Department of Psychology, Queen's University Humphrey Hall, Room 232 62 Arch Street, Kingston, Ontario, K7L 3L3, Canada.
Department of Psychology, Queen's University Humphrey Hall, Room 232 62 Arch Street, Kingston, Ontario, K7L 3L3, Canada; Department of Psychological Clinical Science, University of Toronto Scarborough Science Wing, Room SW427D 1265 Military Trail Toronto, Ontaro, M1C 1A4, Canada.
J Behav Ther Exp Psychiatry. 2021 Jun;71:101621. doi: 10.1016/j.jbtep.2020.101621. Epub 2020 Oct 24.
Biased attention to negative information is a mechanism for risk and relapse in depression. Attentional bias modification (ABM) paradigms manipulate attention away from negative information to reduce this bias. ABM results have been mixed due to inconsistent methodologies and stimuli design. This randomized controlled trial used a novel approach to modifying attentional bias.
An eye tracker manipulated stimuli in response to participants' fixations to preferentially reward attention to positive stimuli by obscuring or enhancing image quality of negative and positive stimuli, respectively. Participants with major depressive disorder completed three 35-min sessions of active (n = 20) or sham (n = 20) ABM training. Attentional bias, memory for emotional words, and mood were assessed pre- and post-training.
Training reduced negative attentional bias; relative to sham, active training participants focused significantly more on positive compared to negative stimuli in a free-viewing eye-tracker task (p = .038, η = 0.109) and, at trend, disengaged from sad information more quickly in a computerized task (p = .052, η = 0.096). Active training participants remembered more happy than sad words in an emotional word learning task, indicating a distal transfer of training to emotional memory (p = .036, η = 0.11). Training did not significantly affect mood in the one-week trial.
Future studies should build on this proof-of-principle study with larger sample sizes and more intensive treatment to explore which mechanisms of training may lead to improvements in mood.
Attention biases in depression are modifiable through reward-based, eye-tracking training. These data suggest generalizability of training to other cognitive faculties - recall for affective information.
对负面信息的偏见关注是抑郁风险和复发的一种机制。注意偏差修正（ABM）范式通过将注意力从负面信息上转移开，从而减少这种偏见。由于方法学和刺激设计不一致，ABM 的结果好坏参半。本随机对照试验采用了一种新颖的方法来修正注意偏差。
眼动追踪器根据参与者的注视来操纵刺激，通过分别使负面和正面刺激的图像质量模糊或增强，从而优先奖励对正面刺激的注意力。患有重度抑郁症的参与者完成了三次 35 分钟的主动（n=20）或假（n=20）ABM 训练。在训练前后评估了注意偏差、情绪词记忆和情绪。
与假训练相比，训练减少了消极注意偏差；与假训练相比，在自由观看眼动追踪任务中，主动训练参与者显著更多地关注积极刺激，而不是消极刺激（p=0.038，η=0.109），在计算机化任务中，更快速地脱离悲伤信息的趋势也更明显（p=0.052，η=0.096）。在情绪词学习任务中，主动训练参与者记住了更多的快乐词而不是悲伤词，这表明训练对情绪记忆有远距离转移（p=0.036，η=0.11）。在一周的试验中，训练对情绪没有显著影响。
未来的研究应该在更大的样本量和更密集的治疗基础上，进一步探索训练的哪些机制可能导致情绪的改善，从而进一步验证这一原理。
通过基于奖励的眼动追踪训练，可以改变抑郁症患者的注意力偏差。这些数据表明，训练可以推广到其他认知能力，例如对情感信息的回忆。
