles RL, Weisberg RB, Beard C. A systematic review of the word sentence association paradigm (WSAP). J Behav Ther Exp Psychiatry. 2019;64:133-148. doi:10.1016/j.jbtep.2019.04.003. 11. Connor KM, Davidson JRT, Churchill LE, Sherwood A, Foa E, Weisler RH. Psychometric properties of the Social Phobia Inventory (SPIN). Br J Psychiatry. 200
- Individual participant dataSharing planned: Yes. Individual participant data are not available at this stage because the trial is ongoing and data collection is not complete. After study completion, data cleaning, and primary reporting, the team will determine whether de-identified individual participant data can be shared in line with institutional approvals, participant consent, and applicable regulations.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Saima Riaz Riaz, PhD principal investigator
University of Gujrat
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing WSAP-based interpretation bias modification in people with Social Anxiety Disorder and Interpretation Bias, run by Ather Mujitaba at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 12 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact ather mujitaba mujitaba Mujitaba, PhD Scholar (+923297596056, ather.mujitaba@gift.edu.pk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
short version of the Spielberger State-Trait Anxiety Inventory (time frame: Baseline (pre-intervention, same visit) and immediate post-intervention after the single-session training (same visit, approximately 30 to 60 minutes after intervention)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07406321, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Feb 2026.