Index Of Attentional Bias Research Articles

Eyes on the body: Assessing attentional bias toward body-related stimuli in Anorexia Nervosa.

The aim of the present study was to assess whether patients with Anorexia Nervosa (AN) presented an attentional bias toward pictures of other women's bodies, as this bias could implicitly promote self-other comparisons thus increasing body/weight concerns. The sample included 48 healthy controls (HC) and 54 patients with AN. All participants performed a dot-probe task with pictures of bodies or body parts of underweight (UWB), normal weight (NWB) and overweight (OWB) women, while their gaze was recorded with an eye-tracking system. Two indices of attentional bias, a gaze direction bias and a gaze duration bias were extracted. The models conducted on both direction bias and duration bias showed a significant main effect of group, revealing a stronger attentional bias toward bodies in patients as compared to controls. One sample t-tests conducted on the direction bias of patients with AN revealed that they presented a significant positive bias at 500 ms toward all the bodies. At 1500 ms, instead, they presented a positive bias toward UWB and an avoidance bias of OWB. HC instead presented an initial avoidance of all body stimuli, and an avoidance of NWB and OWB at 1500 ms. Our results revealed a stronger attentional bias toward other women's bodies in patients than in HC. Moreover, patients presented a tendency to focalize their attention on UWB while they avoided maintaining their attention on OWB. This pattern might promote upward social comparisons, which are usually associated with negative self-evaluation and increased levels of body dissatisfaction.

The free-viewing matrix task: A reliable measure of attention allocation in psychopathology

Aberrant attention allocation has been implicated in the etiology and maintenance of a range of psychopathologies. However, three decades of research, relying primarily on manual response-time tasks, have been challenged on the grounds of poor reliability of its attention bias indices. Here, in a large, multisite, international study we provide reliability information for a new eye-tracking-based measure of attention allocation and its relation to psychopathology and age. Data from 1567 participants, across a wide range of psychiatric diagnoses and ages, were aggregated from nine sites around the world. Of these, 213 participants also provided retest data. Acceptable overall internal consistency and test-retest reliability were observed among adult participants (Cronbach’s alpha = 0.86 and r(213) = 0.89, respectively), as well as across all examined psychopathologies. Youth demonstrated lower internal consistency scores (Cronbach’s alpha = 0.65). Finally, the percent dwell time index derived from the task statistically differentiated between healthy participants and participants diagnosed with social anxiety disorder, major depression, and post-traumatic stress disorder. These results potentially address a long-standing reliability crisis in this research field. Aberrant attention allocation patterns in a variety of psychiatric disorders may be targeted with the hope of affecting symptoms. The attention allocation index derived from the matrix task offers reliable means to measure such cognitive target engagement in clinical contexts.

Reliability (or lack thereof) of smartphone ecological momentary assessment of visual dot probe attention bias toward threat indices

Background and objectivesCognitive bias theories posit that generalized anxiety disorder (GAD) and social anxiety disorder (SAD) are entwined with attention bias toward threats, commonly indexed by faster response time (RT) on threat-congruent (vs. threat-incongruent) trials on the visual dot probe. Moreover, although smartphone ecological momentary assessment (EMA) of the visual dot probe has been developed, their psychometric properties are understudied. This study thus aimed to assess the reliability of 8 smartphone-delivered visual dot probe attention bias and related indices in persons with and without GAD and SAD. MethodsCommunity-dwelling adults (n = 819; GAD: 64%; SAD: 49%; Mixed GAD and SAD: 37%; Non-GAD/SAD Controls: 24%) completed a five-trial smartphone-delivered visual dot probe for a median of 60 trials (12 sessions x 5 trials/session) and an average of 100 trials (20 sessions x 5 trials/session). ResultsAs hypothesized, Global Attention Bias Index, Disengagement Effect, and Facilitation Bias had low-reliability estimates. However, retest-reliability and internal reliability were good for Trial-Level Bias Scores (TLBS) (Bias Toward Treat: intra-class correlation coefficients (ICCs) = 0.626–0.644; split-half r = 0.640–0.670; Attention Bias Variability: ICCs = 0.507–0.567; split-half r = 0.520–0.580) and (In)congruent RTs. Poor retest-reliability and internal reliability estimates were consistently observed for all traditional attention bias and related indices but not TLBS. LimitationsOur visual dot probe EMA should have administered ≥320 trials to match best-practice guidelines based on similar laboratory studies. ConclusionsFuture research should strive to examine attention bias paradigms beyond the dot-probe task that evidenced meaningful test-retest reliability properties in laboratory and real-world naturalistic settings.

