Bias-contingent attention bias modification and attention control training in treatment of PTSD: a randomized control trial

AbstractBackgroundRandomized control trials (RCTs) comparing attention control training (ACT) and attention bias modification (ABM) in posttraumatic stress disorder (PTSD) have shown mixed results. The current RCT extends the extant literature by comparing the efficacy of ACT and a novel bias-contingent-ABM (BC-ABM), in which direction of training is contingent upon the direction of pre-treatment attention bias (AB), in a sample of civilian patients with PTSD.MethodsFifty treatment-seeking civilian patients with PTSD were randomly assigned to either ACT or BC-ABM. Clinician and self-report measures of PTSD and depression, as well as AB and attention bias variability (ABV), were acquired pre- and post-treatment.ResultsACT yielded greater reductions in PTSD and depressive symptoms on both clinician-rated and self-reported measures compared with BC-ABM. The BC-ABM condition successfully shifted ABs in the intended training direction. In the ACT group, there was no significant change in ABV or AB from pre- to post-treatment.ConclusionsThe current RCT extends previous results in being the first to apply ABM that is contingent upon AB at pre-treatment. This personalized BC-ABM approach is associated with significant reductions in symptoms. However, ACT produces even greater reductions, thereby emerging as a promising treatment for PTSD.

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Attention bias modification augments cognitive–behavioral group therapy for social anxiety disorder: a randomized controlled trial

Psychological Medicine ◽

10.1017/s003329171700366x ◽

2017 ◽

Vol 48 (13) ◽

pp. 2177-2185 ◽

Cited By ~ 10

Author(s):

Amit Lazarov ◽

Sofi Marom ◽

Naomi Yahalom ◽

Daniel S. Pine ◽

Haggai Hermesh ◽

...

Keyword(s):

Social Anxiety ◽

Controlled Trial ◽

Attention Bias ◽

Post Treatment ◽

Self Report ◽

Cognitive Behavioral ◽

Attention Bias Modification ◽

Cognitive Behavioral Group Therapy ◽

Behavioral Group ◽

Bias Modification

AbstractBackgroundCognitive–behavioral group therapy (CBGT) is a first-line treatment for social anxiety disorder (SAD). However, since many patients remain symptomatic post-treatment, there is a need for augmenting procedures. This randomized controlled trial (RCT) examined the potential augmentation effect of attention bias modification (ABM) for CBGT.MethodsFifty patients with SAD from three therapy groups were randomized to receive an 18-week standard CBGT with either ABM designed to shift attention away from threat (CBGT + ABM), or a placebo protocol not designed to modify threat-related attention (CBGT + placebo). Therapy groups took place in a large mental health center. Clinician and self-report measures of social anxiety and depression were acquired pre-treatment, post-treatment, and at 3-month follow-up. Attention bias was assessed at pre- and post-treatment.ResultsPatients randomized to the CBGT + ABM group, relative to those randomized to the CBGT + placebo group, showed greater reductions in clinician-rated SAD symptoms post-treatment, with effects maintained at 3-month follow-up. Group differences were not evident for self-report or attention-bias measures, with similar reductions in both groups. Finally, reduction in attention bias did not mediate the association between group and reduction in Liebowitz Social Anxiety Scale Structured Interview (LSAS) scores.ConclusionsThis is the first RCT to examine the possible augmenting effect of ABM added to group-based cognitive–behavioral therapy for adult SAD. Training patients’ attention away from threat might augment the treatment response to standard CBGT in SAD, a possibility that could be further evaluated in large-scale RCTs.

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Biobehavioral Markers of Attention Bias Modification in Temperamental Risk for Anxiety: A Randomized Control Trial

Journal of the American Academy of Child & Adolescent Psychiatry ◽

10.1016/j.jaac.2017.11.016 ◽

2018 ◽

Vol 57 (2) ◽

pp. 103-110 ◽

Cited By ~ 17

Author(s):

Pan Liu ◽

Bradley C. Taber-Thomas ◽

Xiaoxue Fu ◽

Koraly E. Pérez-Edgar

Keyword(s):

Randomized Control Trial ◽

Attention Bias ◽

Attention Bias Modification ◽

Randomized Control ◽

Biobehavioral Markers ◽

Bias Modification

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What Drives Symptom Reduction in Attention Bias Modification Treatment? A Randomized Controlled Experiment in Clinically Anxious Youths

Clinical Psychological Science ◽

10.1177/2167702620902130 ◽

2020 ◽

Vol 8 (3) ◽

pp. 506-518 ◽

Cited By ~ 1

Author(s):

Marian Linetzky ◽

Jeremy W. Pettit ◽

Wendy K. Silverman ◽

Daniel S. Pine ◽

Yair Bar-Haim

Keyword(s):

Spatial Attention ◽

Attention Bias ◽

Anxiety Symptoms ◽

Attention Control ◽

Attention Bias Modification ◽

Randomized Controlled ◽

Treatment Expectancies ◽

Randomized Controlled Experiment ◽

Underlying Mechanisms ◽

Bias Modification

Attention-bias modification (ABM) is a novel treatment for anxiety disorders. We tested the contribution of two possible factors implicated in ABM’s efficacy: training of threat-related selective spatial attention and exposure to threat. We also measured general attention control to examine its potential role in treatment effects. A four-arm randomized controlled design was used, which dissociated spatial attention and threat exposure while equating treatment expectancies. One hundred clinically anxious youths were randomized and assessed at pretreatment, midtreatment, posttreatment, and 3-month follow-up. All four groups manifested large reductions in anxiety symptoms; there were no significant between-group differences. Level of change in anxiety symptoms significantly correlated with level of change in youths’ self-rated attention control. Findings did not support the role of either dissociated spatial attention or threat exposure as underlying mechanisms. Implications of the findings are discussed including possible roles of expectations and general attention control in ABM efficacy.

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