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von Koch L, Kathmann N, Reuter B. Lack of speeded disengagement from facial expressions of disgust in remitted major depressive disorder: Evidence from an eye-movement study. Behav Res Ther 2023; 160:104231. [PMID: 36463834 DOI: 10.1016/j.brat.2022.104231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 10/30/2022] [Accepted: 11/15/2022] [Indexed: 11/25/2022]
Abstract
Acute major depression is characterized by specific abnormalities in the way emotional material is attended to. In late stages of stimulus processing, clinically depressed and dysphoric individuals show difficulties to disengage attention from emotionally negative material. It is unclear, however, whether aberrant disengagement is a transitory attentional phenomenon tied to depressive symptoms, or whether it constitutes a more stable disposition that outlast the symptomatic episode. To address this issue, the current study examined 39 currently euthymic individuals previously affected by major depression (RMD) and 40 healthy control participants reporting no lifetime psychopathology (ND). We used a gaze-contingent eye tracking paradigm designed to separately assess the attentional components of engagement and disengagement when viewing facial expressions of sadness, disgust and happiness. Never-depressed healthy participants, but not remitted euthymic individuals, showed speeded disengagement from facial expressions of disgust. We propose that the lack of this distinct acceleration in previously depressed but fully remitted individuals might reflect an attentional disposition that carries over to euthymic phases of the disease. On the other hand, a tendency to disengage quickly from areas in the visual field that convey social disdain could potentially act as a protective, possibly mood-stabilizing bias in resilient individuals.
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Affiliation(s)
- Lara von Koch
- Department of Psychology, Humboldt-Universität zu Berlin, Germany.
| | - Norbert Kathmann
- Department of Psychology, Humboldt-Universität zu Berlin, Germany
| | - Benedikt Reuter
- Department of Psychology, Humboldt-Universität zu Berlin, Germany; Department of Medicine, MSB Medical School Berlin, Germany
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2
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Nieto I, Vazquez C. Disentangling the mediating role of modifying interpretation bias on emotional distress using a novel cognitive bias modification program. J Anxiety Disord 2021; 83:102459. [PMID: 34358756 DOI: 10.1016/j.janxdis.2021.102459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/12/2021] [Accepted: 07/26/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Negative interpretation bias is a potential risk factor for emotional disorders. In this study, we tested a clinically inspired 4-session online Cognitive Bias Modification-Interpretation (CBM-IClin) program to modify negative interpretation biases. METHODS We randomized one hundred and twenty-one volunteer young adults (Mean age = 21.6 years, SD = 3.5; 85 % women) with varying levels of emotional distress to either an experimental or waitlist control group. Mediation analyses were used to disentangle the associations between the intervention, changes in interpretation biases (assessed by both a self-report and an experimental task), and changes in measures of cognitive vulnerability and symptoms of depression and anxiety. RESULTS The results showed that the CBM-IClin could change negative interpretation biases. Also, it had a direct effect on the change in negative memory bias, an indirect effect on the change in depression symptoms via the change in interpretation bias, and both direct and indirect effects on the change in self-reported dysfunctional attitudes. LIMITATIONS The study included a non-clinical sample of participants and it did not control for some potential confounding factors (e.g., attentional disorders). Furthermore, participants' engagement during the sessions at home was not supervised. CONCLUSIONS The CBM-IClin is a potential tool to prevent and intervene in emotional disorders in young adults and could complement other traditional CBM procedures or clinical interventions.
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Affiliation(s)
- Inés Nieto
- Department of Clinical Psychology, School of Psychology, Complutense University of Madrid, Spain.
| | - Carmelo Vazquez
- Department of Clinical Psychology, School of Psychology, Complutense University of Madrid, Spain
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3
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Nieto I, Vazquez C. 'Relearning how to think': A brief online intervention to modify biased interpretations in emotional disorders-study protocol for a randomised controlled trial. Trials 2021; 22:510. [PMID: 34332616 PMCID: PMC8325786 DOI: 10.1186/s13063-021-05459-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 07/15/2021] [Indexed: 11/18/2022] Open
Abstract
Background Cognitive biases play an important role in the development and maintenance of emotional disorders, such as depression and anxiety. Novel procedures, known as Cognitive Bias Modification (CBM), aim to reduce these dysfunctional information processing modes. This study develops a brief clinically based online intervention programme to modify biased interpretations in depression and anxiety (CBM-IClin), overcoming some methodological issues that have been addressed in previous literature. Methods Volunteer participants will be recruited via social media and posters at the university. They will be randomly assigned to an experimental group or a waiting list control group. Both groups will complete two assessment sessions (before and after the intervention) consisting of questionnaires measuring cognitive and emotional variables as well as experimental tasks measuring cognitive biases (i.e. attention, memory, and interpretation). After the first assessment session, only participants in the experimental group will receive a link to follow the four CBM-IClin sessions at home. All participants will receive, via email, follow-up questionnaires 2 weeks and 3 months after the second assessment. Discussion This study will test the 'Relearning how to think', an online programme potentially beneficial to modify cognitive biases in emotional disorders. Several limitations of previous CBM procedures are addressed, and the impact of the programme both on objective cognitive bias tasks and clinical symptoms will be explored. Trial registration ClinicalTrials.gov NCT03987477. Prospectively registered on June 17, 2019
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Affiliation(s)
- Inés Nieto
- Department of Clinical Psychology, School of Psychology, Complutense University of Madrid, 28223, Madrid, Spain.
