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Visual search attentional bias modification reduced social phobia in adolescents
Abstract
Background and objectives An attentional bias for negative information plays an important role in the development and maintenance of (social) anxiety and depression, which are highly prevalent in adolescence. Attention Bias Modification (ABM) might be an interesting tool in the prevention of emotional disorders. The current study investigated whether visual search ABM might affect attentional bias and emotional functioning in adolescents.Methods A visual search task was used as a training paradigm; participants (n = 16 adolescents, aged 13-16) had to repeatedly identify the only smiling face in a 4 × 4 matrix of negative emotional faces, while participants in the control condition (n = 16) were randomly allocated to one of three placebo training versions. An assessment version of the task was developed to directly test whether attentional bias changed due to the training. Self-reported anxiety and depressive symptoms and self-esteem were measured pre- and post-training.Results After two sessions of training, the ABM group showed a significant decrease in attentional bias for negative information and self-reported social phobia, while the control group did not. There were no effects of training on depressive mood or self-esteem.Limitations No correlation between attentional bias and social phobia was found, which raises questions about the validity of the attentional bias assessment task. Also, the small sample size precludes strong conclusions.Conclusions Visual search ABM might be beneficial in changing attentional bias and social phobia in adolescents, but further research with larger sample sizes and longer follow-up is needed.
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In the citing paper
“In most ABM training methods, nonthreat targets are more likely to appear in different locations [ 5 0 8 _ T D $ D I F F ] from threat cues, which encourages attention-orienting away from threat.”
From Anxiety and Threat-Related Attention: Cognitive-Motivational Framework and Treatment (2018) · cites this paper as [71]
In the citing paper
“Evidence for the therapeutic efficacy of alternative ABM training methods is limited.”
From Anxiety and Threat-Related Attention: Cognitive-Motivational Framework and Treatment (2018) · cites this paper as [71]
In the citing paper
“Lack of consensus regarding why conventional ABM threat-avoidance training has inconsistent effects (discussed earlier) has encouraged the development of various alternative methods which have preliminary data suggesting efficacy”
From Anxiety and Threat-Related Attention: Cognitive-Motivational Framework and Treatment (2018) · cites this paper as [71]
In the citing paper
“Multi-session emotional face visual search training has mixed effects on nonclinical adolescent anxiety, with problems of poor compliance possibly owing to insufficient goal engagement [71,73,74].”
From Anxiety and Threat-Related Attention: Cognitive-Motivational Framework and Treatment (2018) · cites this paper as [71]
In the citing paper
“Changes in attentional bias have been observed in healthy children (Eldar, Ricon, & Bar-Haim, 2008) and unselected adolescents (de Voogd, Wiers, Prins, & Salemink, 2014), but not when visual search training effects were measured with a dot-probe assessment task (Platt et al., 2015).”
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 de Voogd, Wiers, Prins, & Salemink, 2014
In the citing paper
“In unselected adolescents, the visual search training also reduced social anxiety symptoms (de Voogd et al., 2014), but not depressive symptoms (Platt et al., 2015;de Voogd 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 de Voogd et al., 2014
In the citing paper
“In unselected adolescents, the visual search training also reduced social anxiety symptoms (de Voogd et al., 2014), but not depressive symptoms (Platt et al., 2015;de Voogd 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 de Voogd et al., 2014
In the citing paper
“Consistent with earlier research in youth (Waters, Pittaway, Mogg, Bradley, & Pine, 2013;de Voogd et al., 2014), VS attentional training led to an increased bias for positive information, as assessed with the closely matched EVST, but not with the DPT.”
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 de Voogd et al., 2014
In the citing paper
“Findings from these studies indicate that ABM-positive-search training reduces self-reported stress and cortisol measures of stress reactivity in adults (Dandeneau et al., 2007), social anxiety symptoms in youth (De Voogd et al., 2014) and clinician-rated symptom severity of anxiety disorders in children (Waters et al., 2013(Waters et al., , 2015(Waters et al., , 2016)).”
From Anxiety and attention to threat: cognitive mechanisms and treatment with attention bias modification (2016) · cites this paper as De Voogd et al., 2014
In the citing paper
“Regarding effects of ABM-positive-search training on AB, most studies found changes in AB measures for threat and positive stimuli, although these changes varied across studies.”
From Anxiety and attention to threat: cognitive mechanisms and treatment with attention bias modification (2016) · cites this paper as De Voogd et al., 2014
In the citing paper
“facilitated detection of positive relative to negative faces on the visual-search task in anxious youth (De Voogd et al., 2014)”
From Anxiety and attention to threat: cognitive mechanisms and treatment with attention bias modification (2016) · cites this paper as De Voogd et al., 2014
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“…beneficial emotional outcomes (lower perceived stress, enhanced self-esteem/positive self-regulation: Dandeneau et al., 2007; Dandeneau and Baldwin, 2009; reduced anxiety/social phobia: Waters et al., 2013, 2015, 2016; De Voogd et al., 2014; but see De Voogd et al., 2016, for null findings).”
