Home-delivered attention bias modification training via smartphone to improve attention control in sub-clinical generalized anxiety disorder: A randomized, controlled multi-session experiment.

Abstract

Mogg and Bradley (2016) proposed that attentional bias (to threat stimuli) among patients with generalized anxiety disorder (GAD) may be associated with the top-down attention control process. Additionally, some scholars (e.g., Enock & McNally, 2013) have designed mobile applications to enable patients to engage in home-delivered attentional bias modification (HD-ABM); however, many problems related to these training systems have not yet been addressed. A total of 82 participants (61 women, mean age = 21.47 y) who received GAD diagnoses were randomly assigned to an HD-ABM (n = 30), placebo training (n = 30), or waiting list (n = 22) group. Both the HD-ABM and placebo groups were trained with the attention training application (through Android phones three times a day for four weeks). (1) All measures of participants' self-reported symptoms (except for trait anxiety) were significantly lower in Week 4 and in the follow-up. (2) Attentional network test (ANT) results demonstrated that all participants' alerting scores significantly increased by Week 4. (3) Participants in the HD-ABM and placebo groups demonstrated significant increases in their self-reported attention control scores, decreases in their attention bias index (ABI) scores, and progress in their executive control abilities. Self-report scales may have been insufficient for measuring effectiveness in the present study. This study helps to elucidate the mechanism underlying changes in attention processes after HD-ABM training implemented through a mobile application in GAD.