(A Lack of) Sex Differences in the Effects of Acute Stress on Attentional Bias to Threat

Attentional bias (i.e., a bias toward processing certain stimuli) can be influenced by context, motivation, and state. Prior work has suggested that stress may affect attentional bias to threat, but there is inconsistency in this work with respect to how stress influences it—if it does at all. Some evidence suggests that sex differences may exist in stress effects on attentional bias, but to date no experiment has tested this possibility. We addressed the above by investigating the effects of an acute stressor, a Zoom-adapted Trier Social Stress Test, on attentional bias to threat and positive stimuli using a facial dot-probe task (N=150, 89 women). Salivary cortisol was measured pre- and post-manipulation to verify stress induction and assess the association of cortisol with attentional bias. Although participants showed expected attentional bias to threat, we found no effect of stress nor a stress by sex interaction on attentional bias to threatening or positive stimuli. We did, however, find an interaction between stress and sex in overall reaction time, such that stressed women responded faster than control women. Associations with cortisol and computationally modeled estimates of attention will be presented. Although we observed significant attentional biases to threat as well as stress-induced differences in overall reaction time, we found no evidence indicating that stress affects behavioral indices of attentional bias in either men or women within our paradigm.

Attentional biases in facial emotion processing in individuals at clinical high risk for psychosis.

Individuals at clinical high risk (CHR) for psychosis exhibit altered facial emotion processing (FEP) and poor social functioning. It is unclear whether FEP deficits result from attentional biases, and further, how these abnormalities are linked to symptomatology (e.g., negative symptoms) and highly comorbid disorders that are also tied to abnormal FEP (e.g., depression). In the present study, we employed an eye-tracking paradigm to assess attentional biases and clinical interviews to examine differences between CHR (N = 34) individuals and healthy controls (HC; N = 46), as well as how such biases relate to symptoms and functioning in CHR individuals. Although no CHR-HC differences emerged in attentional biases, within the CHR group, symptoms and functioning were related to biases. Depressive symptoms were related to some free-view attention switching biases (e.g., to and from fearful faces, r = .50). Negative symptoms were related to more slowly disengaging from happy faces (r = .44), spending less time looking at neutral faces (r = - .42), and more time looking at no face (Avolition, r = .44). In addition, global social functioning was related to processes that overlapped with both depression and negative symptoms, including time looking at no face (r = - .68) and free-view attention switching with fearful faces (r = - .40). These findings are consistent with previous research, indicating that negative symptoms play a prominent role in the CHR syndrome, with distinct mechanisms relative to depression. Furthermore, the results suggest that attentional bias indices from eye-tracking paradigms may be predictive of social functioning.

The COVID-19 anxiety syndrome and selective attentional bias towards COVID-19-related stimuli in UK residents during the 2020-2021 pandemic.

The psychological and social effects of the COVID‐19 pandemic are pervasive, and there is potential for a long‐lasting impact on mental health. In the current study, we sought to provide, in a representative sample of UK residents during the third COVID‐19 lockdown in February 2021, further evidence for the validation of the COVID‐19 anxiety syndrome construct. We did this by evaluating the COVID‐19 anxiety syndrome against measures of personality, health anxiety and COVID‐19 anxiety in predicting levels of generalized anxiety and depression and by examining whether increased health anxiety and COVID‐19 psychological distress (COVID‐19 anxiety and COVID‐19 anxiety syndrome) scores were associated with increased attentional bias to COVID‐19‐related stimuli. A series of correlation analyses revealed that neuroticism, health anxiety, COVID‐19 anxiety and COVID‐19 anxiety syndrome scores were positively and significantly correlated with generalized anxiety and depression scores and that the perseveration component of the COVID‐19 anxiety syndrome predicted generalized anxiety and depression scores independently of age, gender, conscientiousness, openness, health anxiety and COVID‐19 anxiety. Furthermore, results indicated that only the total COVID‐19 anxiety syndrome score and the scores on the avoidance and perseveration components were positively and significantly correlated with attentional bias indices. More specifically, the general attentional bias index was only shown to be positively and significantly correlated with the total COVID‐19 anxiety syndrome score and its perseveration component, while slowed disengagement was only shown to be negatively and significantly correlated with the total COVID‐19 anxiety syndrome score and its avoidance component. The implications of these findings are discussed.

