56 Outcome Probability Task: Association with Safety Behaviors and Avenues for Future Imaging Research

Objective:Probability bias—overestimation of the likelihood that feared social outcomes will occur—is a mechanism targeted for symptom reduction in cognitive behavioral therapy for social anxiety. Safety behaviors (i.e., the conscious and unconscious actions taken to reduce discomfort in feared social situations) are related to cognitive biases and can be manipulated to reduce probability bias. The purpose of this research was to test the hypothesis that scores from a newly developed computer task to measure probability bias, the Outcome Probability Task (OPT; Draheim & Anderson, 2022) would be associated with self-reported safety behaviors during a speech task.Participants and Methods:Participants (N=90) included diverse students from a university in a southern, metropolitan area. Individuals reported an average age of 20.74 (SD=3.57) and self-identified as 'Woman’ (69%), 'Man’ (30%), 'Transgender’ (1%), or 'Non-binary/Agender’ (1%), and 'African American or Black’ (52%), 'Asian or Asian American’ (19%), 'White’ (16%), 'Multi-racial’ (7%), 'Hispanic or Latine’ (5%), or 'Middle Eastern’ (1%). Participants viewed social images and imagined themselves in the scenarios, then rated the likelihood that they would be negatively evaluated on a 0-100% scale (higher ratings indicate greater probability bias), gave a speech, and completed a standardized self-report measure of safety behaviors to rate how often they engaged in avoidant safety behaviors during the speech.Results:Results from a linear regression indicated that OPT scores (ß=.43) were positively associated with self-reported safety behaviors during a speech task, R2 = .19, F(1, 88) = 20.02, p < .001, 95% CI [0.170, 0.443].Conclusions:Negatively biased expectations about fear-relevant social situations—measured by a digital imagery task, the OPT—may contribute to increased engagement in avoidant safety behaviors during a speech task among a convenience sample. Outcome probability bias has previously only been measured through self-report, and the OPT is a promising new measure to multi-modally assess this aspect of social cognition. This task could be used along with imaging techniques to better understand the functional brain activity involved in outcome probability bias. Future studies could explore how activity in the orbitofrontal cortex, which is associated with the anticipation of negative outcomes, relates to responses on the OPT. If there is a connection, this brain region could be an indicator of improvement following intervention, such as cognitive behavioral therapy, for probability biases involved in social anxiety.