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Cited by 540Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesNeural and Behavioral Psychology StudiesPsychological Treatments and Assessments

Attention modification program in individuals with generalized anxiety disorder

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Amir, Nader, Beard, Courtney, Burns, Michelle, Bomyea, Jessica·2009·Journal of Abnormal Psychology
DOI 10.1037/a0012589PMC PMC2645540
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Abstract

Research suggests that individuals with generalized anxiety disorder (GAD) show an attention bias for threat-relevant information. However, few studies have examined the causal role of attention bias in the maintenance of anxiety and whether modification of such biases may reduce pathological anxiety symptoms. In the present article, the authors tested the hypothesis that an 8-session attention modification program would (a) decrease attention bias to threat and (b) reduce symptoms of GAD. Participants completed a probe detection task by identifying letters (E or F) replacing one member of a pair of words. The authors trained attention by including a contingency between the location of the probe and the nonthreat word in one group (Attention Modification Program; AMP) and not in the other (attention control condition; ACC). Participants in the AMP showed change in attention bias and a decrease in anxiety, as indicated by both self-report and interviewer measures. These effects were not present in the ACC group. These results are consistent with the hypothesis that attention plays a causal role in the maintenance of GAD and suggest that altering attention mechanisms may effectively reduce anxiety.

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  • Recent ABM studies find increased ability to improve directed attention away from hypervigilant threat focus and subsequent symptom/impairment improvement, particularly for anxiety disorders.

    “Recent attentional bias modification (ABM) studies find an increased ability to improve directed attention away from a hypervigilant threat focus and subsequent improvement in symptoms and impairment, particularly for anxiety disorders”

    From United we stand: emphasizing commonalities across cognitive-behavioral therapies. (2013) · cites this paper as Amir et al., 2009

    The Discussion reports that the attention modification group showed less bias toward threat and fewer anxiety symptoms than the control group. The Results also report that more participants in that group no longer met diagnostic criteria for generalized anxiety disorder. The paper does not report a separate improvement in impairment, and its findings directly concern GAD rather than anxiety disorders broadly. (LLM, conf=0.85)

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  • Non-CBT treatments such as mindfulness-based interventions or bias modification programs have shown some promise in reducing GAD severity but often did not enroll GAD patients with prominent depression, restore high endstate functioning, or significantly resolve depression when present.

    “non-CBT treatments such as mindfulness-based interventions consisting solely of meditative practice71–73 or bias modification programs74, 75, which may be seen as requiring less effort to deliver, have shown some promise in reducing GAD severity but often did not enroll GAD patients with prominent levels of depression72), restore patients to high endstate functioning75, 76, or significantly resolv”

    From AN OPEN TRIAL OF EMOTION REGULATION THERAPY FOR GENERALIZED ANXIETY DISORDER AND COOCCURRING DEPRESSION. (2015) · cites this paper as [74]

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  • Briefer, more homogeneous interventions have emerged.

    “briefer, more homogeneous interventions have emerged (e.g., ABM; Amir et al., 2009)”

    From United we stand: emphasizing commonalities across cognitive-behavioral therapies. (2013) · cites this paper as Amir et al., 2009

  • Simple computer-based cognitive bias training tasks alter processing biases in non-clinical and clinical groups.

    “These simple, computer-based training tasks have been found to alter processing biases (eg, in attention) in both non-clinical (Browning et al, 2010b; MacLeod et al, 2002) and clinical groups (Amir et al, 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 Amir et al, 2009

  • After promising preclinical studies, first successful clinical applications of attentional bias modification have been reported in targeted prevention and in clinically anxious patient groups, with maintenance of clinical improvement four months after training.

    “After promising preclinical studies (MacLeod et al., 2002), first successful clinical applications have been reported in targeted prevention (See et al., 2009) and in clinically anxious patient groups (Amir et al., 2009;Schmidt et al., 2009), and targeted prevention (See et al., 2009) with maintenance of clinical improvement reported four months after the training (Schmidt et al., 2009).”

    From Addiction, adolescence, and the integration of control and motivation (2011) · cites this paper as Amir et al., 2009

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Research works printed but not linked: 3

  1. Ballenger JC Davidson JRT Lecrubier Y Nutt DJ Borkovec TD Rickels K Stein DJ Wittchen HU 2001 Consensus statement on generalized anxiety disorder Journal of Clinical Psychiatry 62 53 58 11414552
  2. Barlow DH DiNardo PA Vermilea BB Vermilyea J Blanchard EB 1986 Co-morbidity and depression among the anxiety disorders: Issues in diagnosis and classification The Journal of Nervous and Mental Disease 174 63 72 3944596
  3. First MB Spitzer RL Gibbon M Williams JB 1994 Structured clinical interview for DSM-IV-patient edition (SCID-I/P, version 2.0) New York Biometrics Research Department

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Authors
Amir, N., Beard, C., Burns, M., & Bomyea, J.
Affiliations
  • San Diego State University (US)
  • University of Georgia (US)
ORCID
Venue
Journal of Abnormal Psychology
Publisher
American Psychological Association (APA)
Published
2009-02
Volume
118
Issue
1
Pages
28-33
ISSN
  • 0021-843X (ISSN-L)
  • 1939-1846
DOI
10.1037/a0012589
PMC
PMC2645540
OpenAlex
W2039854536
Cited by
539
References
27
Citations by year
2026: 7 · 2025: 7 · 2024: 8 · 2023: 10 · 2022: 10 · 2021: 21 · 2020: 23 · 2019: 38 · 2018: 31 · 2017: 30 · 2016: 30 · 2015: 52 · 2014: 56 · 2013: 37 · 2012: 45
FWCI
74.06
Type
journal article
Language
en
Open access
Locations
  • Journal of Abnormal Psychology (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institutes of Health (R34 MH073004-01; R34 MH077129-01)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
  • Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
Keywords
generalized anxiety disorder, attentional bias, threat attention, anxiety maintenance, attention training, anxiety symptoms
MeSH terms
Adult, Anxiety Disorders, Attention, Educational Status, Female, Humans, Male, Mental Processes, Severity of Illness Index, Vocabulary, Cognitive Behavioral Therapy, Diagnostic and Statistical Manual of Mental Disorders

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