Bias-contingent attention bias modification and attention control training in treatment of PTSD: a randomized control trial

Lazarov, Amit; Suarez‐Jimenez, Benjamin; Abend, Rany; Naim, Reut; Shvil, Erel; Helpman, Liat; Lee, Seonjoo; Papini, Santiago; Duroski, Ariel; Rom, Rony; Schneier, Franklin R.; Pine, Daniel S.; Bar‐Haim, Yair; Neria, Yuval

doi:10.1017/s0033291718003367

Cited by 54 publications

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“…While attempting to address this by including depressive symptoms and a functioning measure, many other non-symptoms may play a causal role in PTSD, as well as in bridging PTSD and other disorders (Jones et al, 2017). These may include, among others, threat-related cognitive biases (Lazarov et al, 2018(Lazarov et al, , 2019, neural abnormalities (O'Doherty et al, 2015;Koch et al, 2016), social functioning (Wilcox, 2010), and other factors which have been implicated in PTSD such as age (Konnert and Wong, 2015) and gender (Lehavot et al, 2018). Thus, future network-based research should include additional non-symptom nodes to enrich our understanding of PTSD (Jones et al, 2017).…”

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confidence: 99%

Symptom structure of PTSD and co-morbid depressive symptoms – a network analysis of combat veteran patients

et al. 2019

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Background Despite extensive research, symptom structure of posttraumatic stress disorder (PTSD) is highly debated. The network approach to psychopathology offers a novel method for understanding and conceptualizing PTSD. However, extant studies have mainly used small samples and self-report measures among sub-clinical populations, while also overlooking co-morbid depressive symptoms. Methods PTSD symptom network topology was estimated in a sample of 1489 treatment-seeking veteran patients based on a clinician-rated PTSD measure. Next, clinician-rated depressive symptoms were incorporated into the network to assess their influence on PTSD network structure. The PTSD-symptom network was then contrasted with the network of 306 trauma-exposed (TE) treatment-seeking patients not meeting full criteria for PTSD to assess corresponding network differences. Finally, a directed acyclic graph (DAG) was computed to estimate potential directionality among symptoms, including depressive symptoms and daily functioning. Results The PTSD symptom network evidenced robust reliability. Flashbacks and getting emotionally upset by trauma reminders emerged as the most central nodes in the PTSD network, regardless of the inclusion of depressive symptoms. Distinct clustering emerged for PTSD and depressive symptoms within the comorbidity network. DAG analysis suggested a key triggering role for re-experiencing symptoms. Network topology in the PTSD sample was significantly distinct from that of the TE sample. Conclusions Flashbacks and psychological reactions to trauma reminders, along with their strong connections to other re-experiencing symptoms, have a pivotal role in the clinical presentation of combat-related PTSD among veterans. Depressive and posttraumatic symptoms constitute two separate diagnostic entities, but with meaningful between-disorder connections, suggesting two mutually-influential systems.

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confidence: 99%

Symptom structure of PTSD and co-morbid depressive symptoms – a network analysis of combat veteran patients

et al. 2019

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“…In addition, many treated patients with ASD still develop PTSD (Kornør et al, 2008), creating a need for alternative treatments. Here, we test the efficacy of attention control therapy (ACT), a novel computerized intervention for PTSD (Badura‐Brack et al, 2015; Lazarov et al, 2019), in reducing risk for PTSD among patients with ASD. The delivery of ACT does not require highly trained therapists, it is less emotionally demanding than many psychotherapies, and has a high dissemination potential, especially for individuals who are physically disabled or immobile following trauma (Amstadter, Broman‐Fulks, Zinzow, Ruggiero, & Cercone, 2009).…”

Section: Introductionmentioning

confidence: 99%

“…Four randomized trials directly contrasted the efficacy of ABM and ACT for PTSD (Badura‐Brack et al, 2015; Lazarov et al, 2019; Schoorl, Putman, & Van Der Does, 2013). Schoorl et al (2013) found ACT and ABM to be equally effective for PTSD symptoms.…”

