Mental Health on the Go: Effects of a Gamified Attention-Bias Modification Mobile Application in Trait-Anxious Adults
Open accessAbstract
Interest in the use of mobile technology to deliver mental-health services has grown in light of the economic and practical barriers to treatment. Yet research on alternative delivery strategies that are more affordable, accessible, and engaging is in its infancy. Attention-bias modification training (ABMT) has the potential to reduce treatment barriers as a mobile intervention for stress and anxiety, but the degree to which ABMT can be embedded in a mobile gaming format and its potential for transfer of benefits is unknown. In the present study, we examined effects of a gamified ABMT mobile application in highly trait-anxious participants ( N = 78). A single session of the active training relative to the placebo training reduced subjective anxiety and observed stress reactivity. Critically, the long (45 min) but not the short (25 min) active training condition reduced the core cognitive process implicated in ABMT (threat bias) as measured by an untrained, gold-standard protocol.
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Dennis and O'Toole (2014) found rewards (points) associated with reduced subjective anxiety and stress reactivity in highly trait-anxious participants.
“With a group of highly trait-anxious participants, Dennis and O'Toole (2014) found rewards (in the form of points) associated with reduced subjective anxiety and stress reactivity.”
From Gamification for health and wellbeing: A systematic review of the literature (2016) · cites this paper as Dennis and O'Toole (2014)
The Method (Measures; page not supplied) says participants earned points during the app task. The Results (Effects of Training Condition on Anxious Mood and Stress Reactivity; page not supplied) report reduced subjective anxiety for short-training ABMT, and the Discussion reports reduced stress reactivity. The paper does not establish that points or rewards themselves were associated with those reductions; its reported associations concern training condition and changes in threat bias. (LLM, conf=0.88)
Experimental — accuracy not yet measuredDennis and O'Toole (2014) found a gamified mobile attention-bias modification training using virtual characters significantly reduced subjective anxiety and stress reactivity compared to placebo.
“Dennis and O'Toole (2014) compared a gamified mobile attention-bias modification training for anxiety using virtual characters with a placebo training and found it to significantly reduce subjective anxiety and stress reactivity.”
From Gamification for health and wellbeing: A systematic review of the literature (2016) · cites this paper as Dennis and O'Toole (2014)
ABM threat-avoidance training is repetitious and boring, which may reduce treatment compliance.
“ABM threat-avoidance training is also repetitious and boring, which may reduce treatment compliance [20,21].”
From Anxiety and Threat-Related Attention: Cognitive-Motivational Framework and Treatment (2018) · cites this paper as [20]
Lack of consensus about why conventional ABM has inconsistent effects has encouraged development of alternative methods with preliminary efficacy data.
“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 [20]
Preliminary nonclinical studies report short-term positive effects with several ABM methods.
“Preliminary nonclinical studies report short-term positive effects (e.g., reduced stress reactivity after singlesession training) with several methods (A-FACT, gamified ABM, person-identity matching, emotional face visual search training) [18,20,68,70].”
From Anxiety and Threat-Related Attention: Cognitive-Motivational Framework and Treatment (2018) · cites this paper as [20]
Evidence for therapeutic efficacy of alternative ABM training methods is limited.
“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 [20]
In most ABM training methods, nonthreat targets are more likely to appear in different locations from threat cues, encouraging attention-orienting away from threat.
“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 [20]
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- Authors
- Dennis, T. A., & O’Toole, L. J.
- Affiliations
- The Graduate Center, CUNY (US)
- Corresponding author
- Dennis, Tracy A.
- ORCID
- O’Toole, Laura J.
- Venue
- Clinical Psychological Science
- Publisher
- SAGE Publications
- Published
- 2014-03-06
- Volume
- 2
- Issue
- 5
- Pages
- 576-590
- ISSN
- 2167-7026 (ISSN-L)
- 2167-7034
- PMC
- PMC4447237
- OpenAlex
- W2037416608
- Cited by
- 197
- References
- 78
- Citations by year
- 2026: 9 · 2025: 9 · 2024: 11 · 2023: 11 · 2022: 22 · 2021: 13 · 2020: 21 · 2019: 17 · 2018: 31 · 2017: 14 · 2016: 22 · 2015: 13 · 2014: 4
- FWCI
- 27.47
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Psychological Science (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (K01MH075764)
- National Institute of General Medical Sciences (S06GM060654)
- National Center for Research Resources (G12RR003037)
- National Institute on Minority Health and Health Disparities (G12MD007599)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Developmental and Educational Psychology › Educational Games and Gamification
- Keywords
- attentional bias modification, mobile mental health intervention, gamified mobile application, anxiety, stress reactivity, trait anxiety, threat bias, barriers to treatment, training duration
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