Background and objectives

Biased attention to negative information is a mechanism for risk and relapse in depression. Attentional bias modification (ABM) paradigms manipulate attention away from negative information to reduce this bias. ABM results have been mixed due to inconsistent methodologies and stimuli design. This randomized controlled trial used a novel approach to modifying attentional bias.

Methods

An eye tracker manipulated stimuli in response to participants’ fixations to preferentially reward attention to positive stimuli by obscuring or enhancing image quality of negative and positive stimuli, respectively. Participants with major depressive disorder completed three 35-min sessions of active (n = 20) or sham (n = 20) ABM training. Attentional bias, memory for emotional words, and mood were assessed pre- and post-training.

Results

Training reduced negative attentional bias; relative to sham, active training participants focused significantly more on positive compared to negative stimuli in a free-viewing eye-tracker task (p = .038, η_p² = 0.109) and, at trend, disengaged from sad information more quickly in a computerized task (p = .052, η_p² = 0.096). Active training participants remembered more happy than sad words in an emotional word learning task, indicating a distal transfer of training to emotional memory (p = .036, η_p² = 0.11). Training did not significantly affect mood in the one-week trial.

Limitations

Future studies should build on this proof-of-principle study with larger sample sizes and more intensive treatment to explore which mechanisms of training may lead to improvements in mood.

Conclusions

Attention biases in depression are modifiable through reward-based, eye-tracking training. These data suggest generalizability of training to other cognitive faculties - recall for affective information.

中文翻译：

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抑郁症中的注意力偏差修正：一项使用新颖、基于奖励的眼动追踪方法的随机试验

背景和目标

对负面信息的偏见关注是导致抑郁症风险和复发的一种机制。注意偏差修正 (ABM) 范式操纵注意力远离负面信息以减少这种偏差。由于不一致的方法和刺激设计，ABM 结果喜忧参半。这项随机对照试验使用了一种新颖的方法来改变注意力偏差。

方法

眼动仪根据参与者的注视来操纵刺激，通过分别模糊或增强负面和正面刺激的图像质量来优先奖励对正面刺激的注意力。患有重度抑郁症的参与者完成了三个 35 分钟的主动（n = 20）或假（n = 20）ABM 训练。在训练前和训练后评估注意力偏差、情绪词记忆和情绪。

结果

训练减少了负面的注意力偏差；相对于假动作，在自由观察眼动仪任务中，主动训练参与者明显更多地关注积极刺激而不是消极刺激（p = .038，η _p ²  = 0.109），并且在趋势上，在一个趋势中更快地脱离悲伤信息计算机化任务（p = .052，η _p ²  = 0.096）。在情感词学习任务中，主动训练参与者记住的快乐词多于悲伤词，表明训练向情感记忆的远端转移（p = .036，η _p ²  = 0.11）。在为期一周的试验中，训练没有显着影响情绪。

限制

未来的研究应该建立在这一原理验证研究的基础上，以更大的样本量和更密集的治疗来探索哪些训练机制可能会导致情绪的改善。

结论

抑郁症中的注意力偏差可以通过基于奖励的眼动追踪训练来改变。这些数据表明训练对其他认知能力的普遍性——情感信息的回忆。