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Attention Bias Modification Treatment: A Meta-Analysis Toward the Establishment of Novel Treatment for Anxiety
Open accessAbstract
Background Attention Bias Modification Treatment (ABMT) is a newly-emerging promising treatment for anxiety disorders. While recent randomized control trials (RCTs) suggest that ABMT reduces anxiety, therapeutic effects have not been summarized quantitatively. Methods Standard meta-analytic procedures were used to summarize the effect of ABMT on anxiety. Using MEDLINE, January 1995 to February 2010, we identified RCTs comparing the effects on anxiety of ABMT and quantified effect sizes using Hedge’s d. Results Twelve studies met inclusion criteria, including 467 participants from 10 publications. ABMT produced significantly greater reductions in anxiety than control training, with a medium effect (d = 0.61, p <.001). Age and gender did not moderate the effect of ABMT on anxiety, while several characteristics of the ABMT training did. Conclusions ABMT shows promise as a novel treatment for anxiety. Additional RCTs are needed to fully evaluate the degree to which these findings replicate and apply to patients. Future work should consider the precise role for ABMT in the broader anxiety-disorder therapeutic armamentarium.
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“Many ABM studies have shown that this redirection of attention yields greater reduction of self-reported and clinically rated fear symptoms than attending directly to phobic stimuli (Hakamata, Lissek, Bar-Haim, Britton, et al. 2010; Heeren, Reese, McNally & Philippot, 2012; however, see Mogg, Waters & Bradley (2017) for inconsistent findings when ABM is compared to more rigorous control conditions”
From Advancing the treatment of anxiety disorders in transition‐age youth: a review of the therapeutic effects of unconscious exposure. (2025) · cites this paper as Hakamata, Lissek, Bar-Haim, Britton, et al. 2010
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“Furthermore, successful modification of cognitive biases parallels symptom improvement following cognitive behavioral therapy (Pishyar et al., 2008), pharmacotherapy (Mogg et al., 2004), or systematic training aimed at altering biases (Hakamata et al., 2010; Beard et al., 2011).”
From Mindfulness Training Alters Emotional Memory Recall Compared to Active Controls: Support for an Emotional Information Processing Model of Mindfulness (2012) · cites this paper as Hakamata et al., 2010
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“Initial positive results with this strategy have been reported in chronic pain [14] and in psychopathology [8].”
From Attentional bias and chronic pain: Where to go from here? (2014) · cites this paper as [8]
In the citing paper
“and, importantly, have also been found to reduce self-reported symptoms of anxiety and depression (Hakamata et al, 2010; Wells and Beevers, 2009).”
From Using an Experimental Medicine Model to Explore Combination Effects of Pharmacological and Cognitive Interventions for Depression and Anxiety (2011) · cites this paper as Hakamata et al, 2010
In the citing paper
“Although there is evidence that attentional cognitive bias training does ameliorate symptoms of depression, this literature is less consistent (Baert et al, 2010; Wells et al, 2009) than that demonstrating an anxiolytic effect (Hakamata et al, 2010).”
From Using an Experimental Medicine Model to Explore Combination Effects of Pharmacological and Cognitive Interventions for Depression and Anxiety (2011) · cites this paper as Hakamata et al, 2010
In the citing paper
“For example, evidence of dysfunction in PFC-dependent attentional processes has led to the development and testing of attention retraining therapies.97,175”
From Neural Substrates of Childhood Anxiety Disorders (2012) · cites this paper as [175]
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“A power analysis indicated that in order to detect a Time  Condition interaction between eight groups in predicting anxiety or depression scores, with a small effect size (f ¼ 0.10, based on Beard, Sawyer, & Hofmann, 2012;Hakamata et al., 2010;Hallion & Ruscio, 2011), a power of 90%, and an alpha of .05,472 participants were needed for the full study.”
From Online attentional bias modification training targeting anxiety and depression in unselected adolescents: short- and long-term effects of a randomized controlled trial (2016) · cites this paper as Hakamata et al., 2010
In the citing paper
“Recent meta-analyses and reviews of random controlled trials (RCTs) report small-to-moderate effect sizes of ABM on anxiety symptoms (Cristea, Kok et al., 2015;Cristea, Mogoas ¸e et al., 2015;Hakamata et al., 2010;Hallion & Ruscio, 2011;Heeren, Mogoase, Philippot et al., 2015;Mogoas ¸e et al., 2014;Van Bockstaele et al., 2014).”
From Anxiety and attention to threat: cognitive mechanisms and treatment with attention bias modification (2016) · cites this paper as Hakamata et al., 2010
In the citing paper
“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.”
In the citing paper
“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]”
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Metadata
- Authors
- Hakamata, Y., Lissek, S., Bar-Haim, Y., Britton, J. C., Fox, N. A., Leibenluft, E., Ernst, M., & Pine, D. S.
- Affiliations
- National Institute of Mental Health (JP)
- National Institute of Mental Health (US)
- University of Maryland, College Park (US)
- Corresponding author
- Hakamata, Yuko
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2010-12
- Volume
- 68
- Issue
- 11
- Pages
- 982-990
- ISSN
- 0006-3223 (ISSN-L)
- PMC
- PMC3296778
- OpenAlex
- W2153922516
- Semantic Scholar
- 4eace0c1355ded852a1a6cac9a70897eac3af37c
- Cited by
- 869
- References
- 48
- Citations by year
- 2026: 16 · 2025: 31 · 2024: 28 · 2023: 42 · 2022: 24 · 2021: 50 · 2020: 44 · 2019: 60 · 2018: 68 · 2017: 62 · 2016: 65 · 2015: 101 · 2014: 75 · 2013: 89 · 2012: 70
- FWCI
- 8.05
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Japan Society for the Promotion of Science
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- attentional bias modification, anxiety disorders, anxiety treatment, cognitive bias modification, effect size, treatment moderators, age and gender differences
- MeSH terms
- Anxiety, Anxiety Disorders, Attention, Behavior Therapy, Humans
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