Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
Faculty of Computer Science, Dalhousie University, Halifax, NS, Canada.
JMIR Ment Health. 2024 Sep 2;11:e56326. doi: 10.2196/56326.
Smartphone-delivered attentional bias modification training (ABMT) intervention has gained popularity as a remote solution for alleviating symptoms of mental health problems. However, the existing literature presents mixed results indicating both significant and insignificant effects of smartphone-delivered interventions.
This systematic review and meta-analysis aims to assess the impact of smartphone-delivered ABMT on attentional bias and symptoms of mental health problems. Specifically, we examined different design approaches and methods of administration, focusing on common mental health issues, such as anxiety and depression, and design elements, including gamification and stimulus types.
Our search spanned from 2014 to 2023 and encompassed 4 major databases: MEDLINE, PsycINFO, PubMed, and Scopus. Study selection, data extraction, and critical appraisal were performed independently by 3 authors using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. When necessary, we pooled the standardized mean difference with a 95% CI. In addition, we conducted sensitivity, subgroup, and meta-regression analyses to explore moderator variables of active and placebo ABMT interventions on reducing symptoms of mental health problems and attentional bias.
Our review included 12 papers, involving a total of 24,503 participants, and we were able to conduct a meta-analysis on 20 different study samples from 11 papers. Active ABMT exhibited an effect size (Hedges g) of -0.18 (P=.03) in reducing symptoms of mental health problems, while the overall effect remained significant. Similarly, placebo ABMT showed an effect size of -0.38 (P=.008) in reducing symptoms of mental health problems. In addition, active ABMT (Hedges g -0.17; P=.004) had significant effects on reducing attentional bias, while placebo ABMT did not significantly alter attentional bias (Hedges g -0.04; P=.66).
Our understanding of smartphone-delivered ABMT's potential highlights the value of both active and placebo interventions in mental health care. The insights from the moderator analysis also showed that tailoring smartphone-delivered ABMT interventions to specific threat stimuli and considering exposure duration are crucial for optimizing their efficacy. This research underscores the need for personalized approaches in ABMT to effectively reduce attentional bias and symptoms of mental health problems.
PROSPERO CRD42023460749; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=460749.
智能手机传递的注意偏向修改训练（ABMT）干预作为缓解心理健康问题症状的远程解决方案已经越来越受欢迎。然而，现有文献的结果喜忧参半，表明智能手机传递的干预措施既有显著效果，也有不显著效果。
本系统评价和荟萃分析旨在评估智能手机传递的 ABMT 对注意力偏向和心理健康问题症状的影响。具体来说，我们研究了不同的设计方法和管理方法，重点关注常见的心理健康问题，如焦虑和抑郁，以及设计元素，包括游戏化和刺激类型。
我们的搜索范围从 2014 年到 2023 年，涵盖了 4 个主要数据库：MEDLINE、PsycINFO、PubMed 和 Scopus。使用 PRISMA（系统评价和荟萃分析的首选报告项目）指南，3 名作者独立进行了研究选择、数据提取和批判性评价。必要时，我们用 95%CI 对标准化均数差进行了合并。此外，我们还进行了敏感性、亚组和荟萃回归分析，以探索主动和安慰剂 ABMT 干预对减少心理健康问题和注意力偏向症状的调节变量。
我们的综述共纳入了 12 篇论文，涉及 24503 名参与者，我们能够对 11 篇论文中的 20 个不同研究样本进行荟萃分析。主动 ABMT 在减轻心理健康问题症状方面的效果大小（Hedges g）为-0.18（P=.03），而总体效果仍然显著。同样，安慰剂 ABMT 在减轻心理健康问题症状方面的效果大小为-0.38（P=.008）。此外，主动 ABMT（Hedges g -0.17；P=.004）对减轻注意力偏向有显著效果，而安慰剂 ABMT 则没有显著改变注意力偏向（Hedges g -0.04；P=.66）。
我们对智能手机传递的 ABMT 潜力的理解突出了主动和安慰剂干预在心理健康护理中的价值。调节分析的结果还表明，针对特定威胁刺激和考虑暴露时间来调整智能手机传递的 ABMT 干预对优化其疗效至关重要。这项研究强调了在 ABMT 中采用个性化方法的必要性，以有效减轻注意力偏向和心理健康问题的症状。
PROSPERO CRD42023460749；https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=460749。