Implementation of the diffusion model on dot-probe task performance in children with behavioral inhibition.

Attentional bias to threat, the process of preferentially attending to potentially threatening environmental stimuli over neutral stimuli, is positively associated with behavioral inhibition (BI) and trait anxiety. However, the most used measure of attentional bias to threat, the dot-probe task, has been criticized for demonstrating poor reliability. The present study aimed to assess whether utilizing a sequential sampling model to describe performance could detect adequate test-retest reliability for the dot-probe task, demonstrate stronger cueing effects, and improve the association with neural signals of early attention. One hundred and twenty children aged 9-12years completed the dot-probe task twice. During the second administration, event-related potentials (ERPs) were obtained as time-sensitive neural markers of attention. BI was not associated with traditional or diffusion model measures of performance. Traditional and diffusion model measures of performance were also not associated with N1, P2, or N2 ERP amplitude. There were main effects of Visit, in which RTs were faster and standard deviation of RT smaller during the second administration due to an increase in drift rate and a decrease in non-decision time. The traditional RT bias score (r = 0.06) and bias scores formed via diffusion model parameters (all r's < 0.40) all demonstrated poor reliability. Results confirm recommendations to move away from using the dot-probe task as the primary or sole index of attentional bias.

A Pictorial Dot Probe Task to Assess Food-Related Attentional Bias in Youth With and Without Obesity: Overview of Indices and Evaluation of Their Reliability.

Several versions of the dot probe detection task are frequently used to assess maladaptive attentional processes associated with a broad range of psychopathology and health behavior, including eating behavior and weight. However, there are serious concerns about the reliability of the indices derived from the paradigm as measurement of attentional bias toward or away from salient stimuli. The present paper gives an overview of different attentional bias indices used in psychopathology research and scrutinizes three types of indices (the traditional attentional bias score, the dynamic trial-level base scores, and the probability index) calculated from a pictorial version of the dot probe task to assess food-related attentional biases in children and youngsters with and without obesity. Correlational analyses reveal that dynamic scores (but not the traditional and probability indices) are dependent on general response speed. Reliability estimates are low for the traditional and probability indices. The higher reliability for the dynamic indices is at least partially explained by general response speed. No significant group differences between youth with and without obesity are found, and correlations with weight are also non-significant. Taken together, results cast doubt on the applicability of this specific task for both experimental and individual differences research on food-related attentional biases in youth. However, researchers are encouraged to make and test adaptations to the procedure or computational algorithm in an effort to increase psychometric quality of the task and to report psychometric characteristics of their version of the task for their specific sample.

Relationship Between Attention Bias and Psychological Index in Individuals With Chronic Low Back Pain: A Preliminary Event-Related Potential Study.

Introduction: Attention bias towards pain-related information exists in patients with chronic pain, and recently, attention bias modification (ABM) training has been administered to patients with chronic pain. In this study, we conducted an attention bias modification task in conjunction with event-related potential measurements for individuals with chronic low back pain (LBP) and investigated the relationship between attention bias and psychological assessment.Methods: Eleven women and two men with chronic LBP participated in the study.Results: The Japanese version of the STarT Back Screening Tool (J-SBST) total score was significantly correlated with the N1 amplitude of Cz. The J-SBST psychological score was significantly correlated with the N1 amplitude of Cz and with reaction time (RT). The Japanese version of the Pain Catastrophizing Scale (PCS) and Japanese version of the Beck Depression Inventory-Second Edition (BDI-II) scores were significantly correlated with the P2 amplitude at Fz (only PCS), Cz, and Pz.Conclusions: Our findings suggest that J-SBST, which provides a comprehensive evaluation of psychological factors, PCN with measuring of catastrophizing in the context of actual or anticipated pain, and BDI-II, can likely help identify chronic LBP patients with attention bias. For chronic LBP patients who are classified according to J-SBST or PCN pain-related outcome improvement with ABM training can be expected.

Evaluating the reliability of attention bias and attention bias variability measures in the dot-probe task among people with social anxiety disorder.