| | - Carmelo Vazquez
- Department of Clinical Psychology, School of Psychology, Complutense University of Madrid, 28223, Madrid, Spain
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4
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Shani R, Tal S, Derakshan N, Cohen N, Enock PM, McNally RJ, Mor N, Daches S, Williams AD, Yiend J, Carlbring P, Kuckertz JM, Yang W, Reinecke A, Beevers CG, Bunnell BE, Koster EHW, Zilcha-Mano S, Okon-Singer H. Personalized cognitive training: Protocol for individual-level meta-analysis implementing machine learning methods. J Psychiatr Res 2021; 138:342-348. [PMID: 33901837 DOI: 10.1016/j.jpsychires.2021.03.043] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/12/2021] [Accepted: 03/19/2021] [Indexed: 10/21/2022]
Abstract
Accumulating evidence suggests that cognitive training may enhance well-being. Yet, mixed findings imply that individual differences and training characteristics may interact to moderate training efficacy. To investigate this possibility, the current paper describes a protocol for a data-driven individual-level meta-analysis study aimed at developing personalized cognitive training. To facilitate comprehensive analysis, this protocol proposes criteria for data search, selection and pre-processing along with the rationale for each decision. Twenty-two cognitive training datasets comprising 1544 participants were collected. The datasets incorporated diverse training methods, all aimed at improving well-being. These training regimes differed in training characteristics such as targeted domain (e.g., working memory, attentional bias, interpretation bias, inhibitory control) and training duration, while participants differed in diagnostic status, age and sex. The planned analyses incorporate machine learning algorithms designed to identify which individuals will be most responsive to cognitive training in general and to discern which methods may be a better fit for certain individuals.
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Affiliation(s)
- Reut Shani
- Department of Psychology, School of Psychological Sciences, University of Haifa, Haifa, Israel; The Integrated Brain and Behavior Research Center (IBBR), University of Haifa, Haifa, Israel.
| | - Shachaf Tal
- Department of Psychology, School of Psychological Sciences, University of Haifa, Haifa, Israel
| | - Nazanin Derakshan
- Department of Psychological Sciences, Birkbeck University of London, London, UK
| | - Noga Cohen
- Department of Special Education, University of Haifa, Haifa, Israel; The Edmond J. Safra Brain Research Center for the Study of Learning Disabilities, University of Haifa, Haifa, Israel
| | - Philip M Enock
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | | | - Nilly Mor
- Department of Psychology, The Hebrew University of Jerusalem, Israel; Seymour Fox School of Education, The Hebrew University of Jerusalem, Israel
| | | | - Alishia D Williams
- Department of Psychology, Faculty of Science, University of New South Wales, Sydney, Australia
| | | | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Jennie M Kuckertz
- Department of Psychiatry, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Wenhui Yang
- Department of Psychology, Hunan Normal University, China
| | | | - Christopher G Beevers
- Institute for Mental Health Research and Department of Psychology, University of Texas at Austin, Austin, TX, USA
| | - Brian E Bunnell
- Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, USA
| | - Ernst H W Koster
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Sigal Zilcha-Mano
- Department of Psychology, School of Psychological Sciences, University of Haifa, Haifa, Israel
| | - Hadas Okon-Singer
- Department of Psychology, School of Psychological Sciences, University of Haifa, Haifa, Israel; The Integrated Brain and Behavior Research Center (IBBR), University of Haifa, Haifa, Israel
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5
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Positive attentional biases moderate the link between attentional bias for threat and anxiety. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01448-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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6
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Simulating thoughts to measure and study internal attention in mental health. Sci Rep 2021; 11:2251. [PMID: 33500510 PMCID: PMC7838298 DOI: 10.1038/s41598-021-81756-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 12/29/2020] [Indexed: 12/20/2022] Open
Abstract
Our mind's eye and the role of internal attention in mental life and suffering has intrigued scholars for centuries. Yet, experimental study of internal attention has been elusive due to our limited capacity to control the timing and content of internal stimuli. We thus developed the Simulated Thoughts Paradigm (STP) to experimentally deliver own-voice thought stimuli that simulate the content and experience of thinking and thereby experimental study of internal attentional processes. In independent experiments (N = 122) integrating STP into established cognitive-experimental tasks, we found and replicated evidence that emotional reactivity to negative thoughts predicts difficulty disengaging internal attention from, as well as biased selective internal attention of, those thoughts; these internal attention processes predict cognitive vulnerability (e.g., negative repetitive thinking) which thereby predict anxiety and depression. Proposed methods and findings may have implications for the study of information processing and attention in mental health broadly and models of internal attentional (dys)control in cognitive vulnerability and mental health more specifically.
