Jones Emma B, Sharpe Louise
School of Psychology A18, The University of Sydney, 2006 NSW, Australia.
School of Psychology A18, The University of Sydney, 2006 NSW, Australia.
J Affect Disord. 2017 Dec 1;223:175-183. doi: 10.1016/j.jad.2017.07.034. Epub 2017 Jul 18.
Cognitive bias modification (CBM) is a novel, but controversial intervention with considerable divergence amongst conclusions in individual studies and reviews. This systematic review synthesizes meta-analyses of CBM to determine whether CBM is effective, and what parameters most reliably evoke the process of CBM.
A systematic literature search resulted in twelve meta-analyses in total, from which the published effect sizes were extracted.
Attention bias modification (ABM) shifted targeted biases in adults (ES = 0.24-1.16), was effective as a buffer to stressor vulnerability (ES = 0.33-0.77) and in symptom control (ES = 0.16-0.41). Cognitive bias modification for interpretation (CBM-I) modified targeted biases (ES = 0.52-0.81) but did not reliably reduce stressor vulnerability (ES = 0.01-0.24, p > .05). CBM consistently reduced anxiety symptoms, but effects on depressive symptomatology were less compelling. The long-term efficacy of CBM was only supported in addiction studies.
The review included a single CBM-I only meta-analysis, and two meta-analyses with pooled reporting on ABM and CBM-I outcomes.
Overall, this synthesis shows CBM is effective in the short-term for anxiety in adults, and highlights some conditions under which CBM is most efficacious. Rather than debating the efficacy of CBM, future research should focus on developing procedures that more reliably induce bias modification and determining the most efficacious clinical applications.
认知偏差矫正（CBM）是一种新颖但存在争议的干预措施，各个研究和综述的结论存在很大差异。本系统综述综合了CBM的荟萃分析，以确定CBM是否有效，以及哪些参数能最可靠地引发CBM过程。
系统的文献检索共得到12项荟萃分析，从中提取已发表的效应量。
注意力偏差矫正（ABM）改变了成年人的目标偏差（效应量=0.24-1.16），作为应激源易感性的缓冲有效（效应量=0.33-0.77）且在症状控制方面有效（效应量=0.16-0.41）。解释性认知偏差矫正（CBM-I）改变了目标偏差（效应量=0.52-0.81），但未能可靠地降低应激源易感性（效应量=0.01-0.24，p>.05）。CBM持续减轻焦虑症状，但对抑郁症状的影响不那么显著。CBM的长期疗效仅在成瘾研究中得到支持。
该综述仅纳入了一项CBM-I的荟萃分析，以及两项对ABM和CBM-I结果进行汇总报告的荟萃分析。
总体而言，本综述表明CBM在短期内对成年人焦虑有效，并突出了CBM最有效的一些条件。未来的研究不应再争论CBM的疗效，而应专注于开发能更可靠地诱发偏差矫正的程序，并确定最有效的临床应用。
