A randomized controlled trial of gaze-contingent music reward therapy for major depressive disorder

Dana Shamai-Leshem*, Amit Lazarov, Daniel S. Pine, Yair Bar-Haim

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Heightened attention allocation toward negative-valanced information and reduced attention allocation toward positive-valanced information represent viable targets for attention bias modification in major depressive disorder. Accordingly, we conducted a randomized controlled trial testing the efficacy of a novel gaze-contingent attention bias modification procedure for major depressive disorder. Method: Sixty patients with major depressive disorder were randomly assigned to either eight training sessions of feedback-based gaze-contingent music reward therapy designed to divert patients’ gaze toward positive over sad stimuli, or to a control condition which entailed eight sessions of gaze-noncontingent music. Clinician-rated and self-reported measures of depression, and proportion of dwell-time on sad faces, were assessed pretreatment, posttreatment, and at a 3-month follow-up. Results: Gaze-contingent music reward therapy produced a greater reduction in dwell-time on sad faces compared with the control condition, but it failed to generalize to novel faces. Both groups manifested similarly significant reductions in depression symptoms from pre- to posttreatment that were maintained at follow-up. Exploratory analyses suggest that first-episode patients may benefit more from this therapy than patients with a history of multiple episodes. Conclusions: Gaze-contingent music reward therapy can modify attention biases in depression, but clear differential clinical effects did not emerge. Theoretical and practical implications are discussed.

Original languageEnglish
Pages (from-to)134-145
Number of pages11
JournalDepression and Anxiety
Issue number2
StatePublished - Feb 2020


  • attention
  • attention allocation
  • attention bias
  • attention bias modification
  • depression
  • eye tracking
  • major depressive disorder


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