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Moderation and mediation of the effect of attention training in social anxiety disorder
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UNLABELLED: While attention modification programs (AMP) have shown promise as laboratory-based treatments for social anxiety disorder, trials of internet-delivered AMP have not yielded significant differences between active and control conditions. To address these inconsistencies, we examined the moderational and mediational role of attention bias in the efficacy of attention training. We compared data reported by Carlbring et al. (2012) to an identical AMP condition, with the exception that participants were instructed to activate social anxiety fears prior to each attention training session (AMP + FACT; n = 39). We also compared all attention training groups to an internet-delivered cognitive-behavioral therapy (iCBT) condition (n = 40). Participants in the AMP + FACT group experienced greater reductions in social anxiety symptoms than both active (n = 40) and control (n = 39) groups reported by Carlbring et al., and did not differ in symptom reductions from the iCBT group. Higher attention bias predicted greater symptom reductions for participants who completed AMP, but not for the control group. Moreover, change in attention bias mediated the relationship between AMP group (active condition reported by Carlbring et al. versus AMP + FACT) and change in social anxiety symptoms. These results suggest the importance of interpreting findings related to symptom change in attention training studies in the context of bias effects. TRIAL REGISTRATION: ISRCTN01715124.
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“This implies that a change in attentional bias is the hypothesized mediating process, and some studies indeed found such a mediational role of attentional bias (Dennis & O'Toole, 2014;Kuckertz et al., 2014;Wells & Beevers, 2010).”
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 Kuckertz et al., 2014
In the citing paper
“As previous research has shown that baseline attentional bias moderated training effects (e.g., Boettcher et al., 2013;Kuckertz et al., 2014)”
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 Kuckertz et al., 2014
In the citing paper
“The absence of (social) stress with online training at home compared to lab studies might explain recent null findings (Boettcher, Berger, & Renneberg, 2012;Boettcher et al., 2013;Kuckertz et al., 2014).”
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 Kuckertz et al., 2014
In the citing paper
“in one Internetbased ABMT study, Kuckertz et al. [34] found that participants instructed to activate their social anxiety fears prior to each ABMT session demonstrated significantly greater anxiety reductions than participants receiving ABMT without these additional instructions.”
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Metadata
- Authors
- Kuckertz, J. M., Gildebrant, E., Liliequist, B., Karlström, P., Väppling, C., Bodlund, O., Stenlund, T., Hofmann, S. G., Andersson, G., Amir, N., & Carlbring, P.
- Affiliations
- San Diego State University (US)
- Umeå University (SE)
- Boston University (US)
- Linköping University (SE)
- Stockholm University (SE)
- Corresponding author
- Carlbring, Per
- ORCID
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2014-02
- Volume
- 53
- Pages
- 30-40
- ISSN
- 0005-7967 (ISSN-L)
- OpenAlex
- W2109887133
- Semantic Scholar
- 8bf902d5e8e651df5fe28f911d5b1f29ed2bfdfc
- Cited by
- 117
- References
- 65
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 5 · 2023: 3 · 2022: 7 · 2021: 11 · 2020: 7 · 2019: 12 · 2018: 14 · 2017: 10 · 2016: 17 · 2015: 15 · 2014: 7
- FWCI
- 17.61
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Behaviour Research and Therapy (publishedVersion, cc-by)
- PubMed (publishedVersion)
- KTH Publication Database DiVA (KTH Royal Institute of Technology) (submittedVersion, other-oa)
- DiVA at Umeå University (Umeå University) (submittedVersion, other-oa)
- Funders
- Swedish Research Council for Health, Working Life and Welfare
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- social anxiety disorder, attention training, attentional bias, internet-based cognitive behavioral therapy, mediation, moderation, symptom change
- MeSH terms
- Adult, Attention, Female, Humans, Male, Middle Aged, Phobic Disorders, Social Behavior, Cognitive Behavioral Therapy, Treatment Outcome, Internet, Young Adult
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