The dot-probe task is a widely used experimental paradigm that evaluates attention biases within anxiety disorders. Considerable research has focused on improving the reliability of dot-probe scores because the task's original attention bias index has shown very low test-retest reliability. The current study serves as a replication and extension of Price et al. (2015), who systematically examined the effects of methodological choices on reliability of dot-probe task results. Fifty-six adults diagnosed with social anxiety disorder were asked to complete a facial dot-probe task twice, approximately 1 week apart. Test-retest reliability and internal consistency were examined for 10 dot-probe attention bias indices across 55 sets of outlier cutoffs. Both Pearson's r and intraclass correlation coefficients were used. Trial-level bias score indices of mean bias toward threat and attention bias variability, which measure attention bias dynamically using individual pairs of trials, demonstrated the highest reliability and were less sensitive to changes in outlier cutoffs as compared with the dot probe's classic attention bias index and others. Results demonstrate the potential for post hoc outlier cutoff selection to artificially inflate reliability, particularly for unreliable indices. A priori cutoff selection is recommended for future research. Intraclass correlation coefficients are also recommended for assessment of reliability because Pearson's r does not account for poor agreement between scores. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Mechanisms of cross-modal selective attentional bias for negative faces of anger and disgust in high-trait anxiety individuals.

Research reveals that selective attentional bias to socially negative information is a reliable characteristic of individuals with high-trait anxiety (HTA). However, for selective attentional bias across sensory channels (visual and auditory), the interaction between attentional bias type and negative face type remains unclear. In this study, we recruited 30 individuals with high- and low-trait anxiety (LTA) (15 in each group), and measured their engagement and disengagement bias indices using the cross-modal attentional-probe paradigm, and measured the occipital P1 component using a 64-channel electroencephalography system. The results showed that under the engagement condition in the HTA group, the occipital P1 amplitude of an angry face was smaller than that of a neutral face, and there also exhibited smaller attentional bias indices of angry faces in the HTA group than that of the LTA group. For the presence of disgusted faces, the attentional bias indices of the HTA group were smaller than that of the LTA group under the disengagement condition. These findings demonstrate that the selective attentional bias occurs both in the engagement and the disengagement facets within the cross modal. There is a feature of facilitated attentional engagement bias for an angry face, and a feature of promoted attentional disengagement bias for a disgusted face in HTA individuals.

Effects of Different Graphic Health Warning Types on the Intention to Quit Smoking.

Anti-smoking advertisements are widely used to demonstrate to smokers the harm of smoking, and graphic health warnings (GHWs) are expected to have a positive effect on the intention to quit smoking. This study investigated which type of GHW (health-related threat (H-GHW) vs. social threat (S-GHW)) is more effective. Two types of GHWs for tobacco were shown to 28 daily smokers and 25 non-smokers while measuring their eye movements using an eye tracker. The time spent fixating on the GHWs was measured as an index of attentional bias. Participants were also asked to evaluate the unpleasantness of the images. They stated their intention to quit smoking in response to each image in a separate session. Multiple regression analysis was used to identify the effects of psychosocial factors on the intention to quit smoking in smokers and the intention to remain as non-smokers in the non-smokers. Both smokers and non-smokers reported greater unpleasantness and cessation intentions in response to H-GHWs than to S-GHWs. Non-smokers found both types of GHWs more unpleasant than smokers did. No differences were found in gaze fixation on GHWs between the two groups. When smokers viewed S-GHWs, the intention to quit smoking was greater as they felt more unpleasant. For non-smokers, the intention to remain non-smokers was greater when they felt more unpleasant and when the attention to H-GHWs was lower. Different psychological factors in anti-smoking advertisements are involved in the intention to quit smoking in smokers and to maintain a non-smoking status in non-smokers. Different approaches should be used according to the types of warning (e.g., warnings emphasizing a negative influence on others or on their own health) in anti-smoking campaigns.

Attentional bias for alcohol cues in visual search—Increased engagement, difficulty to disengage or both?

Cognitive models emphasise the importance of attentional bias in addiction. However, many attentional bias tasks have been criticised for questionable psychometric properties and inability to differentiate between engagement and disengagement processes. This study therefore examined the suitability of two alternative tasks for assessing attentional bias within the context of alcohol use. Participants were undergraduate students (N = 169) who completed the Visual Search Task and Odd-One-Out Task, the latter of which is designed to differentiate between engagement and disengagement processes of attention, at baseline and one week later. Participants also completed baseline measures of alcohol consumption, craving, and alcohol use problems. Internal consistency was adequate for the Visual Search Task index, and weak for the Odd-One-Out Task indices. Test-retest reliability was weak for both tasks. The Visual Search Task index and the disengagement (but not the engagement) index of the Odd-One-Out Task showed a positive association with alcohol consumption. This study was restricted to a non-clinical student sample. The relatively high error rate of the Odd-One-Out Task might have reduced its sensitivity as an index of attentional bias. Both tasks showed some merit as attentional bias measures, and results suggested that attentional disengagement might be particularly related to alcohol use. However, the reliability of the current measures was inadequate. One potential explanation for the low reliability is that non-clinical samples may have weak and unstable attentional biases to alcohol. Future efforts should be made to improve the psychometric qualities of both tasks and to administer them in a clinical sample.