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7
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Loijen A, Vrijsen JN, Egger JI, Becker ES, Rinck M. Biased approach-avoidance tendencies in psychopathology: A systematic review of their assessment and modification. Clin Psychol Rev 2020; 77:101825. [DOI: 10.1016/j.cpr.2020.101825] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 01/21/2020] [Accepted: 01/22/2020] [Indexed: 01/18/2023]
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8
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Neural correlates of emotion-attention interactions: From perception, learning, and memory to social cognition, individual differences, and training interventions. Neurosci Biobehav Rev 2020; 108:559-601. [DOI: 10.1016/j.neubiorev.2019.08.017] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Revised: 07/02/2019] [Accepted: 08/21/2019] [Indexed: 12/12/2022]
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9
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Østergaard T, Lundgren T, Rosendahl I, Zettle RD, Jonassen R, Harmer CJ, Stiles TC, Landrø NI, Haaland VØ. Acceptance and Commitment Therapy Preceded by Attention Bias Modification on Residual Symptoms in Depression: A 12-Month Follow-Up. Front Psychol 2019; 10:1995. [PMID: 31555180 PMCID: PMC6727662 DOI: 10.3389/fpsyg.2019.01995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 08/14/2019] [Indexed: 12/25/2022] Open
Abstract
Depression is a highly recurrent disorder with limited treatment alternatives for reducing risk of subsequent episodes. Acceptance and commitment therapy (ACT) and attention bias modification (ABM) separately have shown some promise in reducing depressive symptoms. This study investigates (a) if group-based ACT had a greater impact in reducing residual symptoms of depression over a 12-month follow-up than a control condition, and (b) if preceding ACT with ABM produced added benefits. This multisite study consisted of two phases. In phase 1, participants with a history of depression, currently in remission (N = 244), were randomized to either receive 14 days of ABM or a control condition. In phase 2, a quasi- experimental design was adopted, and only phase-1 participants from the Sørlandet site (N = 124) next received an 8-week group-based ACT intervention. Self-reported and clinician-rated depression symptoms were assessed at baseline, immediately after phase 1 and at 1, 2, 6, and 12 months after the conclusion of phase 1. At 12-month follow-up, participants who received ACT exhibited fewer self-reported and clinician-rated depressive symptoms. There were no significant differences between ACT groups preceded by ABM or a control condition. There were no significant differences between ACT groups preceded by ABM or a control condition. Group-based ACT successfully decreased residual symptoms in depression over 12 months, suggesting some promise in preventing relapse.
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Affiliation(s)
- Tom Østergaard
- Department of Psychiatry, Sørlandet Hospital, Arendal, Norway
- Department of Psychology, Clinical Neuroscience Research Group, University of Oslo, Oslo, Norway
| | - Tobias Lundgren
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Ingvar Rosendahl
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Robert D. Zettle
- Department of Psychology, Wichita State University, Wichita, KS, United States
| | - Rune Jonassen
- Department of Psychology, Clinical Neuroscience Research Group, University of Oslo, Oslo, Norway
| | - Catherine J. Harmer
- Department of Psychology, Clinical Neuroscience Research Group, University of Oslo, Oslo, Norway
- Psychopharmacology and Emotion Research Laboratory, University Department of Psychiatry, Oxford, United Kingdom
| | - Tore C. Stiles
- Department of Psychology, Clinical Neuroscience Research Group, University of Oslo, Oslo, Norway
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Nils Inge Landrø
- Department of Psychology, Clinical Neuroscience Research Group, University of Oslo, Oslo, Norway
- Division of Psychiatry, Diakonhjemmet Hospital, Oslo, Norway
| | - Vegard Øksendal Haaland
- Department of Psychiatry, Sørlandet Hospital, Arendal, Norway
- Department of Psychology, Clinical Neuroscience Research Group, University of Oslo, Oslo, Norway
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10
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A novel process-based approach to improve resilience: Effects of computerized mouse-based (gaze)contingent attention training (MCAT) on reappraisal and rumination. Behav Res Ther 2019; 118:110-120. [DOI: 10.1016/j.brat.2019.04.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 04/11/2019] [Accepted: 04/12/2019] [Indexed: 11/19/2022]
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11
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Wolters LH, Prins PJM, Garst GJA, Hogendoorn SM, Boer F, Vervoort L, de Haan E. Mediating Mechanisms in Cognitive Behavioral Therapy for Childhood OCD: The Role of Dysfunctional Beliefs. Child Psychiatry Hum Dev 2019; 50:173-185. [PMID: 30032391 PMCID: PMC6428795 DOI: 10.1007/s10578-018-0830-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Reframing cognitions is assumed to play an important role in treatment for obsessive-compulsive disorder (OCD). However, there hardly is any empirical support for this assumption, especially for children. The aim of this study was to examine if changing dysfunctional beliefs is a mediating mechanism of cognitive behavioral therapy (CBT) for childhood OCD. Fifty-eight children (8-18 years) with OCD received CBT. Dysfunctional beliefs (OBQ-CV) and OCD severity (CY-BOCS) were measured pre-treatment, mid-treatment, post-treatment, and at 16-week follow-up. Results showed that OCD severity and dysfunctional beliefs decreased during CBT. Changes in severity predicted changes in beliefs within the same time interval. Our results did not support the hypothesis that changing dysfunctional beliefs mediates treatment effect. Future studies are needed to replicate these findings and shed more light on the role of explicit and implicit cognitions in treatment for childhood OCD.
