Online Attention Bias Modification for Obsessive-Compulsive Disorder: A Randomized Controlled Trial

Abstract

There is evidence that attention bias modification trainings (ABMT) based on the dot-probe task are a promising therapeutic approach for several anxiety disorders. However, little is known about the malleability of attention bias in obsessive-compulsive disorder (OCD) and its impact on OCD symptoms. The present study tested this hypothesis using an online ABMT designed to train attention away from OCD-related stimuli. We hypothesized that ABMT would reduce attention bias and OCD symptoms. Participants were randomized to receive the active ABMT (n = 58) or a placebo control training (PCT; n = 50) and completed a minimum of 8 training sessions over a period of 4 weeks. As predicted, participants receiving ABMT showed a significant reduction in attention bias. This effect was not present in the placebo condition. ABMT did however not significantly outperform the PCT with regard to symptom reduction. In both conditions self-reported OCD symptoms decreased and the reduction of symptoms remained stable at 1-month follow-up. The present findings suggest that online ABMT can effectively reduce attention bias in OCD, but question its effectiveness in reducing OCD symptoms. More research on the mechanisms of attention training is inevitably needed before online ABMT can be recommended for clinical application.

Online Cognitive Bias Modification of Interpretation for Children With Obsessive-Compulsive Disorder

“…Studies revealed that Cognitive Behavioral Therapy (CBT) is effective in improving OCD in adults and non-adults (Salemink, Wolters, & de Haan, 2015); however, this treatment is not acceptable or accessible for numerous patients (Black & Grisham, 2018). Studies demonstrated that only 5%-25% of patients with OCD have access to CBT (Amir et al, 2015;Andersson et al, 2012) and from those, only 40%-60% respond to the treatment (Habedank, Lennartz, Arslan, & Ertle, 2017;Williams & Grisham, 2013). Therefore, it is necessary to conduct further research for the development and assessment of new treatment methods for OCD.…”

“…Several studies revealed that CBMI and CBMA reduce cognitive biases in individuals with OCD. CBMA only reduces attention bias towards OCD-related stimuli, and presents no significant effect on the severity of OCD (Habedank et al, 2017;Mohsenpourian, Nokani, Jamilian, & Ghasemi, 2019;Rouel & Smith, 2018); while CBMI not only impacts interpretation bias, but also reduces OCD severity (Black & Grisham, 2016;Clerkin & Teachman, 2011;Dalir, Alipour, Zare, & Farzad, 2016). CBMI, in comparison with the main treatment of OCD, i.e.…”