School of Psychological Sciences (Arad, Azriel, Lazarov, Bar-Haim), Sackler School of Medicine (Weiser, Bloch), and Sagol School of Neuroscience (Bar-Haim), Tel Aviv University, Tel Aviv, Israel; Section on Development and Affective Neuroscience, NIMH, Bethesda, Md. (Pine); Psychiatric Division, Sheba Medical Center, Ramat Gan, Israel (Sol, Weiser); Psychiatry Division, Sourasky Medical Center, Tel Aviv, Israel (Garber, Bloch).
Am J Psychiatry. 2023 May 1;180(5):357-366. doi: 10.1176/appi.ajp.20220533. Epub 2023 Mar 22.
Social anxiety disorder is common and impairing. The efficacy of pharmacotherapy is moderate, highlighting the need for alternative therapies. This study compared the efficacy of gaze-contingent music reward therapy (GC-MRT), an eye-tracking-based attention bias modification treatment, with a selective serotonin reuptake inhibitor (SSRI) treatment or a waiting list control condition in reducing social anxiety disorder symptoms. Superior clinical effects of similar magnitude were expected for the active treatments relative to the control condition.
Participants were 105 treatment-seeking adults with social anxiety disorder, randomly allocated to 12 weeks of GC-MRT, SSRI, or waiting list control. Mean changes in clinician-rated and self-reported social anxiety symptoms from baseline to mid- and posttreatment assessments were compared between groups using generalized estimating equations. Changes in attentional dwell time on threat were also examined.
Analysis indicated a significant differential reduction in symptoms between groups. Patients in the GC-MRT and SSRI groups had lower social anxiety scores at the mid- and posttreatment assessments compared with patients in the waiting list group. The efficacy of the active treatments did not differ. Only patients in the GC-MRT group showed reduction in dwell time on threat from baseline to posttreatment assessment.
Eye-tracking-based attention bias modification is an acceptable and effective treatment option for social anxiety disorder.
社交焦虑障碍较为常见且会造成损害。药物治疗的疗效中等，凸显出需要替代疗法。本研究比较了基于眼动的注意偏向矫正治疗（注视相关音乐奖励疗法，GC-MRT）、选择性 5-羟色胺再摄取抑制剂（SSRI）治疗或等待名单对照条件对减轻社交焦虑障碍症状的疗效。预计相对于对照条件，积极治疗会产生相似幅度的更好临床效果。
105 名寻求治疗的社交焦虑障碍成年患者被随机分配至 GC-MRT、SSRI 或等待名单对照 12 周。使用广义估计方程比较组间从基线到中期和治疗后评估的临床医生评定和自我报告的社交焦虑症状的平均变化。还检查了注意力停留时间的变化。
分析表明组间症状的差异显著减轻。GC-MRT 和 SSRI 组的患者在中期和治疗后评估中的社交焦虑评分低于等待名单组的患者。积极治疗的疗效没有差异。只有 GC-MRT 组的患者在从基线到治疗后评估的时间里，对威胁的注意力停留时间减少。
基于眼动的注意偏向矫正治疗是社交焦虑障碍的一种可接受且有效的治疗选择。