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Affiliation(s)
- L H Wolters
- Department of Child and Adolescent Psychiatry, Academic Medical Center, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands.
- Academic Center for Child and Adolescent Psychiatry, De Bascule, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands.
| | - P J M Prins
- Faculty of Social and Behavioural Sciences, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS, Amsterdam, The Netherlands
| | - G J A Garst
- Faculty of Social and Behavioural Sciences, University of Amsterdam, Nieuwe Achtergracht 127, 1018 WS, Amsterdam, The Netherlands
| | - S M Hogendoorn
- Academic Center for Child and Adolescent Psychiatry, De Bascule, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands
| | - F Boer
- Department of Child and Adolescent Psychiatry, Academic Medical Center, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands
| | - L Vervoort
- Department of developmental, personality and social psychology, Ghent University, Henri Dunantlaan 2, 9000, Ghent, Belgium
| | - E de Haan
- Academic Center for Child and Adolescent Psychiatry, De Bascule, Meibergdreef 5, 1105 AZ, Amsterdam, The Netherlands
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12
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McNally RJ. Attentional bias for threat: Crisis or opportunity? Clin Psychol Rev 2019; 69:4-13. [DOI: 10.1016/j.cpr.2018.05.005] [Citation(s) in RCA: 136] [Impact Index Per Article: 27.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 05/20/2018] [Accepted: 05/20/2018] [Indexed: 01/26/2023]
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13
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Okon-Singer H, Henik A, Gabay S. Increased inhibition following negative cues: A possible role for enhanced processing. Cortex 2019; 122:131-139. [PMID: 30638583 DOI: 10.1016/j.cortex.2018.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 11/28/2018] [Accepted: 12/06/2018] [Indexed: 11/28/2022]
Abstract
Based on findings showing that attention is captured by aversive stimuli, previous studies have hypothesized that inhibition of return (IOR) is reduced at spatial locations previously occupied by threat cues. Yet evidence for this view is limited: Only a few studies have demonstrated a reduced degree of IOR following threat cues, while most have not found differences in IOR between aversive and neutral cues. In contrast to previous studies that used the spatial cuing paradigm and for the most part employed mild negative stimuli as cues, we examined the influence of highly aversive, colored and complex pictures of real life situations. As opposed to the stimuli used in previous studies, these pictures are thought to result in enhanced processing as well as in specific enhancement for threat pictures in comparison to neutral ones. Based on evidence indicating that enhanced processing of spatial cues results in increased IOR, we hypothesized that the negative picture cues employed in the present study would yield increased IOR. This hypothesis was confirmed in two experiments. We suggest that the enhancement of IOR following highly threatening cues may be related to efficient spatial orienting of attention in response to stimuli that are important from an evolutionary point of view. The results are discussed in the context of neurocognitive mechanisms that may underlie the modulation of IOR by emotional information.
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Affiliation(s)
- Hadas Okon-Singer
- Department of Psychology, University of Haifa, Israel; The Integrated Brain and Behavior Research Center (IBBR), University of Haifa, Israel.
| | - Avishai Henik
- Department of Psychology and Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Shai Gabay
- Department of Psychology, University of Haifa, Israel; The Institute of Information Processing and Decision Making (IIPDM), University of Haifa, Israel.
