Neural changes with attention bias modification for anxiety: a randomized trial

Abstract

Attention bias modification (ABM) procedures typically reduce anxiety symptoms, yet little is known about the neural changes associated with this behavioral treatment. Healthy adults with high social anxiety symptoms (n = 53) were randomized to receive either active or placebo ABM. Unlike placebo ABM, active ABM aimed to train individuals' attention away from threat. Using the dot-probe task, threat-related attention bias was measured during magnetic resonance imaging before and after acute and extended training over 4 weeks. A subset of participants completed all procedures (n = 30, 15 per group). Group differences in neural activation were identified using standard analyses. Linear regression tested predictive factors of symptom reduction (i.e., training group, baseline indices of threat bias). The active and placebo groups exhibited different patterns of right and left amygdala activation with training. Across all participants irrespective of group, individuals with greater left amygdala activation in the threat-bias contrast prior to training exhibited greater symptom reduction. After accounting for baseline amygdala activation, greater symptom reduction was associated with assignment to the active training group. Greater left amygdala activation at baseline predicted reductions in social anxiety symptoms following ABM. Further research is needed to clarify brain-behavior mechanisms associated with ABM training.

Spatiotemporal brain dynamics underlying attentional bias modifications

“…For example, exaggerated biases toward emotionally negative stimuli could participates in intensifying anxiety (e.g. Amir et al, 2008;Britton et al, 2015;Heeren et al, 2015). Based on the evidence that abnormal AB contributes to the development and maintenance of many psychiatric disorders, important efforts have been invested into the development of behavioral interventions aiming to reduce ABs (Hakamata et al, 2010;Lopes et al, 2015;MacLeod and Clarke, 2014).…”

“…Amir et al, 2008;Suway et al, 2013) and clinical populations (e.g. Attwood et al, 2008;Eldar and Bar-Haim, 2010;Field et al, 2009;Lopes et al, 2014;Schoenmakers et al, 2010;Shafran et al, 2008), only few examined the neural underpinnings of ABM (Britton et al, 2015;Browning et al, 2010;Eldar and Bar-Haim, 2010;Li et al, 2016;Nelson et al, 2015;O'Toole and Dennis, 2012;Osinsky et al, 2014;Suway et al, 2013).…”

Hjärnan formas av psykologisk behandling

“…In the current project, three (12%) clinical participants dropped out from post-treatment MRI assessment. These figures vary in the literature, ranging from 4% (Gingnell et al, 2016) to 43% (Britton et al, 2015). In Study III, thirteen individuals participated in the MRI at one-year follow-up (50% drop-out), and thus must be interpreted with caution.…”

“…Taylor et al (2014) assessed a non-clinical group with individuals experiencing social anxiety symptoms and reported decreased responses in the amygdala and insula, and increases in the dACC, dlPFC and vmPFC, after a single session of attention bias modification. In contrast, Britton et al (2015) performed a randomised trial comparing active ABM to an ABM placebo condition for four weeks in individuals with sub-clinical SAD, showing that the active training group exhibited increased and the placebo group decreased activation of the amygdala following training. However, it is important to note that the two studies used different fMRI experimental tasks.…”

“…However, it is important to note that the two studies used different fMRI experimental tasks. Taylor et al (2014) used a common emotional face assessment task while Britton et al (2015) were training the participants to redirect their attention away from threatening stimuli.…”