Attention-Bias Modification May Benefit Adolescents With MDD

Adolescents with major depressive disorder who performed a computer-based task designed to shift their attention from negative to positive stimuli over the course of several weeks showed greater reductions in self-reported depressive and anxious symptoms 12 months later than those attending equally to neutral and sad stimuli, according to a study appearing in the March issue of the Journal of the American Academy of Child & Adolescent Psychiatry. The findings suggest that this technique, known as attention-bias modification (ABM), may offer a potential treatment tool for treating youth with mild to moderate depression.

Adults and adolescents with depression, as well as adolescents at risk for MDD, often show a biased attention to sad-related negative stimuli and an absence of biases toward positive stimuli. During ABM treatment, participants are exposed to pairs of words that differ in emotional valence for a short period, followed by a probe that is more frequently presented in the location of the neutral stimuli than the negative ones. Several studies have found that ABM decreases depressive symptoms in adults, but little is known of whether such findings extend to youth with depression.

Researchers in China randomly assigned 45 youth with MDD in grades 7 to 12 who were not receiving psychotherapy and/or pharmacotherapy to an active ABM intervention or placebo ABM training. Participants in the active ABM group first completed eight 20-minute ABM sessions over two weeks designed to shift participants’ attention away from sad words to neutral words. At a nine-week follow-up, participants completed four 30-minute ABM sessions over two weeks that were designed to shift attention to positive words. The participants in the placebo group performed the same number of ABM sessions, but attention was directed toward neutral and sad words equally often. Attentional biases and depressive symptoms were assessed before and after each training period, and depressive symptoms were reassessed at eight- and 12-month follow-ups.

The authors found that adolescents in the active ABM group showed larger reductions in both negative attention bias and clinician-rated depressive symptoms and higher remission rates after the initial two-week intervention compared with adolescents performing the same task but attending equally to neutral and sad words. Greater reductions in self-reported depressive and anxious symptoms at a 12-month follow-up were also found in adolescents who completed the active ABM task.

“Our findings are consistent with a growing body of literature demonstrating that modifying cognitive biases directly through computerized tasks can be beneficial for psychopathology in youth with depressive symptoms and anxiety,” the authors wrote. “More generally, results support cognitive conceptualizations of depression proposing that negative biases in attention may be causally related to the maintenance of depressive symptoms.”

For related information, see the Psychiatric News article “Attention-Control Training Reduces PTSD Symptoms.”

(Image: iStock/Rasica)