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14
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Todd J, van Ryckeghem DM, Sharpe L, Crombez G. Attentional bias to pain-related information: a meta-analysis of dot-probe studies. Health Psychol Rev 2018; 12:419-436. [DOI: 10.1080/17437199.2018.1521729] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Jemma Todd
- School of Psychology, University of Sydney, Sydney, Australia
| | - Dimitri M.L. van Ryckeghem
- Department of Experimental Psychology, Ghent University, Ghent, Belgium
- Research Unit INSIDE, Institute for Health and Behaviour; Faculty of Language and Literature, Humanities, Arts and Education, Luxembourg University, Luxembourg City, Luxembourg
| | - Louise Sharpe
- School of Psychology, University of Sydney, Sydney, Australia
| | - Geert Crombez
- Department of Experimental Psychology, Ghent University, Ghent, Belgium
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15
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Woud ML, Blackwell SE, Steudte-Schmiedgen S, Browning M, Holmes EA, Harmer CJ, Margraf J, Reinecke A. Investigating d-cycloserine as a potential pharmacological enhancer of an emotional bias learning procedure. J Psychopharmacol 2018; 32:569-577. [PMID: 29446699 DOI: 10.1177/0269881118754679] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The partial N-methyl-D-aspartate receptor agonist d-cycloserine may enhance psychological therapies. However, its exact mechanism of action is still being investigated. Cognitive bias modification techniques allow isolation of cognitive processes and thus investigation of how they may be affected by d-cycloserine. We used a cognitive bias modification paradigm targeting appraisals of a stressful event, Cognitive Bias Modification-Appraisal, to investigate whether d-cycloserine enhanced the modification of appraisal, and whether it caused greater reduction in indices of psychopathology. Participants received either 250 mg of d-cycloserine ( n=19) or placebo ( n=19). As a stressor task, participants recalled a negative life event, followed by positive Cognitive Bias Modification-Appraisal training. Before and after Cognitive Bias Modification-Appraisal, appraisals and indices of psychopathology related to the stressor were assessed. Cognitive Bias Modification-Appraisal successfully modified appraisals, but d-cycloserine did not affect appraisals post-training. There were no post-training group differences in frequency of intrusions. Interestingly, d-cycloserine led to a greater reduction in distress and impact on state mood from recalling the event, and lower distress post-training was associated with fewer intrusions. Therefore, d-cycloserine may affect emotional reactivity to recalling a negative event when combined with induction of a positive appraisal style, but via a mechanism other than enhanced learning of the appraisal style.
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Affiliation(s)
- Marcella L Woud
- 1 Department of Psychology, Ruhr-Universität Bochum, Germany
| | | | | | | | - Emily A Holmes
- 4 Division of Psychology, Department for Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | | | - Jürgen Margraf
- 1 Department of Psychology, Ruhr-Universität Bochum, Germany
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16
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Rawdon C, Murphy D, Motyer G, Munafò MR, Penton-Voak I, Fitzgerald A. An investigation of emotion recognition training to reduce symptoms of social anxiety in adolescence. Psychiatry Res 2018; 263:257-267. [PMID: 29602534 DOI: 10.1016/j.psychres.2018.02.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 02/06/2018] [Accepted: 02/06/2018] [Indexed: 12/21/2022]
Abstract
This study aimed to examine the effect of emotion recognition training on social anxiety symptoms among adolescents, aged 15-18 years. The study included a screening session, which identified participants who scored above a cut-off on a self-report measure of social anxiety for enrolment into a randomized controlled trial (Clinical Trials ID: NCT02550379). Participants were randomized to an intervention condition designed to increase the perception of happiness over disgust in ambiguous facial expressions or a sham intervention control condition, and completed self-report measures of social anxiety, fear of negative evaluation, anxiety-related disorders, and depressive symptoms. The intervention group demonstrated a strong shift in the balance point at which they perceived happiness over disgust in ambiguous facial expressions. This increase in positive perception was not associated with any changes in the primary outcome of social anxiety; however, some evidence of improvement in symptomatology was observed on one of a number of secondary outcomes. Those in the intervention group had lower depression symptoms at 2-week follow-up, compared to those in the control group who received the sham intervention training. Potential reasons for why the shift in balance point measurement was not associated with a concurrent shift in symptoms of social anxiety are discussed.
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Affiliation(s)
- Caroline Rawdon
- School of Nursing and Human Sciences, Dublin City University, Glasnevin, Dublin 9, Ireland.
| | - Daria Murphy
- University College Dublin School of Psychology, Newman Building Belfield, Dublin 4 Dublin, Leinster Ireland.
| | - Gillian Motyer
- University College Dublin School of Psychology, Newman Building Belfield, Dublin 4 Dublin, Leinster Ireland.
| | - Marcus R Munafò
- School of Experimental Psychology, University of Bristol, 12a Priory Road, Bristol BS8 1TU, United Kingdom; MRC Integrative Epidemiology Unit, University of Bristol, 12a Priory Road, Bristol BS8 1TU, United Kingdom; National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, United Kingdom.
| | - Ian Penton-Voak
- School of Experimental Psychology, University of Bristol, 12a Priory Road, Bristol BS8 1TU, United Kingdom; National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, United Kingdom.
| | - Amanda Fitzgerald
- University College Dublin School of Psychology, Newman Building Belfield, Dublin 4 Dublin, Leinster Ireland.
