Less is more: Patient-level meta-analysis reveals paradoxical dose-response effects of a computer-based social anxiety intervention targeting attentional bias

Rebecca B. Price*, Jennie M. Kuckertz, Nader Amir, Yair Bar-Haim, Per Carlbring, Meredith L. Wallace

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

18 Scopus citations

Abstract

Background: The past decade of research has seen considerable interest in computer-based approaches designed to directly target cognitive mechanisms of anxiety, such as attention bias modification (ABM). Methods: By pooling patient-level datasets from randomized controlled trials of ABM that utilized a dot-probe training procedure, we assessed the impact of training "dose" on relevant outcomes among a pooled sample of 693 socially anxious adults. Results: A paradoxical effect of the number of training trials administered was observed for both posttraining social anxiety symptoms and behavioral attentional bias (AB) toward threat (the target mechanism of ABM). Studies administering a large (>1,280) number of training trials showed no benefit of ABM over control conditions, while those administering fewer training trials showed significant benefit for ABM in reducing social anxiety (P =.02). These moderating effects of dose were not better explained by other examined variables and previously identified moderators, including patient age, training setting (laboratory vs. home), or type of anxiety assessment (clinician vs. self-report). Conclusions: Findings inform the optimal dosing for future dot-probe style ABM applications in both research and clinical settings, and suggest several novel avenues for further research.

Original languageEnglish
Pages (from-to)1106-1115
Number of pages10
JournalDepression and Anxiety
Volume34
Issue number12
DOIs
StatePublished - Dec 2017

Funding

FundersFunder number
Cognitive Retraining Technologies, LLC
National Institute of Mental Health Career Development
National Institute of Mental HealthK23MH100259, K01MH096944
Cetacean Research Technology

    Keywords

    • attention bias modification
    • attention training
    • dose-response
    • patient-level meta-analysis
    • social anxiety

    Fingerprint

    Dive into the research topics of 'Less is more: Patient-level meta-analysis reveals paradoxical dose-response effects of a computer-based social anxiety intervention targeting attentional bias'. Together they form a unique fingerprint.

    Cite this