Less is more: Patient-level meta-analysis reveals paradoxical dose-response effects of a computer-based social anxiety intervention targeting attentional bias

Depression and Anxiety

Volumn 34, Issue 12, 2017, Pages 1106-1115

  Price, Rebecca B ^a   Kuckertz, Jennie M ^b   Amir, Nader ^b   Bar Haim, Yair ^c   Carlbring, Per ^d   Wallace, Meredith L ^a  

^a UNIVERSITY OF PITTSBURGH   (United States)

^b SAN DIEGO STATE UNIVERSITY   (United States)

^c TEL AVIV UNIVERSITY   (Israel)

^d STOCKHOLM UNIVERSITY   (Sweden)

Author keywords

attention bias modification; attention training; dose response; patient level meta analysis; social anxiety

Indexed keywords

AGE; ANXIETY ASSESSMENT; ATTENTIONAL BIAS; ATTENTIONAL BIAS MODIFICATION; FACIAL EXPRESSION; HOME; HUMAN; MEDICAL DECISION MAKING; META ANALYSIS; OUTCOME ASSESSMENT; PRIORITY JOURNAL; REVIEW; SELF REPORT; SENSITIVITY ANALYSIS; SOCIAL PHOBIA; ADULT; ANXIETY; COGNITIVE THERAPY; PHYSIOLOGY; PROCEDURES; THERAPY; TREATMENT OUTCOME;

ADULT; ANXIETY; ATTENTIONAL BIAS; COGNITIVE THERAPY; HUMANS; OUTCOME AND PROCESS ASSESSMENT (HEALTH CARE);

EID: 85018997637     PISSN: 10914269     EISSN: 15206394     Source Type: Journal    
DOI: 10.1002/da.22634     Document Type: Review

References (48)