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17
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Østergaard T, Lundgren T, Zettle R, Jonassen R, Harmer CJ, Stiles TC, Landrø NI, Haaland VØ. Acceptance and Commitment Therapy preceded by an experimental Attention Bias Modification procedure in recurrent depression: study protocol for a randomized controlled trial. Trials 2018; 19:203. [PMID: 29587807 PMCID: PMC5870819 DOI: 10.1186/s13063-018-2515-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 01/31/2018] [Indexed: 11/10/2022] Open
Abstract
Background This project studies the effect of group-based Acceptance and Commitment Therapy (ACT) following Attention Bias Modification (ABM) on residual symptoms in recurrent depression. ACT is a cognitive-behavioral intervention combining acceptance and mindfulness processes with commitment and behavior-change processes. ACT enjoys modest empirical support in treating depression and has also shown promising results in secondary prevention of depression. The experimental cognitive bias modification (ABM) procedure has been shown to reduce surrogate markers of depression vulnerability in patients in remission from depression. The aim of the current project is to investigate if the effect of group-based ACT on reducing residual depressive symptoms can be enhanced by preceding it with ABM. Also, assessment of the relationship between conceptually relevant therapeutic processes and outcome will be investigated. Methods/design An invitation to participate in this project was extended to 120 individuals within a larger sample who had just completed a separate randomized, multisite, clinical trial (referred to hereafter as Phase 1) in which they received either ABM (n = 60) or a control condition without bias modification (n = 60). This larger Phase-1 sample consisted of 220 persons with a history of at least two episodes of major depression who were currently in remission or not fulfilling the criteria of major depression. After its inclusion, Phase-1 participants from the Sørlandet site (n = 120) were also recruited for this study in which they received an 8-week group-based ACT intervention. Measures will be taken immediately after Phase 1, 1 month, 2 months, 6 months, and 1 year after the conclusion of Phase 1. Discussion This study sequentially combines acceptable, nondrug interventions from neuropsychology and cognitive-behavioral psychology in treating residual symptoms in depression. The results will provide information about the effectiveness of treatment and on mechanisms and processes of change that may be valuable in understanding and further developing ABM and ACT, combined and alone. Trial registration ClinicalTrials.gov, Identifier: NCT02648165. Registered on 6 January 2016. Electronic supplementary material The online version of this article (10.1186/s13063-018-2515-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tom Østergaard
- Department of Psychiatry, Sørlandet Hospital, Arendal, Norway. .,Clinical Neuroscience Research Group Department of Psychology, University of Oslo, Oslo, Norway.
| | - Tobias Lundgren
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institute, Stockholm Health Care services, Stockholm, Sweden
| | - Robert Zettle
- Department of Psychology, Wichita State University, Wichita, KS, USA
| | - Rune Jonassen
- Clinical Neuroscience Research Group Department of Psychology, University of Oslo, Oslo, Norway
| | - Catherine J Harmer
- Psychopharmacology and Emotional Research Lab (PERL), University Department of Psychiatry, Oxford, UK
| | - Tore C Stiles
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Nils Inge Landrø
- Clinical Neuroscience Research Group Department of Psychology, University of Oslo, Oslo, Norway
| | - Vegard Øksendal Haaland
- Department of Psychiatry, Sørlandet Hospital, Arendal, Norway.,Clinical Neuroscience Research Group Department of Psychology, University of Oslo, Oslo, Norway
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Okon-Singer H. The role of attention bias to threat in anxiety: mechanisms, modulators and open questions. Curr Opin Behav Sci 2018. [DOI: 10.1016/j.cobeha.2017.09.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Cristea IA, Kok RN, Cuijpers P. Invited commentary on … Confusing procedures with process in cognitive bias modification research †. Br J Psychiatry 2017; 211:272-273. [PMID: 29092836 DOI: 10.1192/bjp.bp.117.200972] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 03/22/2017] [Indexed: 11/23/2022]
Abstract
The notion that cognitive bias modification should be appraised exclusively on the basis of trials where its postulated mechanisms were successfully changed starkly contradicts the standards of evidence-based psychotherapy. In the laboratory or as a treatment, cognitive bias modification cannot continue to eschew the rigorous scrutiny applied to other interventions.
