Efficacy of attention bias modification using threat and appetitive stimuli: a meta-analytic review

Beard, Courtney; Sawyer, Alice T.; Hofmann, Stefan G.

doi:10.1016/j.beth.2012.01.002

Cited by 291Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesNeural and Behavioral Psychology StudiesVisual Attention and Saliency Detection

Efficacy of attention bias modification using threat and appetitive stimuli: a meta-analytic review

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Beard, Courtney, Sawyer, Alice T., Hofmann, Stefan G.·2012·Behavior Therapy

DOI 10.1016/j.beth.2012.01.002PMC PMC3494088

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Abstract

Attention bias modification (ABM) protocols aim to modify attentional biases underlying many forms of pathology. Our objective was to conduct an effect size analysis of ABM across a wide range of samples and psychological problems. We conducted a literature search using PubMed, PsycInfo, and author searches to identify randomized studies that examined the effects of ABM on attention and subjective experiences. We identified 37 studies (41 experiments) totaling 2,135 participants who were randomized to training toward neutral, positive, threat, or appetitive stimuli or to a control condition. The effect size estimate for changes in attentional bias was large for the neutral versus threat comparisons (g=1.06), neutral versus appetitive (g=1.41), and neutral versus control comparisons (g=0.80), and small for positive versus control (g=0.24). The effects of ABM on attention bias were moderated by stimulus type (words vs. pictures) and sample characteristics (healthy vs. high symptomatology). Effect sizes of ABM on subjective experiences ranged from 0.03 to 0.60 for postchallenge outcomes, -0.31 to 0.51 for posttreatment, and were moderated by number of training sessions, stimulus type, and stimulus orientation (top/bottom vs. left/right). Fail-safe N calculations suggested that the effect size estimates were robust for the training effects on attentional biases, but not for the effect on subjective experiences. ABM studies using threat stimuli produced significant effects on attention bias across comparison conditions, whereas appetitive stimuli produced changes in attention only when comparing appetitive versus neutral conditions. ABM has a moderate and robust effect on attention bias when using threat stimuli. Further studies are needed to determine whether these effects are also robust when using appetitive stimuli and for affecting subjective experiences.

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Four published meta-analyses have examined the effects of attention bias modification on symptoms and, as a group, reported small-to-medium effect sizes.
“Four published meta-analyses have examined the effects of attention bias modification on symptoms, as a group reporting small-to-medium effect sizes.[8][9][10][11]”
From QUANTITATIVE EVALUATION OF THE CLINICAL EFFICACY OF ATTENTION BIAS MODIFICATION TREATMENT FOR ANXIETY DISORDERS: Review: ABMT for Anxiety Disorders: A Meta-Analysis (2015) · cites this paper as [10]
Prior meta-analytic reviews do not focus specifically on results in clinically affected patients, and no review provides a direct meta-analytic test of ABMT as a stand-alone treatment for clinical anxiety disorders.
“However, prior reviews do not focus specifically on results in clinically affected patients.As a result, no review provides a direct meta-analytic test of the utility of ABMT as a stand-alone treatment for clinical anxiety disorders.”
From QUANTITATIVE EVALUATION OF THE CLINICAL EFFICACY OF ATTENTION BIAS MODIFICATION TREATMENT FOR ANXIETY DISORDERS: Review: ABMT for Anxiety Disorders: A Meta-Analysis (2015) · cites this paper as [10]

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Editorial for the Special Issue on Cognitive Bias Modification Techniques: An Introduction to a Time Traveller’s Tale
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When ignorance is bliss: explicit instruction and the efficacy of CBM-A for anxiety
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Effects of Bias Modification Training in Binge Eating Disorder
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A randomized controlled trial of gaze‐contingent music reward therapy for major depressive disorder
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Assessment of Social Anxiety and its Clinical Expressions
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Attention training improves aberrant neural dynamics during working memory processing in veterans with PTSD
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Authors: Beard, C., Sawyer, A. T., & Hofmann, S. G.
Affiliations: Brown University (US)
Boston University (US)
Corresponding author: Beard, Courtney
ORCID: Beard, Courtney
Hofmann, Stefan G.
Venue: Behavior Therapy
Publisher: Elsevier BV
Published: 2012-12
Volume: 43
Issue: 4
Pages: 724-740
ISSN: 0005-7894 (ISSN-L)
DOI: 10.1016/j.beth.2012.01.002
PMC: PMC3494088
OpenAlex: W2066042204
Cited by: 291
References: 90
Citations by year: 2026: 6 · 2025: 7 · 2024: 17 · 2023: 10 · 2022: 13 · 2021: 15 · 2020: 20 · 2019: 18 · 2018: 24 · 2017: 33 · 2016: 29 · 2015: 46 · 2014: 30 · 2013: 21 · 2012: 1
FWCI: 41.68
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Behavior Therapy (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Mental Health (F32MH083330, MH078308., MH-081116, R01MH078308, R01MH081116)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Visual Attention and Saliency Detection
Keywords: attentional bias modification, attentional bias, threat stimuli, appetitive stimuli, subjective experience, stimulus type, training sessions, stimulus orientation
MeSH terms: Anxiety Disorders, Attention, Humans, Cognitive Behavioral Therapy

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Efficacy of attention bias modification using threat and appetitive stimuli: a meta-analytic review

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