Attention Bias Modification For Social Anxiety: A Systematic ... - PubMed

Full text links CiteDisplay options Display options Format AbstractPubMedPMID

Abstract

Research on attention bias modification (ABM) for social anxiety disorder (SAD) is inconclusive, with some studies finding clear positive effects and other studies finding no significant benefit relative to control training procedures. In this meta-analysis, we assessed the efficacy of ABM for SAD on symptoms, reactivity to speech challenge, attentional bias (AB) toward threat, and secondary symptoms at posttraining as well as SAD symptoms at 4-month follow-up. A systematic search in bibliographical databases uncovered 15 randomized studies involving 1043 individuals that compared ABM to a control training procedure. Data were extracted independently by two raters. The Q statistic was used to assess homogeneity across trials. All analyses were conducted on intent-to-treat data. ABM produced a small but significant reduction in SAD symptoms (g=0.27), reactivity to speech challenge (g=0.46), and AB (g=0.30). These effects were moderated by characteristics of the ABM procedure, the design of the study, and trait anxiety at baseline. However, effects on secondary symptoms (g=0.09) and SAD symptoms at 4-month follow-up (g=0.09) were not significant. Although there was no indication of significant publication bias, the quality of the studies was substandard and wedged the effect sizes. From a clinical point of view, these findings imply that ABM is not yet ready for wide-scale dissemination as a treatment for SAD in routine care. Theoretical implications for the integration of AB in the conceptualization of SAD are discussed.

Keywords: Attention bias modification; Attentional bias; Cognitive bias modification; Meta-analysis; Social anxiety disorder; Speech performance; Systematic review.

Copyright © 2015 Elsevier Ltd. All rights reserved.

PubMed Disclaimer

Similar articles

• Does attention bias modification improve attentional control? A double-blind randomized experiment with individuals with social anxiety disorder. Heeren A, Mogoaşe C, McNally RJ, Schmitz A, Philippot P. Heeren A, et al. J Anxiety Disord. 2015 Jan;29:35-42. doi: 10.1016/j.janxdis.2014.10.007. Epub 2014 Nov 24. J Anxiety Disord. 2015. PMID: 25465885 Clinical Trial.
• Attention bias modification augments cognitive-behavioral group therapy for social anxiety disorder: a randomized controlled trial. Lazarov A, Marom S, Yahalom N, Pine DS, Hermesh H, Bar-Haim Y. Lazarov A, et al. Psychol Med. 2018 Oct;48(13):2177-2185. doi: 10.1017/S003329171700366X. Epub 2017 Dec 20. Psychol Med. 2018. PMID: 29258631 Free PMC article. Clinical Trial.
• Impact of the temporal stability of preexistent attentional bias for threat on its alteration through attention bias modification. Heeren A, Philippot P, Koster EH. Heeren A, et al. J Behav Ther Exp Psychiatry. 2015 Dec;49(Pt A):69-75. doi: 10.1016/j.jbtep.2014.10.012. Epub 2014 Nov 5. J Behav Ther Exp Psychiatry. 2015. PMID: 25468203
• Less is more: Patient-level meta-analysis reveals paradoxical dose-response effects of a computer-based social anxiety intervention targeting attentional bias. Price RB, Kuckertz JM, Amir N, Bar-Haim Y, Carlbring P, Wallace ML. Price RB, et al. Depress Anxiety. 2017 Dec;34(12):1106-1115. doi: 10.1002/da.22634. Epub 2017 Apr 28. Depress Anxiety. 2017. PMID: 28453890 Free PMC article. Review.
• Attention bias modification for anxiety and phobias: current status and future directions. Kuckertz JM, Amir N. Kuckertz JM, et al. Curr Psychiatry Rep. 2015 Feb;17(2):9. doi: 10.1007/s11920-014-0545-x. Curr Psychiatry Rep. 2015. PMID: 25620791 Review.