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Neural mechanism underlying recognition of dynamic emotional faces in social anxiety
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“…(Douglas-Cowie et al., 2007)。除建设 2D 动态情绪面孔库外, Yin 等人(2008) 备制了伯明 翰大学 3D 动态面孔表情库(Birmingham University 3D dynamic facial expression database)。 值得注意的是, 情绪的刺激材料存在显著的 文化差异。以往研究发现人类在识别情绪面孔时 会表现出面孔的异族效应(Other-race effects), 即 识别异族面孔比识别本族面孔更困难(Malpass & Kravitz, 1969)。中国文化与西方文化存在明显的 差异 ,…”
InfluentialTreatment of Anxiety in Children and Adolescents
Dowell, T. L., Donovan, C. L., Farrell, L. J., & Waters, A. M. (2018) · Current Treatment Options in Psychiatry · doi:10.1007/s40501-018-0136-2 · Cited by 6
Sharma, N. P., Dhakal, S., Oliver, A., Gupta, S., Kumari, V., Pandey, R., Niraula, S., & Lau, J. Y. F. (2022) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2022.101765 · Cited by 5
Gall, R., Mcdonald, N., Huang, X., Wears, A., Price, R. B., Ostadabbas, S., Akçakaya, M., & Woody, M. L. (2024) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2024.1360218 · Cited by 5
Attentional Bias Training towards Social Anxiety
Zhao, X., ZHANG, P., & Ling, C. H. E. N. (2014) · Advances in Psychological Science · doi:10.3724/sp.j.1042.2014.01246 · Cited by 5
Efficacy of attention bias modification via smartphones in a large population sample
Chelliah, A., & Robinson, O. J. (2022) · Royal Society Open Science · doi:10.1098/rsos.211629 · Cited by 4
Li, T.-X., & Liang, C. (2024) · Cognitive Therapy and Research · doi:10.1007/s10608-024-10522-9 · Cited by 4
“Although De Voogd et al. (2014) suggested that two sessions of ABM-positive-search training can signifi - cantly reduce social anxiety, the effects of ABM-positive-search training on social anxiety and emotional distress may depend on whether changes in attentional bias can be gen - eralized to…”
el Bouhaddani, S., Veling, W., Schaefer, B., Doreleijers, T., & Domburgh, L. (2018) · Early Intervention in Psychiatry · doi:10.1111/eip.12755 · Cited by 4
Scary in the eye of the beholder: Attentional bias and attentional retraining for social anxiety
Fadardi, J. S., Memarian, S., Parkinson, J. A., Cox, W. M., & Stacy, A. W. (2022) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2022.11.005 · Cited by 4
Kruijt, A., & Carlbring, P. (2018) · doi:10.31234/osf.io/scqf3 · Cited by 7
Ascione, M., Serrano‐Troncoso, E., Carulla‐Roig, M., Martínez, A. B., Álvarez, F. G., Meschberger‐Annweiler, F., Porras-García, B., Ferrer‐García, M., & Gutiérrez‐Maldonado, J. (2024) · Applied Sciences · doi:10.3390/app14114340 · Cited by 3
“Additionally, participants are encouraged to actively search for positive cues within an array of negative or threat cues [20,21].”
BackgroundReducing Pediatric Anxiety through Training: an Integrative Neurocognitive Approach
Britton, J. C., Dellarco, D. V., & Evans, T. C. (2017) · Current Behavioral Neuroscience Reports · doi:10.1007/s40473-017-0118-5 · Cited by 3
Dhakal, S., Gupta, S., Sharma, N. P., Upadhyay, A., Oliver, A., Sumich, A. L., Kumari, V., Niraula, S., Pandey, R., & Lau, J. Y. F. (2023) · Behaviour Research and Therapy · doi:10.1016/j.brat.2023.104267 · Cited by 3
Yuan, J., Shi, G., Zhang, Q., & Cui, L. (2024) · Psychophysiology · doi:10.1111/psyp.14724 · Cited by 3
“Some researchers have made initial attempts at ABM- positive-search training, such as in adolescents or through online interventions (De Voogd et al., 2014, 2017 In terms of methodological perspective, a common issue with most studies on ABM- threat-avoidance training is that they evaluate changes…”
Interpretation and Attentional Bias Training
Salemink, E., Wolters, L. H., & de Haan, E. (2019) · Cambridge University Press eBooks · doi:10.1017/9781108235655.018 · Cited by 3
Self-citationCheie, L., & Prodan, N. (2025) · Journal of Family Research · doi:10.20377/jfr-1087 · Cited by 3
“Attentional biases: Attentional biases toward emotional stimuli were assessed using the Emotional Visual Search Task (de Voogd et al., 2014), a computerized task measuring how quickly participants identify a face with a distinct emotional expression within a 4×4 grid of faces displaying the…”
Yao, H., Wang, S., Shen, L., Zhao, K., & Fu, X. (2025) · Behaviour Research and Therapy · doi:10.1016/j.brat.2025.104844 · Cited by 3
Performance of Working Memory Updating in Socially Anxious Individuals
Yuan, J., Sun, X.-R., Zhang, Q., & Cui, L.-X. (2024) · Depression and Anxiety · doi:10.1155/2024/1799948 · Cited by 4
“Such as in attentional bias modi fi cation, positive-search training, a visual search task for searching a positive stimulus around by negative stimuli, seems more promising in modifying attentional bias in individuals with anxiety [60].”
