A randomized controlled trial of gaze‐contingent music reward therapy for major depressive disorder

Abstract

Background Heightened attention allocation toward negative‐valanced information and reduced attention allocation toward positive‐valanced information represent viable targets for attention bias modification in major depressive disorder. Accordingly, we conducted a randomized controlled trial testing the efficacy of a novel gaze‐contingent attention bias modification procedure for major depressive disorder. Method Sixty patients with major depressive disorder were randomly assigned to either eight training sessions of feedback‐based gaze‐contingent music reward therapy designed to divert patients’ gaze toward positive over sad stimuli, or to a control condition which entailed eight sessions of gaze‐noncontingent music. Clinician‐rated and self‐reported measures of depression, and proportion of dwell‐time on sad faces, were assessed pretreatment, posttreatment, and at a 3‐month follow‐up. Results Gaze‐contingent music reward therapy produced a greater reduction in dwell‐time on sad faces compared with the control condition, but it failed to generalize to novel faces. Both groups manifested similarly significant reductions in depression symptoms from pre‐ to posttreatment that were maintained at follow‐up. Exploratory analyses suggest that first‐episode patients may benefit more from this therapy than patients with a history of multiple episodes. Conclusions Gaze‐contingent music reward therapy can modify attention biases in depression, but clear differential clinical effects did not emerge. Theoretical and practical implications are discussed.

Efficacy of attention bias modification training for depressed adults: a randomized clinical trial

“…The study of attentional biases and ABMT would benefit from identifying more reliable outcomes, novel and psychometrically validated tasks, and the use of multiple measures of attention bias to enable latent variable modeling of bias as potential ways forward. In addition, alternative approaches to modifying negative attentional bias (e.g., Godara et al, 2019;Shamai-Leshem et al, 2020) may be worth exploring as stronger empirical tests of whether modifying negative attentional bias reduces depression symptom severity over time if these methods can achieve greater target engagement than what was demonstrated in this study.…”

“…In addition, alternative approaches to modifying negative attentional bias (e.g. Godara, Sanchez-Lopez, & De Raedt, 2019;Shamai-Leshem, Lazarov, Pine, & Bar-Haim, 2020) may be worth exploring as stronger empirical tests of whether modifying negative attentional bias reduces depression symptom severity over time if these methods can achieve greater target engagement than what was demonstrated in this study.…”

Attention allocation in posttraumatic stress disorder: an eye-tracking study

“…Notwithstanding the above-mentioned limitations, current results show a clear and stable aberration in the attention allocation patterns of patients with PTSD when faced with negatively-valenced stimuli, implicating heightened sustained attention on such stimuli. Thus, sustained attention may serve as a potential target for intervention, possibly through the development of PTSD-adapted gaze-contingent treatments (Lazarov et al, 2017; Shamai-Leshem, Lazarov, Pine, & Bar-Haim, 2020). A randomized controlled trial in patients with PTSD could determine the therapeutic value of modifying one's attention away from negatively-valenced stimuli and toward neutral ones.…”

A review of attentional bias modification trainings for depression

“…At the same time, the positive images that were blurred gradually became clearer as the participants gaze at them longer, while the negative images remained blurred. In the gazecontingent music reward therapy (GC-MRT), 93 participants listened to their wanted music only when they fixed on the positive pictures.…”