See all similar articles

Cited by

• Research hot topics and frontiers in social anxiety over the past decade: a CiteSpace bibliometric analysis based on Web of Science database from 2013 to 2023. Zhang P, Wang M, Ding L, Zhang J, Yuan Y, Tian X. Zhang P, et al. Front Psychiatry. 2024 Oct 23;15:1421907. doi: 10.3389/fpsyt.2024.1421907. eCollection 2024. Front Psychiatry. 2024. PMID: 39507284 Free PMC article. Review.
• Attentional bias modification and attention control training in PTSD: a systematic review and meta-analysis. Zhang F, Huang C, Yan W, Ouyang H, Liu W. Zhang F, et al. Ther Adv Psychopharmacol. 2024 Apr 16;14:20451253241243260. doi: 10.1177/20451253241243260. eCollection 2024. Ther Adv Psychopharmacol. 2024. PMID: 38633357 Free PMC article.
• Memory persistence: from fundamental mechanisms to translational opportunities. Merlo SA, Belluscio MA, Pedreira ME, Merlo E. Merlo SA, et al. Transl Psychiatry. 2024 Feb 14;14(1):98. doi: 10.1038/s41398-024-02808-z. Transl Psychiatry. 2024. PMID: 38355584 Free PMC article. Review.
• Knowledge of Threat Biases Perceptual Decision Making in Anxiety: Evidence From Signal Detection Theory and Drift Diffusion Modeling. Ozturk S, Zhang X, Glasgow S, Karnani RR, Imbriano G, Luhmann C, Jin J, Mohanty A. Ozturk S, et al. Biol Psychiatry Glob Open Sci. 2023 Jul 27;4(1):145-154. doi: 10.1016/j.bpsgos.2023.07.005. eCollection 2024 Jan. Biol Psychiatry Glob Open Sci. 2023. PMID: 38298800 Free PMC article.
• Attentional bias to threat is modulated by stimulus content: an fNIRS study. Liu H, Zhang Q, Elhai JD, Montag C, Yang H. Liu H, et al. Front Hum Neurosci. 2024 Jan 11;17:1308457. doi: 10.3389/fnhum.2023.1308457. eCollection 2023. Front Hum Neurosci. 2024. PMID: 38273882 Free PMC article.

See all "Cited by" articles

Publication types

• Meta-Analysis Actions
  • Search in PubMed
  • Search in MeSH
  • Add to Search
• Research Support, Non-U.S. Gov't Actions
  • Search in PubMed
  • Search in MeSH
  • Add to Search
• Review Actions
  • Search in PubMed
  • Search in MeSH
  • Add to Search
• Systematic Review Actions
  • Search in PubMed
  • Search in MeSH
  • Add to Search

MeSH terms

• Adult Actions
  • Search in PubMed
  • Search in MeSH
  • Add to Search
• Attention / physiology* Actions
  • Search in PubMed
  • Search in MeSH
  • Add to Search
• Cognitive Behavioral Therapy / methods* Actions
  • Search in PubMed
  • Search in MeSH
  • Add to Search
• Cognitive Behavioral Therapy / statistics & numerical data Actions
  • Search in PubMed
  • Search in MeSH
  • Add to Search
• Female Actions
  • Search in PubMed
  • Search in MeSH
  • Add to Search
• Humans Actions
  • Search in PubMed
  • Search in MeSH
  • Add to Search
• Male Actions
  • Search in PubMed
  • Search in MeSH
  • Add to Search
• Outcome Assessment, Health Care / statistics & numerical data* Actions
  • Search in PubMed
  • Search in MeSH
  • Add to Search
• Phobic Disorders / therapy* Actions
  • Search in PubMed
  • Search in MeSH
  • Add to Search
• Randomized Controlled Trials as Topic / statistics & numerical data* Actions
  • Search in PubMed
  • Search in MeSH
  • Add to Search
• Young Adult Actions
  • Search in PubMed
  • Search in MeSH
  • Add to Search

Related information

• Cited in Books
• MedGen

LinkOut - more resources

• Full Text Sources

  • Elsevier Science

• Medical

  • MedlinePlus Health Information