Does Modification of Implicit Associations Regarding Contamination Affect Approach Behavior and Attentional Bias?

  • Christina Dusend
  • Laura M. S. De Putter
  • Ernst H. W. Koster
  • Fanny A. Dietel
  • Ulrike BuhlmannEmail author
Original Article


Individuals with contamination concerns show aberrant interpretational and attentional processes. Yet, it is unclear whether threat-related associations play a causal role in anxiety symptoms and attentional bias. The objective of our study was to investigate if training implicit associations affects stress reactivity and attention in the context of contamination concerns. In a double-blind randomized design, we used a modified Implicit Associations Task (IAT) to train associations between contamination and danger in a non-clinical sample (N = 121). Dependent measures were a brief-IAT to assess changes in associations, contamination-related behavior approach tasks, and a spatial cueing task to measure attentional bias. Results show that training successfully modified implicit associations. However, there were no transfer effects on approach behavior or attention. Findings suggest that the modified IAT is a useful task for training implicit associations, but that transfer to other domains (attention and behavior) is limited. Limitations and future implications are discussed.


Cognitive bias modification Implicit associations Attention Contamination Stressor task 



We thank Laura Brockhoff, Christina Martin, Ina Tuxhorn and Steffi Wenderlich for their assistance in data collection and preparation. We thank Celeste Brennecka for her valuable support with language and style.

Compliance with Ethical Standards

Conflict of Interest

Christina Dusend, Laura M. S. de Putter, Ernst H. W. Koster, Fanny A. Dietel, and Ulrike Buhlmann declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Research Involving Human and Animal Participants

This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

10608_2018_9991_MOESM1_ESM.docx (256 kb)
Supplementary material 1 (DOCX 257 KB)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Christina Dusend
    • 1
  • Laura M. S. De Putter
    • 2
  • Ernst H. W. Koster
    • 2
  • Fanny A. Dietel
    • 1
  • Ulrike Buhlmann
    • 1
    Email author
  1. 1.Department of Clinical Psychology and PsychotherapyWestfälische Wilhelms-Universität MünsterMünsterGermany
  2. 2.Department of Experimental and Clinical Health PsychologyGhent UniversityGhentBelgium

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