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Affiliation(s)
- Ioana A Cristea
- Ioana A. Cristea, PhD, Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania, and Meta-Research Innovation Center at Stanford, Stanford University, Stanford, California, USA; Robin N. Kok, MSc, Department of Psychology, University of Southern Denmark, Odense, Denmark, and Centre for Innovative Medical Technology, Odense University Hospital, Odense, Denmark, and Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, The Netherlands; Pim Cuijpers, PhD, Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, The Netherlands
| | - Robin N Kok
- Ioana A. Cristea, PhD, Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania, and Meta-Research Innovation Center at Stanford, Stanford University, Stanford, California, USA; Robin N. Kok, MSc, Department of Psychology, University of Southern Denmark, Odense, Denmark, and Centre for Innovative Medical Technology, Odense University Hospital, Odense, Denmark, and Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, The Netherlands; Pim Cuijpers, PhD, Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, The Netherlands
| | - Pim Cuijpers
- Ioana A. Cristea, PhD, Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania, and Meta-Research Innovation Center at Stanford, Stanford University, Stanford, California, USA; Robin N. Kok, MSc, Department of Psychology, University of Southern Denmark, Odense, Denmark, and Centre for Innovative Medical Technology, Odense University Hospital, Odense, Denmark, and Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, The Netherlands; Pim Cuijpers, PhD, Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, The Netherlands
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ADHD symptoms in healthy adults are associated with stressful life events and negative memory bias. ACTA ACUST UNITED AC 2017; 10:151-160. [PMID: 29081022 PMCID: PMC5973996 DOI: 10.1007/s12402-017-0241-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 10/09/2017] [Indexed: 11/08/2022]
Abstract
Stressful life events, especially Childhood Trauma, predict ADHD symptoms. Childhood Trauma and negatively biased memory are risk factors for affective disorders. The association of life events and bias with ADHD symptoms may inform about the etiology of ADHD. Memory bias was tested using a computer task in N = 675 healthy adults. Life events and ADHD symptoms were assessed using questionnaires. The mediation of the association between life events and ADHD symptoms by memory bias was examined. We explored the roles of different types of life events and of ADHD symptom clusters. Life events and memory bias were associated with overall ADHD symptoms as well as inattention and hyperactivity/impulsivity symptom clusters. Memory bias mediated the association of Lifetime Life Events, specifically Childhood Trauma, with ADHD symptoms. Negatively biased memory may be a cognitive marker of the effects of Childhood Trauma on the development and/or persistence of ADHD symptoms.
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A Question of Control? Examining the Role of Control Conditions in Experimental Psychopathology using the Example of Cognitive Bias Modification Research. SPANISH JOURNAL OF PSYCHOLOGY 2017; 20:E54. [DOI: 10.1017/sjp.2017.41] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
AbstractWhile control conditions are vitally important in research, selecting the optimal control condition can be challenging. Problems are likely to arise when the choice of control condition is not tightly guided by the specific question that a given study aims to address. Such problems have become increasingly apparent in experimental psychopathology research investigating the experimental modification of cognitive biases, particularly as the focus of this research has shifted from theoretical questions concerning mechanistic aspects of the association between cognitive bias and emotional vulnerability, to questions that instead concern the clinical efficacy of ‘cognitive bias modification’ (CBM) procedures. We discuss the kinds of control conditions that have typically been employed in CBM research, illustrating how difficulties can arise when changes in the types of research questions asked are not accompanied by changes in the control conditions employed. Crucially, claims made on the basis of comparing active and control conditions within CBM studies should be restricted to those conclusions allowed by the specific control condition employed. CBM studies aiming to establish clinical utility are likely to require quite different control conditions from CBM studies aiming to illuminate mechanisms. Further, conclusions concerning the clinical utility of CBM interventions cannot necessarily be drawn from studies in which the control condition has been chosen to answer questions concerning mechanisms. Appreciating the need to appropriately alter control conditions in the transition from basic mechanisms-focussed investigations to applied clinical research could greatly facilitate the translational process.
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Cox JA, Christensen BK, Goodhew SC. Temporal dynamics of anxiety-related attentional bias: is affective context a missing piece of the puzzle? Cogn Emot 2017; 32:1329-1338. [PMID: 28984503 DOI: 10.1080/02699931.2017.1386619] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Previous research has demonstrated that anxious individuals attend to negative emotional information at the expense of other information. This is commonly referred to as attentional bias. The field has historically conceived of this process as relatively static; however, research by [Zvielli, A., Bernstein, A., & Koster, E. H. W. (2014). Dynamics of attentional bias to threat in anxious adults: Bias towards and/or away? PLoS ONE, 9(8), e104025; Zvielli, A., Bernstein, A., & Koster, E. H. W. (2015). Temporal dynamics of attentional bias. Clinical Psychological Science, 3(5), 772-788.], and others, challenges this assumption by demonstrating considerable temporal variability in attentional bias amongst anxious individuals. Still, the mechanisms driving these temporal dynamics are less well known. Using a modified dot-probe task, the present study examined the impact of two relevant contextual variables- affective valence and trial repetition. Affective context was instantiated by the presentation of negative versus neutral pictures before each trial, while repetition context was achieved via the presentation of the valenced pictures in either a blocked- or mixed-trial design. Results indicate that individuals with higher trait-anxiety levels were significantly more influenced by blocked presentations of negative affective information, leading to greater temporal fluctuations in attentional bias. Furthermore, our findings provide additional evidence that attentional bias is best conceptualised as dynamic and variable, and that an individual's affective experience is one factor that regulates attentional bias dynamics. Implications relating to theoretical and methodological factors are discussed.
