Quantitative Evaluation of the Clinical Efficacy of Attention Bias Modification Treatment for Anxiety Disorders

Linetzky, Marian; Pergamin-Hight, Lee; Pine, Daniel S.; Bar‐Haim, Yair

doi:10.1002/da.22344

Cited by 172 publications

(140 citation statements)

References 36 publications

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“…AB has been a treatment target in other fields (e.g., anxiety disorders), and AB modification programs have been found to be effective in reducing AB and associated psychopathology (Linetzky, Pergamin-Hight, Pine, & Bar-Haim, 2015) Therefore, further study of AB may contribute to improving existing treatments and to the development of more precise treatments for disorders related to binge eating. Future research directions are discussed below.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of attentional biases in disorders involving binge eating

et al. 2018

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Objective Attentional bias (AB) may be one mechanism contributing to the development and/or maintenance of disordered eating. AB has traditionally been measured using reaction time in response to a stimulus. Novel methods for AB measurement include eye tracking to measure visual fixation on a stimulus, and electroencephalography to measure brain activation in response to a stimulus. This systematic review summarizes, critiques, and integrates data on AB gathered using the above-mentioned methods in those with binge eating behaviors, including binge eating, loss of control eating, and bulimia nervosa. Method Literature searches on PubMed and PsycInfo were conducted using combinations of terms related to binge eating and biobehavioral AB paradigms. Studies using AB paradigms with three categories of stimuli were included: food, weight/shape, and threat. For studies reporting means and standard deviations of group bias scores, Hedges’ g effect sizes for group differences in AB were calculated. Results Fifty articles met inclusion criteria and were reviewed. Individuals who binge eat in the absence of compensatory behaviors show an increased AB to food cues, but few studies have examined such individuals’ AB toward weight/shape and threatening stimuli. Individuals with bulimia nervosa consistently show an increased AB to shape/weight cues and socially threatening stimuli, but findings for AB to food cues are mixed. Discussion While there are important research gaps, preliminary evidence suggests that the combination of AB to disorder-specific cues (i.e., food and weight/shape) and AB toward threat may be a potent contributor to binge eating. This conclusion underscores previous findings on the interaction between negative affect and AB to disorder-specific cues. Recommendations for future research are provided.

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Section: Discussionmentioning

confidence: 99%

A systematic review of attentional biases in disorders involving binge eating

et al. 2018

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“…Beard et al, 2012; Mogoaşe, et al, 2014). Moreover, active ABMT delivered in clinic settings ameliorates AB and clinician-reported anxiety but not self-reported symptoms in adult anxiety patients (Linetzky et al, 2015). Neuroimaging studies indicate that active training enhanced activation in vlPFC and dlPFC during emotional face processing (Browning et al, 2010; Taylor et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

Frontolimbic functioning during threat-related attention: Relations to early behavioral inhibition and anxiety in children

Taber-Thomas

Pérez‐Edgar

2017

Biological Psychology

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Children with behavioral inhibition (BI), a temperament characterized by biologically-based hyper-vigilance to novelty, display threat-related attention biases (AB) that shape developmental trajectories of risk for anxiety. Here we explore the relations between BI, neural function, and anxiety. Fifty-six 9–12-year-olds (23 behaviorally inhibited) performed the dot-probe task while undergoing fMRI. AB scores were not associated with BI group or parent-rated anxiety symptoms. Trials requiring attention orienting away from threat engaged an executive and threat-attention network (dlPFC, vlPFC, mPFC, and amygdala). Within that network, behaviorally inhibited children showed greater activation in the right dlPFC. Heightened dlPFC activation related to increased anxiety, and BI levels accounted for the direct relation between dlPFC activation and anxiety. Behaviorally inhibited children may engage the executive attention system during threat-related processing as a compensatory mechanism. We provide preliminary evidence that the link between PFC functioning and anxiety might be attributed to early-emerging temperamental vulnerabilities present before the emergence of clinical anxiety.

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“…The vast majority of ABM studies in anxious patients have trained attention away from threat (toward neutral information), invoking an attentional goal state akin to the pattern that conferred risk in our study. Although several studies showed immediate and short-term (e.g., at 4-month follow-up) benefits on anxiety measures (Amir et al, 2009; Schmidt, Richey, Buckner, & Timpano, 2009), more recent findings have been mixed (Linetzky, Pergamin-Hight, Pine, & Bar-Haim, 2015), and no published study has examined clinical effects (depression or anxiety) at longer-term follow-up. In the context of pediatric anxiety, it may be important to consider the possible detrimental effects of training in an avoidance pattern.…”

Section: Discussionmentioning

confidence: 99%

From anxious youth to depressed adolescents: Prospective prediction of 2-year depression symptoms via attentional bias measures.

Price

Rosen

Siegle

et al. 2016

Journal of Abnormal Psychology

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Anxious youth are at heightened risk for subsequent development of depression; however, little is known regarding which anxious youth are at the highest prospective risk. Biased attentional patterns (e.g., vigilance and avoidance of negative cues) are implicated as key mechanisms in both anxiety and depression. Aberrant attentional patterns may disrupt opportunities to effectively engage with, and learn from, threatening aspects of the environment during development and/or treatment, compounding risk over time. Sixty-seven anxious youth (age 9–14; 36 female) completed a dot-probe task to assess baseline attentional patterns provoked by fearful-neutral face pairs. The time course of attentional patterns both during and after threat was assessed via eyetracking and pupilometry. Self-reported depressive and anxiety symptoms were assessed two years after the conclusion of a larger psychotherapy treatment trial. Eyetracking patterns indicative of threat avoidance predicted greater 2-year depression scores, over and above baseline and post-treatment symptoms. Sustained, post-threat pupillary avoidance (reflecting preferential neural engagement with the neutral relative to the previously threatening location) predicted additional variance in depression scores, suggesting sustained avoidance in the wake of threat further exacerbated risk. Identical eyetracking and pupil indices were not predictive of anxiety at 2 years. These biobehavioral markers imply that avoidant attentional processing in the context of anxiety may be a gateway to depression across a key maturational window. Excessive avoidance of threat could interfere with acquisition of adaptive emotion regulation skills during development, culminating in the broad behavioral deactivation that typifies depression. Prevention efforts explicitly targeting avoidant attentional patterns may be warranted.

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Quantitative Evaluation of the Clinical Efficacy of Attention Bias Modification Treatment for Anxiety Disorders

Cited by 172 publications

References 36 publications

A systematic review of attentional biases in disorders involving binge eating

A systematic review of attentional biases in disorders involving binge eating

Frontolimbic functioning during threat-related attention: Relations to early behavioral inhibition and anxiety in children

From anxious youth to depressed adolescents: Prospective prediction of 2-year depression symptoms via attentional bias measures.

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