The effect of attention training on a behavioral test of contamination fears in individuals with subclinical obsessive-compulsive symptoms.

Abstract

In the current study, we evaluated the effectiveness of attention training in individuals with subclinical obsessive-compulsive symptoms. We hypothesized that after completing attention training, participants would be more likely to complete steps in a hierarchy approaching their feared contaminant compared to participants in the control condition. Participants completed a probe detection task by identifying letters replacing one member of a pair of words (neutral or contamination-related). We trained attention by building a contingency between the location of the contamination-related word in the active condition and not in the control condition. Participants in the active group showed a significant reduction in attention bias for threat and completed significantly more steps approaching their feared objects compared to participants in the control group. Our results suggest that attention disengagement training may facilitate approaching feared objects in individuals with obsessive-compulsive symptoms. KeywordsObsessive Compulsive Disorder; Attention Training; Attention; Behavioral Approach Test Obsessive-compulsive disorder (OCD) is a severe mental disorder that has a chronic course unless treated. Although cognitive models of OCD emphasize the role of dysfunctional beliefs (Rachman, 1997;Salkovskis, 1985Salkovskis, , 1989 in the etiology and maintenance of the disorder, others have proposed that OCD symptoms may be the result of aberrant processing of threatrelevant information (e.g., Tallis, 1997; for reviews see Muller & Roberts, 2005;Summerfeldt & Endler, 1998). According to this model, selective attention to threatening information heightens anxiety and anxiety-related avoidance of the perceived threat, and the avoidance behaviors, in turn, prevent disconfirmation of fear-related beliefs and serve to maintain anxiety. Thus, attention bias towards threat may be causally related to behavioral avoidance of perceived threat and the anxiety experienced in the context of the approach behavior.Several researchers have reported that individuals with subclinical or clinical OCD show an attention bias for OCD-relevant material

The effectiveness of an attention bias modification program as an adjunctive treatment for Post-Traumatic Stress Disorder

“…For example, Clarke, Chen, and Guastella (2012) demonstrated that plasticity in attentional bias, defined as change in bias within a single session of ABM training, was predictive of treatment response to subsequent CBT, while attentional bias at a static time point was not. Moreover, Najmi and Amir (2010) found that plasticity in attentional bias within a single session of attention training mediated the effect of ABM training on behavioral approach toward feared objects in individuals with obsessive-compulsive symptoms. Thus, the extent to which attentional bias changes within a single session or is trained during ABM may relate to treatment outcome.…”

“…More specifically, the plasticity in attentional bias, rather than attentional bias in itself, may be implicated in the maintenance of anxiety symptoms. While some data suggests that plasticity of attentional bias mediates outcome for a single session of ABM (Najmi & Amir, 2010), to date no studies have examined whether change in plasticity over a multi-session of ABM treatment protocol mediates the effect on symptom reductions. To examine effects of static versus plastic attentional bias, we report the results of both (a) static attentional bias at pre-treatment and change in static bias from pre- to post-treatment, and (b) plasticity of attentional bias during the first training session and change in this within-session plasticity of time, as moderating or mediating the treatment effects of ABM.…”

Attention training in socially anxious children: A multiple baseline design analysis

“…ATT has been successfully utilized with a variety of anxious adult populations. Although ATT has most commonly been employed with socially anxious adults (e.g., Amir, Beard, Burns, & Bomyea, 2009;Klumpp & Amir, 2010;MacLeod & Bridle, 2006;Schmidt, Richey, Buckner, & Timpano, 2009), it has also been used to treat individuals with generalized anxiety disorder , pathological worry (Hazen, Vasey, & Schmidt, 2009), subclinical obsessive-compulsive disorder (OCD; Najmi & Amir, 2010), high trait levels of anxiety (Rutherford, MacLeod, & Campbell, 2004), and those undergoing stressful life events (MacLeod & Bridle, 2006).…”

Working Memory, Test Anxiety and Effective Interventions: A Review

“…This could then be thought to subsequently improve performance of individuals with TA. CBM-A has shown to significantly reduce negative attention bias and subsequently levels of anxiety in obsessive compulsive symptoms (Najmi & Amir, 2010), generalised anxiety disorder (Hazen, Vasey, & Schmidt, 2009), separation anxiety disorder (Rozenman, Weersing, & Amir, 2011) and other anxiety-based conditions (MacLeod & Mathews, 2012, for a review) including worry (Hayes, Hirsch, & Mathews, 2010) and negative thought intrusion (Hirsch et al, 2011), which are cognitive components thought to be related to the detrimental effects of TA.…”