Attentional bias training in depression: Therapeutic effects depend on depression severity

Ghent University, Department of Psychology, Henri Dunantlaan 2, B-9000 Gent, Belgium.
Journal of Behavior Therapy and Experimental Psychiatry (Impact Factor: 2.23). 02/2010; 41(3):265-74. DOI: 10.1016/j.jbtep.2010.02.004
Source: PubMed

ABSTRACT Depressed individuals show maintained attention to negative information and reduced attention for positive information. Selective biases in information processing are considered to have an important role in the origin, maintenance and recurrence of depressive episodes. In two experiments we investigated the effects of attentional bias manipulation on mood and depressive symptoms. In experiment 1 we investigated the effects of attentional bias manipulation compared to a control procedure in a sample of dysphoric students (N = 48) showing mild to severe levels of depressive symptoms. In experiment 2 we investigated the same attentional training procedure in a sample of depressed in- and outpatients (N = 35). Mild improvements on symptom severity were observed in students showing mild depressive symptoms. However, in students showing moderate to severe depressive symptoms, depressive symptoms increased after the training. No beneficial effects of training on top of therapy and/or medication were found in depressed patients. These results indicate that therapeutic effects of attentional bias modification might be dependent on depression severity.

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    • "Ondanks het potentieel van aandachttraining bij depressie wijst onderzoek naar de effectiviteit van deze procedures op bescheiden resultaten. Initieel veelbelovende positieve effecten op depressiesymptomen tot drie maanden na de training (Wells & Beevers, 2010) werden niet gerepliceerd bij steekproeven van subklinisch en klinisch depressieve personen (Baert et al., 2010; Kruijt, Putman & Van der Does, 2013). Echter, in een studie naar aandachttraining als een methode ter preventie van terugval bij voorheen depressieve personen, is wel gevonden dat training leidde tot minder ernstige depressieve symptomen bij follow-up (Browning et al., 2012). "
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    ABSTRACT: Negatieve vertekeningen in aandacht, interpretatie en geheugen vormen kwetsbaarheidsfactoren voor depressie. Recentelijk legt onderzoek zich toe op het bestuderen van de wisselwerking tussen deze mechanismen. Hier bespreken we hoe aandachtsvertekeningen de emotionele inhoud van interpretaties en herinneringen beïnvloeden, hoe emotionele associaties in het geheugen aandacht sturen, en hoe combinaties van dergelijke cognitieve vertekeningen depressiesymptomen voorspellen. Vervolgens bespreken we de klinische implicaties voor emotie(dis)regulatie bij depressie en voor innovatieve methoden om cognitieve kwetsbaarheid te reduceren
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    • "Statistical significance was set at 2- sided p < 0.05. Based on previous studies (Baert et al., 2010; Wells & Beevers, 2010), an average effect size of 0.8 was estimated on primary dependent measures. With alpha set at 0.05 and power (1-beta) set at 0.80, a minimum sample size of 25 participants per group was obtained for desired effects. "
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    ABSTRACT: Background and Objectives Negative attentional biases are often considered to have a causal role in the onset and maintenance of depressive symptoms. This suggests that reduction of such biases may be a plausible strategy in the treatment of depressive symptoms. The present clinical randomized controlled trial examined long-term effects of a computerized attention bias modification (ABM) procedure on individuals with elevated depressive symptoms. Methods In a double-blind study design, 77 individuals with ongoing mild to severe symptoms of depression were randomly assigned to one of three conditions: 1) ABM training (n=27); 2) placebo (n=27); 3) assessment-only (n=23). In both the ABM and placebo conditions, participants completed 8 sessions of 216-trials (1728 in total) during a 2-week period. Assessments were conducted at pre-training and post-training (0, 2, 4, 8-week, 3, 7-month follow-ups). Change in depressive symptoms and restoration of asymptomatic level were the primary outcome measures. Results In the ABM, but not the other two conditions, significant reductions in depressive symptoms were found at post-training and maintained during the 3-month follow-up. Importantly, more participants remained asymptomatic in the ABM condition, as compared to the other two conditions, from post-training to 7-month follow-up. ABM also significantly reduced secondary outcome measures including rumination and trait anxiety, and notably, the ABM effect on reducing depressive symptoms was mediated by rumination. Limitation Generalization of the findings may be limited because the present sample included only college students. Conclusions The ABM effect on reducing depressive symptoms was maintained for at least 3-month duration in individuals with elevated depressive symptoms, and these results suggest that ABM may be a useful tool for the prevention of depressive symptoms. ( Clinical Trials. gov: NCT01628016)
    Journal of Behavior Therapy and Experimental Psychiatry 09/2014; 79(Pt A). DOI:10.1016/j.jbtep.2014.08.005 · 2.23 Impact Factor
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    • "In a study targeting mild to moderate depression with mild levels of co-occurring anxiety, participants in an attention-training condition showed a greater reduction in depressive symptoms than did participants receiving a control intervention (Wells and Beevers, 2010). Another study found small improvements in symptom severity after computerized training among students showing mild depression symptoms, but symptoms worsened in those with moderate to severe depression (Baert et al., 2010). In this latter study, co-occurring anxiety was in the mild to moderate range, leaving open the question of whether individuals without co-occurring anxiety would show similar effects. "
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    ABSTRACT: Anxiety is characterized by attentional biases to threat, but findings are inconsistent for depression. To address this inconsistency, the present study systematically assessed the role of co-occurring anxiety in attentional bias in depression. In addition, the role of emotional valence, arousal, and gender was explored. Ninety-two non-patients completed the Penn State Worry Questionnaire (Meyer et al., 1990; Molina and Borkovec, 1994) and portions of the Mood and Anxiety Symptom Questionnaire (Watson et al., 1995a,1995b). Individuals reporting high levels of depression and low levels of anxiety (depression only), high levels of depression and anxiety (combined), or low levels of both (control) completed an emotion-word Stroop task during event-related brain potential recording. Pleasant and unpleasant words were matched on emotional arousal level. An attentional bias was not evident in the depression-only group. Women in the combined group had larger N200 amplitude for pleasant than unpleasant stimuli, and the combined group as a whole had larger right-lateralized P300 amplitude for pleasant than unpleasant stimuli, consistent with an early and later attentional bias that is specific to unpleasant valence in the combined group. Men in the control group had larger N200 amplitude for pleasant than unpleasant stimuli, consistent with an early attentional bias that is specific to pleasant valence. The present study indicates that the nature and time course of attention prompted by emotional valence and not arousal differentiates depression with and without anxiety, with some evidence of gender moderating early effects. Overall, results suggest that co-occurring anxiety is more important than previously acknowledged in demonstrating evidence of attentional biases in depression.
    Frontiers in Psychology 04/2014; 5:301. DOI:10.3389/fpsyg.2014.00301 · 2.80 Impact Factor
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