Attention training in individuals with generalized social phobia: A randomized controlled trial.

Abstract

We conducted a randomized, double-blind placebo-controlled trial to examine the efficacy of an attention training procedure in reducing symptoms of social anxiety in forty-four individuals diagnosed with Generalized Social Phobia (GSP). Attention training comprised a probe detection task where pictures of faces with either a threatening or neutral emotional expression cued different locations on the computer screen. In the Attention Modification Program (AMP), participants responded to a probe that always followed neutral faces when paired with a threatening face, thereby directing attention away from threat. In the Attention Control Condition (ACC), the probe appeared with equal frequency in the position of the threat and neutral faces. Results revealed that the AMP facilitated attention disengagement from threat from pre- to post-assessment, and reduced clinician- and self-reported symptoms of social anxiety relative to the ACC. Participants no longer meeting DSM-IV criteria for GSP at post-assessment were 50% in the AMP and 14% in the ACC. Symptom reduction in the AMP group was maintained during four-month follow-up assessment. These results suggest that computerized attention training procedures may be beneficial for treating social phobia.

Attention training toward and away from threat in social phobia: Effects on subjective, behavioral, and physiological measures of anxiety

“…Further, regarding cognitive models of Social Phobia, the present data support the idea that selective attention to threatening social stimuli is causally involved in the maintenance of social anxiety (e.g., Amir et al, 2008;Amir et al, 2009;Schmidt et al, 2009). Indeed, these findings bolster the argument that, rather than being a by-product of social phobia, selective attention bias has a causal role in the maintenance of this disorder (Clark, 2001;Clark & Wells, 1995;Rapee & Heimberg, 1997).…”

“…More precisely, the current double-blind randomized clinical trial adds to a small but growing empirical literature revealing the efficacy of computerized attention training procedure in reducing clinical symptoms in individuals who suffers from social phobia (Amir et al, 2009Amir et al,2010, Schmidt et al, 2009). …”

Attention bias modification via single-session dot-probe training: Failures to replicate

“…Individual bias acquisition scores were not related to congruent biases on an affective task-switching task presenting new, non-trained stimuli. This finding seems to be in contrast with prior studies reporting transfer from dot-probe training to new stimuli presented in a spatial cueing (attention) task (Amir et al, 2009;Amir et al, 2008;Heeren et al, 2011). Furthermore, we found no evidence for transfer of individual training effects to interpretation bias.…”

“…In their study, participants were trained to attend either toward or away from threatening pictures, but training effects did not generalize to an emotional interference task measuring processes related to attention. These findings contradict earlier observations suggesting that dotprobe training effects generalize to a spatial cueing task, that is, conditions resembling the initial training task (Amir et al, 2009;Amir, Weber, Beard, Bomyea, & Taylor, 2008;Heeren, Lievens, & Philippot, 2011). Moreover, there is some evidence for transfer of ABM to memory.…”

Exploring the function of selective attention and hypervigilance for threat in anxiety

“…An example of an ATT protocol based on a modified version of the dot probe paradigm was developed by Amir and colleagues (Amir, Beard, Burns, & Bomyea, 2009;Amir, Beard, Taylor, Klumpp, Elias, & Burns, 2009). This ATT involved trials in which a threat-neutral or neutral-neutral stimulus pair was followed by a probe stimulus that the participant had to identify (an E or an F).…”