Monitor on Psychology - November 2011 - (Page 44)

a chicken-and-egg problem: Does anxiety cause a negative attention bias, or does the bias cause anxiety? “It’s kind of like a feedback loop, where the fears feed into the cognitive biases and those cognitive biases may maintain or even exacerbate the fears over time,” says Brad Schmidt, PhD, who directs the anxiety and behavioral health clinic at Florida State University. Intriguingly, though, studies show that by altering the bias, one can dial emotional vulnerability up or down. Most of these studies simply use a modified version of the dot-probe test. In a 2002 study, for instance, MacLeod and colleagues used a dotprobe task to train students either to attend to or avoid negative of active treatment — 72 percent of patients in the treatment group no longer met diagnostic criteria for social anxiety disorder, compared with 11 percent of patients in the control group. Even more startling, the diagnostic differences were still evident at a follow-up exam four months later. Other studies have also had positive results. A 2010 metaanalysis of 12 studies (Biological Psychiatry, Vol. 68, No. 11) concluded that attention-bias modification “shows promise” as a treatment for anxiety. “When we look at the studies collectively, we see that attentional bias modification really seems to work for anxiety disorders,” says study co-author Yair A definite buzz is emerging around CBM. Still, it’s not yet known how CBM stacks up against current treatments or how best to deliver it as therapy. words. Seeing the probes flash repeatedly in particular areas of the screen, the subjects learned where to focus their attention — either on or away from the negative stimuli. Later, subjects were given a stressful anagram task to complete. Immediately following the stress test, the students who were trained to focus on negative stimuli showed increased anxiety compared with the students trained to avoid them (Journal of Abnormal Psychology, Vol. 111, No. 1). “That was the start of showing this could be useful,” MacLeod says, not only as a treatment, but also as a tool to study the cognitive roots of anxiety and other mental health conditions. “We can modify one facet of attention or another specifically so we can see which have an emotional impact in the laboratory,” he says. Moving beyond anxiety Of course, CBM also has considerable appeal as a potential therapy. Most studies so far have been small, but initial results are positive. In a 2009 study described in the Journal of Abnormal Psychology (Vol. 118, No. 1), Schmidt and colleagues tested attention bias in 36 people with social anxiety disorder. Half completed a repetitive dot-probe task designed to train attention away from images of disgusted faces. By repeatedly flashing probes in the locations where neutral faces had appeared, Schmidt reasoned, the subjects would learn to focus their attention away from the negative images. Meanwhile, participants in the control group were shown probes that replaced neutral and disgusted faces with equal frequency. After just eight 15-minute sessions — a mere two hours 44 Bar-Haim, PhD, a clinical psychologist and neuroscientist at Tel Aviv University. As far as cognitive bias goes, anxiety has been studied much more thoroughly than any other condition, Bar-Haim says. Still, it’s not the only condition in which such habits of thought are believed to play a role. He’s currently exploring the connection between attention biases and post-traumatic stress disorder in soldiers. On the battlefield, being tuned in to threats is advantageous. “That’s how you survive,” he says. “But eventually, when you come back home, these biases are not adaptive.” The research isn’t published yet, but so far, he says, there appears to be a “rather clear link” between PTSD and negative attention bias. Negative bias has also been implicated in depression, though the association isn’t quite as clear as it is for anxiety. “It remains to be determined whether extended attentional bias training is beneficial in depression,” MacLeod says. Interpretation bias (rather than attention bias) probably plays a stronger role in depression, he says. Indeed, depressed individuals are more likely to interpret ambiguous information in a negative way (Cognition and Emotion, Vol. 16, No. 3). Compared with attention bias, interpretation bias has thus far received less research focus, he adds. Still, some early studies have indicated that depressed people may be good candidates for CBM. A small study by Holmes and her Oxford colleague Simon Blackwell, PsyD, found four of seven depressed volunteers had improvements in mood and/or mental health after one week of CBM training in their homes (Applied Cognitive Psychology, Vol. 24, No. 3). Meanwhile, other investigators are beginning to apply CBM M o n i to r o n p s yc h o l o g y • n ov e M b e r 2 0 1 1

Table of Contents for the Digital Edition of Monitor on Psychology - November 2011

Monitor on Psychology - November 2011
Letters
President’s Column
Contents
Guest Column
‘Grand Challenges’ offers blueprint for mental health research
Documentary seeks to reach parents of LGBT kids
Treating veterans will cost at least $5 billion by 2020
Selfless volunteering might lengthen your life
Combat and stress up among U.S. military in Afghanistan
South Africa to host international psychology conference
Study uncovers a reason behind sex differences in mental illness
Navy psychologist gives a voice to combat trauma
In Brief
Psychologist suicide
On Your Behalf
Journey back to Heart Mountain
Psychology is key to pain management, report finds
ACT goes international
Judicial Notebook
Random Sample
Time Capsule
Questionnaire
Science Watch
Behavior change in 15-minute sessions?
Health-care reform 2.0
Perspective on Practice
Giving a heads up on concussion
Practice Profile
Searching for meaning
Inspiring young researchers
Aging, with grace
Public Interest
Thank you!
APA News
Division Spotlight
American Psychological Foundation
The man who gave Head Start a start
Personalities

Monitor on Psychology - November 2011