Attention bias towards threat in African American children exposed to early life trauma

BackgroundAttentional bias is linked to a range of mood disorders, including posttraumatic stress disorder (PTSD). The present study examined attention bias patterns in African American children exposed to trauma, in order to better understand potential risk factors for PTSD. Methods31 children (ages 8–14) completed an eye-tracking task to assess gaze bias patterns while viewing pairs of emotional and neutral faces. Trauma exposure and PTSD symptoms were assessed in a subsample of children (n = 24). ResultsRepeated measures analysis of variance (ANOVA) results examining attention bias indices and gender showed greater attention bias toward angry faces than happy faces (p < 0.01) and toward emotional faces in males than females (p < 0.05). Correlational analyses showed attention bias toward angry faces was associated with greater levels of child trauma exposure (p < 0.05). Based on linear regression analysis, child trauma exposure accounted for 17 % of variance in attention bias toward angry versus neutral faces independent of gender or posttraumatic stress symptoms (p < 0.05). ConclusionsTrauma exposure in children is related to altered attention bias, via enhanced attention towards threatening cues. Results contribute to evidence that males and females may exhibit different attentional patterns. This study highlights the importance of additional research on attention bias patterns and prospective mental health outcomes across gender and through development.

Social anxiety and attentional bias variability: electrophysiological evidence of attentional control deficits.

Attentional control has an important role in attentional bias in social anxiety. This study aimed to investigate whether attentional bias in social anxiety was caused by attentional control deficit. Event-related potentials and behavioural attentional bias index (trial-level attentional bias variability) were recorded as participants completed the dot-probe task. The behaviour result showed that compared with the low socially anxious individuals, the high socially anxious individuals had a marginally higher score of attentional bias variability. For event-related potentials results, target-locked frontocentral N2 amplitude was significantly larger under the incongruent condition than the congruent condition in the low socially anxious group, whereas there was no significant difference between these two conditions in the high socially anxious group. The low socially anxious group also exhibited reduced target-locked P2 amplitude from the congruent condition to the incongruent condition. Our findings provide electrophysiological evidence of attentional control dysregulation in socially anxious individuals, which contributes to modifying social anxiety-related attentional bias.

Attention biases in perfectionism: Biased disengagement of attention from emotionally negative stimuli

Background and objectivesPerfectionism is associated with the development and maintenance of several psychological disorders. Consequently, efforts to better understand perfectionism have potential transdiagnostic impact. One mechanism proposed to underlie perfectionism is an attention bias towards information signalling threats to perfectionism whereby people with elevated perfectionism selectively attend to threatening stimuli. MethodThe present study assessed whether two core dimensions of perfectionism, perfectionistic strivings and perfectionistic concerns, are characterised by a threat-related attention bias, and whether this bias was characterised by attention being more rapidly captured by the stimuli (engagement bias), or of greater difficulty to disengage attention (disengagement bias). Participants (N = 108) completed measures of perfectionistic strivings and concerns, and symptoms of psychological distress before completing a modified dot-probe task to measure attention biases. Attention bias index scores were calculated across three factors: engagement bias vs disengagement bias, perfectionism relevant vs irrelevant stimuli, and negative vs positive emotional stimuli. ResultsOverall, perfectionistic concerns were associated with a disengagement bias for negative stimuli, regardless of whether stimuli were perfectionism relevant or not. No other significant main or interaction effects were observed. LimitationsThe study was cross-sectional in design, and no temporal or causal inferences could be made. Additionally, participants were from a community sample and therefore replication is required in clinical populations. ConclusionThese findings demonstrate that individuals higher in perfectionistic concerns experience difficulty withdrawing their attention from emotionally negative stimuli. These findings contribute new information to our theoretical understandings of perfectionism and provide support for the cognitive-behavioural model of perfectionism.

