Attention Bias Modification Treatment for Adolescents With Major Depression: A Randomized Controlled Trial.

OBJECTIVE: Attention bias modification (ABM) is a promising treatment for depression, but trial data remain restricted to adults. The present trial examined effects of ABM on adolescent depression. METHOD: A total of 45 adolescents with major depressive disorder (MDD), selected from a school population (n = 2,731) using a 2-stage case-finding procedure, were randomized to an active ABM intervention (n = 23) or placebo ABM training (n = 22). In the active condition, participants completed a neutral ABM over 2 weeks for 8 sessions (320 trials each) to shift attention away from sad words to neutral words. At a 9-week follow-up, they received a positive ABM for 2 weeks with 4 more sessions (480 trials each), shifting attention to positive words. The placebo training used the same tasks but shifted attention toward neutral and sad words equally often. Attentional biases and clinical status determined by semi-structured interviews and questionnaires were obtained before and after each training. Depressive symptoms were reassessed at 8- and 12-month follow-ups. RESULTS: Greater reductions in attentional bias score and clinician-rated depressive symptoms were found for active ABM compared with placebo after initial neutral ABM. More participants no longer met diagnostic criteria for MDD in active ABM than in placebo. Greater reductions in self-reported depressive and anxious symptoms at the 12-month follow-up were also found in active ABM compared with placebo. CONCLUSION: ABM may be a potential treatment tool for mild to moderate adolescent major depression. CLINICAL TRIAL REGISTRATION INFORMATION: Attention Bias Modification Treatment for Major Depressive Disorder in Adolescents: A Randomized Controlled Trial; http://clinicaltrials.gov/; NCT02078258.

Attention Bias Modification training in individuals with depressive symptoms: A randomized controlled trial.

BACKGROUND AND OBJECTIVES: Negative attentional biases are often considered to have a causal role in the onset and maintenance of depressive symptoms. This suggests that reduction of such biases may be a plausible strategy in the treatment of depressive symptoms. The present clinical randomized controlled trial examined long-term effects of a computerized attention bias modification (ABM) procedure on individuals with elevated depressive symptoms. METHODS: In a double-blind study design, 77 individuals with ongoing mild to severe symptoms of depression were randomly assigned to one of three conditions: 1) ABM training (n = 27); 2) placebo (n = 27); 3) assessment-only (n = 23). In both the ABM and placebo conditions, participants completed 8 sessions of 216-trials (1728 in total) during a 2-week period. Assessments were conducted at pre-training and post-training (0, 2, 4, 8-week, 3, 7-month follow-ups). Change in depressive symptoms and restoration of asymptomatic level were the primary outcome measures. RESULTS: In the ABM, but not the other two conditions, significant reductions in depressive symptoms were found at post-training and maintained during the 3-month follow-up. Importantly, more participants remained asymptomatic in the ABM condition, as compared to the other two conditions, from post-training to 7-month follow-up. ABM also significantly reduced secondary outcome measures including rumination and trait anxiety, and notably, the ABM effect on reducing depressive symptoms was mediated by rumination. LIMITATION: Generalization of the findings may be limited because the present sample included only college students. CONCLUSIONS: The ABM effect on reducing depressive symptoms was maintained for at least 3-month duration in individuals with elevated depressive symptoms, and these results suggest that ABM may be a useful tool for the prevention of depressive symptoms. CLINICALTRIALS.GOV: NCT01628016.