Attention bias modification in depression: A randomized trial using a novel, reward-based, eye-tracking approach

Woolridge, Stephanie; Harrison, Geoffrey; Best, Michael W.; Bowie, Christopher R.

doi:10.1016/j.jbtep.2020.101621

Cited by 24 publications

(25 citation statements)

References 43 publications

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“…Subsequent effects were smaller, suggesting that the effects of ABMT may wane over time. Future work may want to consider novel ways to further enhance the efficacy of ABMT (Woolridge et al, 2020) or even adopting Sequential Multiple Assignment Randomized Trial (SMART; Lei et al, 2012) study designs, where individuals can be randomized to different treatments once the salutary effects of ABMT begin to diminish. Interventions that target different cognitive biases (e.g., interpretation, memory) may be viable next-step treatments.…”

Section: Discussionmentioning

confidence: 99%

Change in negative attention bias mediates the association between attention bias modification training and depression symptom improvement.

Beevers¹,

Hsu²,

Schnyer³

et al. 2021

Journal of Consulting and Clinical Psychology

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Objective: Attention bias modification training (ABMT) is purported to reduce depression by targeting and modifying an attentional bias for sadness-related stimuli. However, few tests of this hypothesis have been completed. Method: The present study examined whether change in attentional bias mediated a previously reported association between ABMT condition (active ABMT, sham ABMT, assessments only; N = 145) and depression symptom change among depressed adults. The preregistered, primary measure of attention bias was a discretized eye-tracking metric that quantified the proportion of trials where gaze time was greater for sad stimuli than neutral stimuli. Results: Contemporaneous longitudinal simplex mediation indicated that change in attentional bias early in treatment partially mediated the effect of ABMT on depression symptoms. Specificity analyses indicated that in contrast to the eye-tracking mediator, reaction time assessments of attentional bias for sad stimuli (mean bias and trial level variability) and lapses in sustained attention did not mediate the association between ABMT and depression change. Results also suggested that mediation effects were limited to a degree by suboptimal measurement of attentional bias for sad stimuli. Conclusion: When effective, ABMT may improve depression in part by reducing an attentional bias for sad stimuli, particularly early on during ABMT.What is the public health significance of this article? Prior work has shown that ABMT reduces depression but it is unclear why this is so. The present study confirms that ABMT works by reducing a tendency to focus attention on negative information, which in turn reduces symptoms of depression.

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Section: Discussionmentioning

confidence: 99%

Change in negative attention bias mediates the association between attention bias modification training and depression symptom improvement.

Beevers¹,

Hsu²,

Schnyer³

et al. 2021

Journal of Consulting and Clinical Psychology

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“…Sample sizes were relatively small in the majority of the studies: only five studies included more than fifty subjects [ 25 , 36 , 39 , 46 , 48 ]; ten had 25–50 subjects [ 28 , 29 , 32 , 34 , 37 , 41 , 43 , 44 , 45 , 47 ]; and seven had 10–25 subjects [ 30 , 31 , 33 , 35 , 38 , 40 , 42 ].…”

Section: Resultsmentioning

confidence: 99%

“…Seven studies are included within this section. Five studies addressed depressive disorders (major depressive disorder [ 28 ]; dysphoric or depressive symptoms [ 29 , 46 , 48 ]; and “negative” mood [ 47 ]), one study addressed social anxiety disorders [ 32 ], and another alcohol dependence [ 33 ]. Three studies addressed non-clinical samples [ 46 , 47 , 48 ], while one other study consisted of a protocol description for a placebo-controlled trial which would involve a sub-clinical population of students identified as at-risk for depressive disorders based on a below- vs. above-cut-off score on the Beck Depression Inventory [ 29 ].…”

Section: Resultsmentioning

confidence: 99%

“…Three studies addressed non-clinical samples [ 46 , 47 , 48 ], while one other study consisted of a protocol description for a placebo-controlled trial which would involve a sub-clinical population of students identified as at-risk for depressive disorders based on a below- vs. above-cut-off score on the Beck Depression Inventory [ 29 ]. The remaining studies consisted of clinical trials on in- and outpatients [ 28 , 32 , 33 ].…”

Section: Resultsmentioning

confidence: 99%

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Gaze-Contingent Eye-Tracking Training in Brain Disorders: A Systematic Review

et al. 2022

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Eye movement abnormalities in association with cognitive and emotional deficits have been described in neurological, neurodevelopmental, and psychiatric disorders. Eye-Tracking (ET) techniques could therefore enhance cognitive interventions by contingently providing feedback to patients. Since no consensus has been reached thus far on this approach, this study aimed at systematically reviewing the current evidence. This review was performed and reported according to PRISMA guidelines. Records were searched for in PubMed, Web of Science, and Scopus (1990–2021) through the following string: (‘Eye Tracking’ OR ‘Eye-Tracking’ OR ‘Oculomotor’) AND (‘Neuropsychol*’ OR ‘Cognitive’) AND (‘Rehabilitation’ OR ‘Training’ OR ‘Stimulation’). Study outcomes were thematically classified and qualitatively synthesized. A structured quality assessment was performed. A total of 24 articles were included, addressing neurodevelopmental (preterm infants and children with autism spectrum disorder, Rett syndrome, or ADHD; N = 14), psychiatric (mood and anxiety disorders or alcohol dependence; N = 7), and neurological conditions (stroke; N = 3). Overall, ET gaze-contingent training proved to be effective in improving cognitive and emotional alterations. However, population heterogeneity limits the generalizability of results. ET gaze-contingent protocols allow researchers to directly and dynamically train attentional functions; together with the recruitment of implicit, “bottom-up” strategies, these protocols are promising and possibly integrable with traditional cognitive approaches.

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“…Although results are more disappointing in depressive disorders concerning clinical effects [ 130 , 131 ], a recent result from a high-quality RCT using more elaborate hardware gives hope that similar effects in depression might also be obtained [ 132 ].…”

Section: How Can We Do It Right?mentioning

confidence: 99%

Cognitive Remediation in Psychiatric Disorders: State of the Evidence, Future Perspectives, and Some Bold Ideas

Trapp

Heid²,

Röder³

et al. 2022

Brain Sciences

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Many people with psychiatric disorders experience impairments in cognition. These deficits have a significant impact on daily functioning and sometimes even on the further course of their disease. Cognitive remediation (CR) is used as an umbrella term for behavioral training interventions to ameliorate these deficits. In most but not all studies, CR has proven effective in improving cognition and enhancing everyday functional outcomes. In this paper, after quickly summarizing the empirical evidence, practical advice to optimize the effects of CR interventions is provided. We advocate that CR interventions should be as fun and motivating as possible, and therapists should at least consider using positively toned emotional stimuli instead of neutral stimuli. Participants should be screened for basic processing deficits, which should be trained before CR of higher-order cognitive domains. CR should stimulate metacognition and utilize natural settings to invoke social cognition. Wherever possible, CR tasks should link to tasks that participants face in their everyday life. Therapists should consider that participants might also benefit from positive side effects on symptomatology. Finally, the CR approach might even be utilized in settings where the treatment of cognitive impairments is not a primary target.

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Attention bias modification in depression: A randomized trial using a novel, reward-based, eye-tracking approach

Cited by 24 publications

References 43 publications

Change in negative attention bias mediates the association between attention bias modification training and depression symptom improvement.

Change in negative attention bias mediates the association between attention bias modification training and depression symptom improvement.

Gaze-Contingent Eye-Tracking Training in Brain Disorders: A Systematic Review

Cognitive Remediation in Psychiatric Disorders: State of the Evidence, Future Perspectives, and Some Bold Ideas

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