1. Abend, R., Karni, A., Sadeh, A., Fox, N. A., Pine, D. S., & Bar-Haim, Y. (2013). Learning to attend to threat accelerates and enhances memory consolidation. PloS One, 8(4), e62501.
2. Abend, R., Pine, D. S., Fox, N. A., & Bar-Haim, Y. (2014). Learning and memory consolidation processes of attention-bias modification in anxious and nonanxious individuals. Clinical Psychological Science, 2(5), 620–627.
3. Amir, N., Beard, C., Burns, M., & Bomyea, J. (2009). Attention modification program in individuals with generalized anxiety disorder. Journal of Abnormal Psychology, 118, 28–33.
4. Amir, N., Beard, C., Taylor, C. T., Klumpp, H., Elias, J., Burns, M., & Chen, X. (2009). Attention training in individuals with generalized social phobia: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 77(5), 961–973.
5. Badura-Brack, A. S., Naim, R., Ryan, T. J., Levy, O., Abend, R., Khanna, M. M., … Bar-Haim, Y. (2015). Effect of attention training on attention bias variability and PTSD Symptoms: Randomized controlled trials in Israeli and U.S. combat veterans. American Journal of Psychiatry, 172(12), 1233–1241.
6. Bar-Haim, Y., Lamy, D., Pergamin, L., Bakermans-Kranenburg, M. J., & van IJzendoorn, M. H. (2007). Threat-related attentional bias in anxious and nonanxious individuals: A meta-analytic study. Psychological Bulletin, 133(1), 1–24.
7. Beard, C., Sawyer, A. T., & Hofmann, S. G. (2012). Efficacy of attention bias modification using threat and appetitive stimuli: A meta-analytic review. Behavior Therapy, 43(4), 724–740.
8. Boettcher, J., Berger, T., & Renneberg, B. (2012). Internet-based attention training for social anxiety: A randomized controlled trial. Cognitive Therapy and Research, 36, 522–536.
9. Boettcher, J., Hasselrot, J., Sund, E., Andersson, G., & Carlbring, P. (2014). Combining attention training with internet-based cognitive-behavioural self-help for social anxiety: A randomised controlled trial. Cognitive Behaviour Therapy, 43(1), 34–48.
10. Boettcher, J., Leek, L., Matson, L., Holmes, E. A., Browning, M., MacLeod, C., … Carlbring, P. (2013). Internet-based attention bias modification for social anxiety: A randomised controlled comparison of training towards negative and training towards positive cues. PLoS ONE, 8(9), e71760.
11. Britton, J., Suway, J., Clementi, M., Fox, N., Pine, D., & Bar-Haim, Y. (2015). Neural changes with attention bias modification for anxiety: A randomized trial. Social Cognitive and Affective Neuroscience, 10(7), 913–920.
12. Bunnell, B. E., Beidel, D. C., & Mesa, F. (2013). A randomized trial of attention training for generalized social phobia: Does attention training change social behavior? Behavior Therapy, 44(4), 662–673.
13. Calitri, R., Pothos, E. M., Tapper, K., Brunstrom, J. M., & Rogers, P. J. (2010). Cognitive biases to healthy and unhealthy food words predict change in BMI. Obesity, 18(12), 2282–2287.
14. Carlbring, P., Apelstrand, M., Sehlin, H., Amir, N., Rousseau, A., Hofmann, S. G., & Andersson, G. (2012). Internet-delivered attention bias modification training in individuals with social anxiety disorder - A double blind randomized controlled trial. BMC Psychiatry, 12(1), 66.
15. Cha, C. B., Najmi, S., Park, J. M., Finn, C. T., & Nock, M. K. (2010). Attentional bias toward suicide-related stimuli predicts suicidal behavior. Journal of Abnormal Psychology, 119(3), 616–622.
16. Clarke, P. J., Notebaert, L., & Macleod, C. (2014). Absence of evidence or evidence of absence: Reflecting on therapeutic implementations of attentional bias modification. BioMed Central Psychiatry, 14(1), 8.
17. Cristea, I. A., Kok, R. N., & Cuijpers, P. (2015). Efficacy of cognitive bias modification interventions in anxiety and depression: Meta-analysis. British Journal of Psychiatry, 206(1), 7–16.
18. Fang, A., Sawyer, A., Aderka, I., & Hofmann, S. (2013). Psychological treatment of social anxiety disorder improves body dysmorphic concerns. Journal of Anxiety Disorders, 27(7), 684–691.
19. Fresco, D. M., Coles, M. E., Heimberg, R. G., Liebowitz, M. R., Hami, S., Stein, M. B., & Goetz, D. (2001). The Liebowitz Social Anxiety Scale: A comparison of the psychometric properties of self-report and clinician-administered formats. Psychological Medicine, 31(6), 1025–1035.
20. Hakamata, Y., Lissek, S., Bar-Haim, Y., Britton, J. C., Fox, N. A., Leibenluft, E., … Pine, D. S (2010). Attention bias modification treatment: A meta-analysis toward the establishment of novel treatment for anxiety. Biological Psychiatry, 68, 982–990.
21. Hallion, L. S., & Ruscio, A. M. (2011). A meta-analysis of the effect of cognitive bias modification on anxiety and depression. Psychological Bulletin, 137(6), 940–958.
22. Harmer, C. J., Goodwin, G. M., & Cowen, P. J. (2009). Why do antidepressants take so long to work? A cognitive neuropsychological model of antidepressant drug action. British journal of psychiatry, 195, 102–108.
23. Harris, H., Gliksberg, M., & Sagi, D. (2012). Generalized perceptual learning in the absence of sensory adaptation. Current Biology, 22(19), 1813–1817.
24. Heeren, A., Mogoase, C., Philippot, P., & McNally, R. J. (2015). Attention bias modification for social anxiety: A systematic review and meta-analysis. Clinical Psychology Review, 40, 76–90.