Test-retest reliability of attention bias for food: Robust eye-tracking and reaction time indices

This study assessed internal reliability and test-retest reliability of attention bias scores for food derived from the dot probe task. A visual dot probe task with food and non-food pictures (presented for 3000 ms) was administered to 53 healthy women on two occasions. Attention bias scores for food were calculated based on manual response latencies (reaction time bias) and concurrent assessment of eye-movements (direction bias and dwell-time bias). Subjective hunger and blood glucose levels were measured on both testing occasions. Dietary restraint and eating disorder symptoms were assessed during the second session. Results showed that direction bias had poor internal and test-retest reliability. Dwell time bias had excellent internal and acceptable test-retest reliability. Reaction time bias had acceptable internal and good test-retest reliability. Exploratory correlational analyses found that hunger, blood glucose, dietary restraint and eating disorder symptoms were not consistently significantly correlated with indices of attention bias for food. Overall, these findings contradict previous studies that reported low reliability of attention bias indices derived from the visual dot probe task. The implications are that a longer stimulus presentation time (i.e. ≥ 3000 ms), the use of eye-tracking and the use of appetizing stimuli can yield reliable attention bias scores for food. However, the interpretation of dot-probe scores of attention bias for food based on a dot probe task with 3000 ms presentation time and the score's relationship to theoretically relevant constructs such as hunger, eating restraint and eating disorder symptoms, require further clarification.

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

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.

The reliability of attentional biases for emotional images measured using a free-viewing eye-tracking paradigm.

Cognitive theories of anxiety disorders and depression posit that attentional biases play a role in the development, maintenance, and recurrence of these disorders. Several paradigms have been used to examine attentional biases in anxiety and depression, but information on the reliability of different attentional bias indices is limited. In this study we examined the internal consistency and 6-month test-retest reliability of attentional bias indices derived from a free-viewing eye-tracking paradigm. Participants completed two versions of an eye-tracking task-one that used naturalistic images as stimuli, and one that used face images. In both tasks, participants viewed displays of four images, each display consisting of one threat image, one sad image, one positive/happy image, and one neutral image. The internal consistency of the fixation indices (dwell time and number of fixations) for threat, sad, and positive images over the full 8-s display was moderate to excellent. When the 8-s display was divided into 2-s intervals, the dwell times for the 0- to 2-s and 2- to 4-s intervals showed lower reliability, particularly for the face images. The attentional bias indices for the naturalistic images showed adequate to good stability over the test-retest period, whereas the test-retest reliability estimates for the face images were in the low to moderate range. The implications of these results for attentional bias research are discussed.

The therapeutic potential of attentional bias modification training for insomnia: study protocol for a randomised controlled trial

BackgroundThe efficacy of attentional bias modification (ABM) as a treatment for anxiety and depression has been extensively studied with promising results. Despite some evidence of sleep-related attentional biases in insomnia, only a small number of studies, yielding mixed results, have examined the application of ABM in insomnia. This study specifically aims to determine whether ABM can reduce (i) the presence of an attentional bias for sleep-related threatening words; (ii) insomnia symptom severity; (iii) sleep onset latency; and (iv) pre-sleep cognitive arousal amongst individuals with insomnia compared to a non-treatment control group of individuals with insomnia.Methods/designWe propose a randomised controlled trial of 90 individuals from the general population who meet the criteria for Insomnia Disorder. Following an initial examination for the presence of a sleep-related attentional bias using the dot-probe paradigm, participants will be randomised to an online attentional bias modification training condition, or to a standard attentional bias task (non-treatment) control condition. Both conditions will be delivered online by a web platform. All participants allocated to the non-treatment control group will be offered ABM training once the study is complete. The primary outcome will be the attentional bias indices of vigilance and disengagement and self-reported insomnia symptoms, sleep onset latency and pre-sleep cognitive arousal. Attentional bias and insomnia symptoms will be assessed at baseline (day 1) and post-treatment (2 days after the final training session: day 9). Insomnia symptoms will be again assessed at follow-up (day 16). Secondary outcomes include examining whether sleep associated monitoring and worry are related to a sleep-related attentional bias in insomnia, and whether such reports reduce following ABM. All main analyses will be carried out on completion of follow-up assessments. The trial is supported by the Department of Psychology, Sociology and Politics at Sheffield Hallam University.DiscussionThis study will extend the research base examining the efficacy of attentional bias modification for insomnia.Trial registrationISRCTN (ISRCTN11643569, registered on 5 June 2018).