Department of Psychology, Stockholm University, Stockholm, Sweden ; Freie Universitaet Berlin, Berlin, Germany.
PLoS One. 2013 Sep 30;8(9):e71760. doi: 10.1371/journal.pone.0071760. eCollection 2013.
Biases in attention processes are thought to play a crucial role in the aetiology and maintenance of Social Anxiety Disorder (SAD). The goal of the present study was to examine the efficacy of a programme intended to train attention towards positive cues and a programme intended to train attention towards negative cues. In a randomised, controlled, double-blind design, the impact of these two training conditions on both selective attention and social anxiety were compared to that of a control training condition. A modified dot probe task was used, and delivered via the internet. A total of 129 individuals, diagnosed with SAD, were randomly assigned to one of these three conditions and took part in a 14-day programme with daily training/control sessions. Participants in all three groups did not on average display an attentional bias prior to the training. Critically, results on change in attention bias implied that significantly differential change in selective attention to threat was not detected in the three conditions. However, symptoms of social anxiety reduced significantly from pre- to follow-up-assessment in all three conditions (dwithin = 0.63-1.24), with the procedure intended to train attention towards threat cues producing, relative to the control condition, a significantly greater reduction of social fears. There were no significant differences in social anxiety outcome between the training condition intended to induce attentional bias towards positive cues and the control condition. To our knowledge, this is the first RCT where a condition intended to induce attention bias to negative cues yielded greater emotional benefits than a control condition. Intriguingly, changes in symptoms are unlikely to be by the mechanism of change in attention processes since there was no change detected in bias per se. Implications of this finding for future research on attention bias modification in social anxiety are discussed.
ClinicalTrials.gov NCT01463137.
注意力过程中的偏见被认为在社交焦虑症（SAD）的病因和维持中起着至关重要的作用。本研究的目的是检验旨在训练注意力朝向积极线索和旨在训练注意力朝向消极线索的两种方案的疗效。在随机、对照、双盲设计中，将这两种训练条件对选择性注意和社交焦虑的影响与对照训练条件进行了比较。使用改良的点探测任务，并通过互联网进行。共有 129 名被诊断患有 SAD 的个体被随机分配到这三种条件中的一种，并参加了为期 14 天的方案，每天进行训练/对照。所有三组参与者在训练前平均没有表现出注意力偏见。至关重要的是，注意力偏差变化的结果表明，在三种条件下均未检测到威胁性选择性注意的显著差异变化。然而，所有三种条件下的社交焦虑症状均从预评估到随访评估显著减轻（dwithin = 0.63-1.24），与旨在训练威胁线索注意力的程序相比，控制条件下社交恐惧的减轻幅度显著更大。旨在引起对积极线索的注意力偏差的训练条件与对照条件之间在社交焦虑结果方面没有显著差异。据我们所知，这是第一个 RCT，旨在引起负性线索注意力偏差的条件产生的情绪效益大于对照条件。有趣的是，由于本身没有检测到偏差的变化，因此症状的变化不太可能是由于注意力过程变化的机制所致。对社交焦虑的注意力偏差修正的未来研究讨论了这一发现的意义。
ClinicalTrials.gov NCT01463137。