Section: Introductionmentioning

confidence: 99%

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Attention control therapy for acute stress disorder: A randomized controlled trial

et al. 2020

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Background: A subset of people exposed to traumatic events develop acute stress disorder (ASD), and approximately half of people with ASD develop posttraumatic stress disorder (PTSD). This randomized controlled trial examined the efficacy of internet-delivered attention control therapy (ACT), previously shown to reduce PTSD symptoms, as an adjuvant to treatment as usual in the community for patients with ASD. Methods: About 119 participants with ASD were randomly assigned to ACT or treatment as usual in the community within the first month following their traumatic event. PTSD symptoms and attention patterns were measured. Results: A significant reduction in stress-related symptoms was noted across participants with no difference between the two groups. Approximately half of the participants developed PTSD 2 months after the trauma. High attention bias variability was associated with elevated PTSD symptoms. However, attention bias variability did not change due to the therapy sessions. Conclusions: Internet-delivered ACT was no more effective in reducing risk for PTSD in participants with ASD than treatment as usual in the community. Although elevated attention bias variability was detected in the patients with ASD, ACT failed to engage this cognitive target. Finally, ACT-based prevention research should proceed with caution given the possibility that this intervention might be associated with symptom worsening as indexed by the Clinical Global Impression scale.

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“…Attentional control training is an approach to attention modification that is believed to exert effects upon temporal dynamics of AB by enhancing attentional control (Badura-Brack et al, 2015). This training method, which is similar to control conditions in most attention bias modification studies, was more effective at decreasing PTSS compared to the usual look-away threat ABM (Badura-Brack et al, 2015) and bias-contingent ABM (Lazarov et al, 2018). Attentional control training does not train attention in a specific direction (i.e., towards or away from threat) but instead implicitly encourages participants to ignore the spatial locations of threatening stimuli to perform optimally on the task.…”

Section: Discussionmentioning

confidence: 99%

Attentional bias and its temporal dynamics among war veterans suffering from chronic pain: Investigating the contribution of post-traumatic stress symptoms

Mazidi

Vig

Ranjbar

et al. 2019

Journal of Anxiety Disorders

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Background: Cognitive models propose that attentional dysregulation, including an attentional bias towards threat, is one of the factors through which chronic pain and posttraumatic stress symptoms (PTSS) maintain and exacerbate one another. The current investigation assessed the attentional bias for painful facial expressions and its relationship with PTSS, using both traditional and variability-based attentional bias measures, among veterans with chronic pain and PTSS and controls. Method: Fifty-four veterans with chronic pain and 30 age/education-matched controls participated in this investigation. Participants completed a self-report measure of PTSS and a modified version of the dot-probe task with painful, happy, and neutral facial expressions. Attention was assessed using both traditional and variability-based reaction time measures of attentional bias. Results: Veterans directed attention away from painful facial expressions (i.e., avoidance) relative to both the control group (between-subject effect) and relative to neutral faces (withinsubject effect). Veterans also showed significantly elevated attentional bias variability for both happy and painful facial expressions compared to controls. Attentional bias variability for happy and painful facial expressions was correlated with PTSS among all participants. Conclusion: Veterans with chronic pain and PTSS avoided pain-related stimuli and displayed an overall attentional dysregulation for emotional facial expressions. Avoidance of pain cues may be a coping strategy that these individuals develop under stressful conditions. Implications, limitations, and directions for future research are discussed.

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Bias-contingent attention bias modification and attention control training in treatment of PTSD: a randomized control trial

Cited by 54 publications

References 62 publications

Symptom structure of PTSD and co-morbid depressive symptoms – a network analysis of combat veteran patients

Symptom structure of PTSD and co-morbid depressive symptoms – a network analysis of combat veteran patients

Attention control therapy for acute stress disorder: A randomized controlled trial

Attentional bias and its temporal dynamics among war veterans suffering from chronic pain: Investigating the contribution of post-traumatic stress symptoms

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