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Cited by 70Maternal Mental Health During Pregnancy and PostpartumAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesDigital Mental Health Interventions

Salutary effects of an attention bias modification mobile application on biobehavioral measures of stress and anxiety during pregnancy

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Dennis-Tiwary, Tracy A., Denefrio, Samantha, Gelber, Shari·2017·Biological Psychology
DOI 10.1016/j.biopsycho.2017.05.003PMC PMC5593765
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Abstract

Stress and anxiety during pregnancy are associated with a range of adverse health outcomes, but there is an unmet need for low-barrier treatments that target stress and anxiety. One such treatment approach, attention bias modification training (ABMT), targets the anxiety-related threat bias, a disruption in attention to and neural processing of threat-related information. It remains unclear, however, whether reducing treatment barriers via mobile delivery of ABMT is effective and whether ABMT efficacy varies depending on individual differences in neural processing of threat. The present study tested whether mobile, gamified ABMT reduced prenatal threat bias, anxiety and stress, and whether ABMT efficacy varied with individual differences in neural responses to threat. Participants were 29 women in their 19th-29th week of pregnancy, randomized to four weeks of an ABMT or placebo training (PT) version of the mobile app using a double-blind design. Self-report of anxiety, depression, and stress were obtained; salivary cortisol was collected at home and in lab in response to stressors to index biological stress reactivity. Threat bias was measured using a computerized attention assay during which EEG was recorded to generate event-related potentials (ERPs) to threat cues. Results showed lower levels of lab cortisol following ABMT versus PT. Although the main effect of ABMT on subjective anxiety was not significant, the magnitude of cortisol reduction was correlated with lower levels of subjective anxiety and threat bias. Those receiving ABMT also reported less anxiety when showing smaller ERPs to threat (P1, P2) prior to training, but, conversely reported more anxiety when showing larger ERPs to threat. Use of gamified, mobile ABMT reduced biobehavioral indices of prenatal stress and anxiety, but effects on anxiety varied with individual differences in cortisol response and neurocognitive indices of early attention to threat.

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  • The majority of articles (n = 24) did not deal with the feasibility of the interventions.

    “However, the majority of the articles (n = 24) did not deal with the feasibility of the interventions [20, 35, 36, 38, 40, 43–45, 47, 48, 50, 51, 56, 62, 64, 66, 67, 69, 72–77].”

    From Mental health-related telemedicine interventions for pregnant women and new mothers: a systematic literature review (2023) · cites this paper as [47]

    As applied to this cited article, the claim that it did not deal with feasibility conflicts with its reporting of intervention use and practical difficulties. The Method’s “Participants” section records completion and withdrawal, including a withdrawal caused by technical difficulties; “App use fidelity check” reports usage and missing app-analytics data. This individual paper cannot establish the citing review’s total of 24 articles. (LLM, conf=0.76)

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  • The remaining 14 studies in the review did not mention acceptance.

    “the remaining 14 studies in this review did not mention this issue [35, 36, 40, 44, 47, 50, 56, 66, 67, 69, 73–76].”

    From Mental health-related telemedicine interventions for pregnant women and new mothers: a systematic literature review (2023) · cites this paper as [47]

    The paper’s introductory discussion (indexed under Abstract; page unavailable) explicitly mentions the “acceptability” of treatments during pregnancy and the goal of optimizing treatment acceptability. Thus, this cited study does mention the issue, contrary to the claim that it did not. (LLM, conf=0.85)

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Research works printed but not linked: 2

  1. Hayes AF 2013 Introductionto mediation, moderation, and conditional process analysis: A regression-based approach New York Guilford Press
  2. O’Toole L Dennis TA 2012 Attention training and the threat bias: An ERP study Brain and Cognition 78 1 63 73 10.1016/j.bandc.2011.10.007 22083026 PMC3233611 · DOI

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Authors
Dennis-Tiwary, T. A., Denefrio, S., & Gelber, S.
Affiliations
  • The Graduate Center, CUNY (US)
  • Weill Cornell Medicine (US)
ORCID
Gelber, Shari
Venue
Biological Psychology
Publisher
Elsevier BV
Published
2017-07
Volume
127
Pages
148-156
ISSN
0301-0511 (ISSN-L)
DOI
10.1016/j.biopsycho.2017.05.003
PMC
PMC5593765
OpenAlex
W2611740619
Cited by
70
References
77
Citations by year
2026: 7 · 2025: 6 · 2024: 5 · 2023: 16 · 2022: 9 · 2021: 10 · 2020: 5 · 2019: 4 · 2018: 8
FWCI
4.36
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Biological Psychology (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (UL1TR000457)
  • National Institute of Mental Health (SC1MH104907)
  • National Center for Advancing Translational Sciences
  • National Institute on Minority Health and Health Disparities (G12MD007599)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Keywords
attentional bias modification, pregnancy, prenatal anxiety, prenatal stress, threat bias, mobile health, gamified interventions, salivary cortisol, event-related potentials, individual differences, depression
MeSH terms
Attentional Bias, Adult, Anxiety, Behavior Therapy, Double-Blind Method, Evoked Potentials, Female, Humans, Hydrocortisone, Middle Aged, Pregnancy, Pregnancy Complications, Saliva, Stress, Psychological, Treatment Outcome, Young Adult, Self Report, Mobile Applications

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