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Affiliation(s)
- Jolene A Cox
- a Research School of Psychology, The Australian National University , Canberra , Australia
| | - Bruce K Christensen
- a Research School of Psychology, The Australian National University , Canberra , Australia
| | - Stephanie C Goodhew
- a Research School of Psychology, The Australian National University , Canberra , Australia
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Penton-Voak IS, Munafò MR, Looi CY. Biased Facial-Emotion Perception in Mental Health Disorders: A Possible Target for Psychological Intervention? CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE 2017. [DOI: 10.1177/0963721417704405] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Our perception of emotion in the faces of others affects our own behavior and mood. Indeed, individuals with mood disorders such as depression and aggression often show biases in facial-emotion perception. Here, we review recent and ongoing research suggesting that biased emotion perception may be on the causal pathway of the onset and maintenance of mood disorders, and hence a potential target for intervention. Simple cognitive-bias modification tasks that change participants’ perception of facial expressions of emotion have shown some promise as a therapeutic technique. We outline further directions for continued research investigating the robustness and clinical impact of emotion-bias modification in real-world settings.
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Affiliation(s)
| | - Marcus R. Munafò
- School of Experimental Psychology, University of Bristol
- MRC Integrative Epidemiology Unit, University of Bristol
- UK Centre for Tobacco and Alcohol Studies, University of Bristol
| | - Chung Yen Looi
- School of Experimental Psychology, University of Bristol
- Cambridge Cognition Ltd., Cambridge, United Kingdom
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Modifying Obsessive-Compulsive Beliefs about Controlling One’s Thoughts. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2017. [DOI: 10.1007/s10862-017-9603-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Vazquez C, Blanco I, Sanchez A, McNally RJ. Attentional bias modification in depression through gaze contingencies and regulatory control using a new eye-tracking intervention paradigm: study protocol for a placebo-controlled trial. BMC Psychiatry 2016; 16:439. [PMID: 27931196 PMCID: PMC5146883 DOI: 10.1186/s12888-016-1150-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 11/29/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Attentional biases, namely difficulties both to disengage attention from negative information and to maintain it on positive information, play an important role in the onset and maintenance of the disorder. Recently, researchers have developed specific attentional bias modification (ABM) techniques aimed to modify these maladaptive attentional patterns. However, the application of current ABM procedures has yielded, so far, scarce results in depression due, in part, to some methodological shortcomings. The aim of our protocol is the application of a new ABM technique, based on eye-tracker technology, designed to objectively train the specific attentional components involved in depression and, eventually, to reduce depressive symptoms. METHODS Based on sample size calculations, 32 dysphoric (BDI ≥13) participants will be allocated to either an active attentional bias training group or a yoked-control group. Attentional training will be individually administered on two sessions in two consecutive days at the lab. In the training task series of pairs of faces (i.e. neutral vs. sad; neutral vs. happy; happy vs. sad) will be displayed. Participants in the training group will be asked to localize as quickly as possible the most positive face of the pair (e.g., the neutral face in neutral vs. sad trials) and maintain their gaze on it for 750 ms or 1500 ms, in two different blocks, to advance to the next trial. Participants' maintenance of gaze will be measured by an eye-tracking apparatus. Participants in the yoked-control group will be exposed to the same stimuli and the same average amount of time than the experimental participants but without any instruction to maintain their gaze or any feedback on their performance. Pre and post training measures will be obtained to assess cognitive and emotional changes after the training. DISCUSSION The findings from this research will provide a proof-of-principle of the efficacy of eye-tracking paradigms to modify attentional biases and, consequently, to improve depressed mood. If the findings are positive, this new training approach may result in the improvement of cognitive bias modification procedures in depression. TRIAL REGISTRATION This trial was retrospectively registered on July 28, 2016 with the ClinicalTrials.gov NCT02847793 registration number and the title 'Attentional Bias Modification Through Eye-tracker Methodology (ABMET)'.
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Affiliation(s)
- Carmelo Vazquez
- Faculty of Psychology, Complutense University at Madrid, 28223 Madrid, Spain
| | - Ivan Blanco
- Faculty of Psychology, Complutense University at Madrid, 28223 Madrid, Spain
| | - Alvaro Sanchez
- Department of Experimental Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, B-9000 Ghent, Belgium
| | - Richard J. McNally
- Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA 02138 USA
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The perseverative worry bout: A review of cognitive, affective and motivational factors that contribute to worry perseveration. Biol Psychol 2016; 121:233-243. [DOI: 10.1016/j.biopsycho.2016.04.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 04/07/2016] [Accepted: 04/07/2016] [Indexed: 10/22/2022]
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Anxiety and attention to threat: Cognitive mechanisms and treatment with attention bias modification. Behav Res Ther 2016; 87:76-108. [DOI: 10.1016/j.brat.2016.08.001] [Citation(s) in RCA: 161] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 07/23/2016] [Accepted: 08/01/2016] [Indexed: 01/09/2023]
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Black MJ, Grisham JR. Imagery versus verbal interpretive cognitive bias modification for compulsive checking. Behav Res Ther 2016; 83:45-52. [DOI: 10.1016/j.brat.2016.05.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 05/27/2016] [Accepted: 05/31/2016] [Indexed: 11/24/2022]
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