Clinical Efficacy of Attentional Bias Modification Procedures: An Updated Meta-Analysis

• Published in: Journal of clinical psychology 2014-12, Vol.70 (12), p.1133-1157
• Main Authors: Mogoaşe, Cristina, David, Daniel, Koster, Ernst H. W.
• Format: Article
• Language: English
• Subjects: addictive behaviors; anxiety; Anxiety Disorders - therapy; Attention; attentional bias modification; Bias; Cognitive Therapy - methods; depression; Depressive Disorder - therapy; Estimating techniques; Humans; Intervention; Mental depression; Mental Disorders - therapy; Mental health care; Meta-analysis; Psychometrics; Randomized Controlled Trials as Topic; Substance-Related Disorders - therapy; Systematic review; Treatment Outcome
• ISSN: 0021-9762; 1097-4679
• DOI: 10.1002/jclp.22081

Context Attentional bias modification (ABM) treatment is a promising intervention tool for a variety of clinical conditions. Objectives This study provides an updated review of the clinical effect of ABM by employing standard meta‐analytic procedures to (a) estimate the average effect size of ABM in reducing both attention bias (AB) and symptoms, (b) estimate the average effect size for different conditions (e.g., anxiety, depression, and substance abuse), (c) test possible variables that may moderate the effect sizes, and (d) investigate the relationship between preexistent AB and the reduction in AB and symptoms. Method We included 43 controlled trials with a total of 2,268 participants providing 47 group comparisons (i.e., training vs. control condition). Inclusion criteria were as follows: AB was specifically targeted to reduce symptomatology and emotional vulnerability; participants were randomized to the experimental conditions; a control condition (defined as sham training) existed; symptoms were assessed at least postintervention; sufficient data were provided to allow effect size estimation. Results We obtained a small overall effect size on symptoms postintervention, g = 0.160, 95% confidence interval (CI) = [0.055, 0.265], driven by anxiety studies, g = 0.260, 95% CI = [0.132, 0.388], and studies conducted in healthy participants, g = 0.211, 95% CI = [0.046, 0.375]; no significant effect sizes were found postintervention for other symptom categories. Conclusion The therapeutic benefit of ABM is rather small for anxiety, while the amount of data for other symptom categories is limited. We argue that more efficient, psychometrically sound procedures are needed for assessing and modifying AB.