title: Using attentional bias modification as a cognitive vaccine against depression.
abstract: BACKGROUND
  Negative attentional biases are thought to increase the risk of recurrence in depression, suggesting that reduction of such biases may be a plausible strategy in the secondary prevention of the illness. However, no previous study has tested whether reducing negative attentional bias causally affects risk factors for depressive recurrence. The current experimental medicine study reports the effects of a computerized attentional bias modification (ABM) procedure on intermediate measures of the risk of depressive recurrence (residual depressive symptoms and the cortisol awakening response) in patients with recurrent depression.
  
  
  METHODS
  Sixty-one patients with at least two previous episodes of depression who were currently in remission were randomized to receive either an active (positive) or placebo computer-based ABM regime. The ABM regime presented either pictures of faces or words. Residual depressive symptoms, measured using the Beck Depression Inventory and the cortisol awakening response were measured immediately before and after completion of the bias modification and then again after 4 weeks' follow-up.
  
  
  RESULTS
  Positive, face-based ABM reduced both measures of recurrence risk (Beck Depression Inventory and cortisol awakening response). This effect occurred during the month following completion of bias modification. Word-based modification did not influence the outcome measures.
  
  
  CONCLUSIONS
  Positive face-based ABM was able to reduce intermediate measures of recurrence risk in previously depressed patients. These results suggest that ABM may provide a "cognitive vaccine" against depression and offer a useful strategy in the secondary prevention of the illness.
authors.affiliation: Department of Psychiatry, University of Oxford, Oxford, United Kingdom. michael.browning@psych.ox.ac.uk
authors.forename: Michael
authors.initials: M
authors.lastname: Browning
authors.forename: Emily A
authors.initials: EA
authors.lastname: Holmes
authors.forename: Matthew
authors.initials: M
authors.lastname: Charles
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Cowen
authors.forename: Catherine J
authors.initials: CJ
authors.lastname: Harmer
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001288:Attention; D015982:Bias; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000097:blood / Q000517:prevention & control* / Q000523:psychology* / Q000534:rehabilitation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D055502:Secondary Prevention; D055815:Young Adult
chemical_list: D006854:Hydrocortisone