25. Heeren, A., Reese, H. E., McNally, R. J., & Philippot, P. (2012). Attention training toward and away from threat in social phobia: Effects on subjective, behavioral, and physiological measures of anxiety. Behaviour Research and Therapy, 50, 30–39.
26. Iacobucci, D., Posavac, S. S., Kardes, F. R., Schneider, M. J., & Popovich, D. L. (2015). Toward a more nuanced understanding of the statistical properties of a median split. Journal of Consumer Psychology, 25(4), 652–665.
27. Linetzky, M., Pergamin-Hight, L., Pine, D. S., & Bar-Haim, Y. (2015). Quantitative evaluation of the clinical efficacy of attention bias modification treatment for anxiety disorders. Depression and Anxiety, 32(6), 383–391.
28. MacLeod, C., & Clarke, P. J. F. (2015). The attentional bias modification approach to anxiety intervention. Clinical Psychological Science, 3(1), 58–78.
29. MacLeod, C., Mathews, A., & Tata, P. (1986). Attentional bias in emotional disorders. Journal of Abnormal Psychology, 95(1), 15–20.
30. MacLeod, C., Rutherford, E., Campbell, L., Ebsworthy, G., & Holker, L. (2002). Selective attention and emotional vulnerability: Assessing the causal basis of their association through the experimental manipulation of attentional bias. Journal of Abnormal Psychology, 111(1), 107–123.
31. Maoz, K., Abend, R., Fox, N. A., Pine, D. S., & Bar-Haim, Y. (2013). Subliminal attention bias modification training in socially anxious individuals. Frontiers in Human Neuroscience, 7, 389.
32. McNally, R. J., Enock, P. M., Tsai, C., & Tousian, M. (2013). Attention bias modification for reducing speech anxiety. Behaviour Research and Therapy, 51(12), 882–888.
33. Mednick, S. C., Arman, A. C., & Boynton, G. M. (2005). The time course and specificity of perceptual deterioration. Proceedings of the National Academy of Sciences, 102(10), 3881–3885.
34. Mogoaşe, C., David, D., & Koster, E. H. W. (2014). Clinical efficacy of attentional bias modification procedures: An updated meta-analysis. Journal of Clinical Psychology, 70(12), 1133–1157.
35. Mohlman, J., Price, R. B., & Vietri, J. (2013). Attentional bias in older adults: Effects of generalized anxiety disorder and cognitive behavior therapy. Journal of Anxiety Disorders, 27, 585–591.
36. Mohr, D. C., Burns, M. N., Schueller, S. M., Clarke, G., & Klinkman, M. (2013). Behavioral intervention technologies: Evidence review and recommendations for future research in mental health. General Hospital Psychiatry, 35(4), 332–338.
37. Naim, R., Wald, I., Lior, A., Pine, D. S., Fox, N. A., Sheppes, G., … Bar-Haim, Y. (2014). Perturbed threat monitoring following a traumatic event predicts risk for post-traumatic stress disorder. Psychological medicine, 44(10), 2077–2084.
38. Peckham, A. D., McHugh, R. K., & Otto, M. W. (2010). A meta-analysis of the magnitude of biased attention in depression. Depression and Anxiety, 27(12), 1135–1142.
39. Price, R. B., Greven, I. M., Siegle, G. J., Koster, E. H., & De Raedt, R. (2016). A novel attention training paradigm based on operant conditioning of eye gaze: Preliminary findings. Emotion, 16(1), 110–116.
40. Price, R. B., Kuckertz, J. M., Siegle, G. J., Ladouceur, C. D., Silk, J. S., Ryan, N. D., … Amir, N. (2015). Empirical recommendations for improving the stability of the dot-probe task in clinical research. Psychological Assessment, 27(2), 365–376.
41. Price, R. B., Rosen, D., Siegle, G. J., Ladouceur, C. D., Tang, K., Allen, K. B., … Silk, J. S. (2015). From anxious youth to depressed adolescents: Prospective prediction of 2-year depression symptoms via attentional bias measures. Journal of Abnormal Psychology, 125(2), 267–278.
42. Price, R. B., Siegle, G., & Mohlman, J. (2012). Emotional Stroop performance in older adults: Effects of habitual worry. American Journal of Geriatric Psychiatry, 20(9), 798–805.
43. Price, R. B., Siegle, G., Silk, J. S., Ladouceur, C. D., McFarland, A., Dahl, R. E., Ryan, N. D. (2013). Sustained neural alterations in anxious youth performing an attentional bias task: A pupilometry study. Depression and Anxiety, 30, 22–30.
44. Price, R. B., Wallace, M., Kuckertz, J. M., Amir, N., Graur, S., Cummings, L., … Bar-Haim, Y. (2016). Pooled patient-level meta-analysis of children and adults completing a computer-based anxiety intervention targeting attentional bias. Clinical Psychology Review, 50, 37–49.
45. Riley, R. D., Lambert, P. C., & Abo-Zaid, G. (2010). Meta-analysis of individual participant data: Rationale, conduct, and reporting. British Journal of Medicine, 340, c221.
46. Riley, R. D., Lambert, P. C., Staessen, J. A., Wang, J., Gueyffier, F., Thijs, L., & Boutitie, F. (2008). Meta-analysis of continuous outcomes combining individual patient data and aggregate data. Statistics in Medicine, 27(11), 1870–1893.
47. Smith, P., & Waterman, M. (2004). Processing bias for sexual material: The emotional stroop and sexual offenders. Sex Abuse, 16(2), 163–171.
48. Waters, A. J., Marhe, R., & Franken, I. H. (2012). Attentional bias to drug cues is elevated before and during temptations to use heroin and cocaine. Psychopharmacology, 219(3), 909–921.