BackgroundBlankers, M., Salemink, E., & Wiers, R. W. H. J. (2024) · Springer eBooks · doi:10.1007/978-3-031-59936-1_14 · Cited by 2
Self-citationDikstein, H., Mann, T. G., Halevy-Yosef, R., Enoch‐Levy, A., Hamdan, S., Gur, E., Haim, Y. B., Lazarov, A., Treasure, J. L., & Stein, D. J. (2022) · European Eating Disorders Review · doi:10.1002/erv.2957 · Cited by 3
Xiao, W., Zheng, X., Luo, Y., & Peng, J. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.982909 · Cited by 1
Nuijs, M. D., Larsen, H., Klein, A. M., Grasman, R. P. P. P., Wiers, R. W. H. J., de Voogd, E. L., & Salemink, E. (2025) · Cognitive Therapy and Research · doi:10.1007/s10608-024-10565-y · Cited by 1
“Assessments included the STAI-T, EVST, and SOPT (the latter two not at FU1 & FU2).”
InfluentialSelf-citationNuijs, M. D., Larsen, H., Grafton, B., MacLeod, C., Bögels, S. M., Wiers, R. W. H. J., & Salemink, E. (2025) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2025.102030 · Cited by 1
Self-citationModificación de los sesgos atencionales en el tratamiento de la agresividad
León, F. G., & Parra, G. C. (2022) · Edupsykhé Revista de Psicología y Educación · doi:10.57087/edupsykhe.v19i2.4510 · Cited by 2
He, S., Zhao, R., Li, C., Hui, L., Dong, S., Xu, C., & Cui, L. (2024) · Biological Psychology · doi:10.1016/j.biopsycho.2024.108863 · Cited by 1
Sikki, M., Konikkou, K., Konstantinou, N., & Fanti, K. A. (2025) · Experimental Brain Research · doi:10.1007/s00221-025-07040-9 · Cited by 1
“Our approach agrees with the suggestion that multi - session AMT-positive-search training might be a promising intervention for reducing anxiety symptoms (Mogg et al. 2017 ; Dandeneau et al. 2007 ; De Voogd et al. 2014; Waters et al. 2016 ).”
Heitmann, J., & de Jong, P. J. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.626326 · Cited by 1
Cognitive Biases by Information Processing
(2018) · Advances in psychology, mental health, and behavioral studies (APMHBS) book series · doi:10.4018/978-1-5225-2978-1.ch003 · Cited by 1
Thatcher, H. R. (2016) · Liverpool John Moores University · doi:10.24377/ljmu.t.00004488 · Cited by 1
“Phobics also show likewise biases towards threat for phobia-related information (Heinrichs and Hofmann, 2001; Öhman and Mineka, 2001; Bar-Haim et al., 2007; Rapee et al., 2013; De Voogd et al., 2014; Haberkamp and Schmidt, 2015).”
BackgroundLearning, Cognition, and Emotion
Fielding, J. C., Ryan, K. M., & Waters, A. M. (2020) · The Encyclopedia of Child and Adolescent Development · doi:10.1002/9781119171492.wecad182 · Cited by 1
Pilgrim, K. (2015) · Spectrum Research Repository (Concordia University)
Cholabi, S. S., Javadi, M. H., & Shal, R. S. (2020) · Quarterly Journal of Child Mental Health · doi:10.29252/jcmh.7.1.4
Metadata
- Authors
- De Voogd, E. L., Wiers, R. W., Prins, P. J. M., & Salemink, E.
- Affiliations
- University of Amsterdam (NL)
- Venue
- Journal of Behavior Therapy and Experimental Psychiatry
- Publisher
- Elsevier BV
- Published
- 2014-06
- Volume
- 45
- Issue
- 2
- Pages
- 252-259
- ISSN
- 0005-7916 (ISSN-L)
- OpenAlex
- W2030455218
- Cited by
- 111
- References
- 55
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 9 · 2023: 6 · 2022: 8 · 2021: 5 · 2020: 11 · 2019: 10 · 2018: 13 · 2017: 11 · 2016: 12 · 2015: 14 · 2014: 4
- FWCI
- 13.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Behavior Therapy and Experimental Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- UvA-DARE (University of Amsterdam) (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- ZonMw
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- attentional bias modification, visual search, social anxiety disorder, adolescents, attentional bias, anxiety, depression, self-esteem, emotion regulation training
- MeSH terms
- Adolescent, Analysis of Variance, Attention, Female, Humans, Male, Phobic Disorders, Photic Stimulation, Psychiatric Status Rating Scales, Reaction Time, Cognitive Behavioral Therapy, Bias
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