title: Neural changes with attention bias modification for anxiety: a randomized trial.
abstract: Attention bias modification (ABM) procedures typically reduce anxiety symptoms, yet little is known about the neural changes associated with this behavioral treatment. Healthy adults with high social anxiety symptoms (n = 53) were randomized to receive either active or placebo ABM. Unlike placebo ABM, active ABM aimed to train individuals' attention away from threat. Using the dot-probe task, threat-related attention bias was measured during magnetic resonance imaging before and after acute and extended training over 4 weeks. A subset of participants completed all procedures (n = 30, 15 per group). Group differences in neural activation were identified using standard analyses. Linear regression tested predictive factors of symptom reduction (i.e., training group, baseline indices of threat bias). The active and placebo groups exhibited different patterns of right and left amygdala activation with training. Across all participants irrespective of group, individuals with greater left amygdala activation in the threat-bias contrast prior to training exhibited greater symptom reduction. After accounting for baseline amygdala activation, greater symptom reduction was associated with assignment to the active training group. Greater left amygdala activation at baseline predicted reductions in social anxiety symptoms following ABM. Further research is needed to clarify brain-behavior mechanisms associated with ABM training.
authors.affiliation: Section on Development and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, 20892 USA, Department of Psychology, University of Miami, Coral Gables, FL, 33146 USA, Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, 20742 USA, Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, San Diego, CA, 92120 USA, Department of Psychology, University of Houston, Houston, TX, 77204 USA, and School of Psychological Sciences and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, 69978 Israel Section on Development and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, 20892 USA, Department of Psychology, University of Miami, Coral Gables, FL, 33146 USA, Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, 20742 USA, Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, San Diego, CA, 92120 USA, Department of Psychology, University of Houston, Houston, TX, 77204 USA, and School of Psychological Sciences and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, 69978 Israel j.britton@miami.edu.
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Britton
authors.affiliation: Section on Development and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, 20892 USA, Department of Psychology, University of Miami, Coral Gables, FL, 33146 USA, Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, 20742 USA, Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, San Diego, CA, 92120 USA, Department of Psychology, University of Houston, Houston, TX, 77204 USA, and School of Psychological Sciences and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, 69978 Israel Section on Development and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, 20892 USA, Department of Psychology, University of Miami, Coral Gables, FL, 33146 USA, Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, 20742 USA, Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, San Diego, CA, 92120 USA, Department of Psychology, University of Houston, Houston, TX, 77204 USA, and School of Psychological Sciences and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, 69978 Israel.
authors.forename: Jenna G
authors.initials: JG
authors.lastname: Suway
authors.affiliation: Section on Development and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, 20892 USA, Department of Psychology, University of Miami, Coral Gables, FL, 33146 USA, Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, 20742 USA, Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, San Diego, CA, 92120 USA, Department of Psychology, University of Houston, Houston, TX, 77204 USA, and School of Psychological Sciences and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, 69978 Israel Section on Development and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, 20892 USA, Department of Psychology, University of Miami, Coral Gables, FL, 33146 USA, Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, 20742 USA, Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, San Diego, CA, 92120 USA, Department of Psychology, University of Houston, Houston, TX, 77204 USA, and School of Psychological Sciences and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, 69978 Israel.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Clementi
authors.affiliation: Section on Development and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, 20892 USA, Department of Psychology, University of Miami, Coral Gables, FL, 33146 USA, Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, 20742 USA, Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, San Diego, CA, 92120 USA, Department of Psychology, University of Houston, Houston, TX, 77204 USA, and School of Psychological Sciences and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, 69978 Israel.
authors.forename: Nathan A
authors.initials: NA
authors.lastname: Fox
authors.affiliation: Section on Development and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, 20892 USA, Department of Psychology, University of Miami, Coral Gables, FL, 33146 USA, Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, 20742 USA, Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, San Diego, CA, 92120 USA, Department of Psychology, University of Houston, Houston, TX, 77204 USA, and School of Psychological Sciences and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, 69978 Israel.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Pine
authors.affiliation: Section on Development and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, 20892 USA, Department of Psychology, University of Miami, Coral Gables, FL, 33146 USA, Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, 20742 USA, Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, San Diego, CA, 92120 USA, Department of Psychology, University of Houston, Houston, TX, 77204 USA, and School of Psychological Sciences and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, 69978 Israel.
authors.forename: Yair
authors.initials: Y
authors.lastname: Bar-Haim
mesh_terms: D000293:Adolescent; D000328:Adult; D000679:Amygdala / Q000503:physiopathology; D001008:Anxiety Disorders / Q000523:psychology* / Q000628:therapy*; D001288:Attention / Q000502:physiology*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D004644:Emotions; D005145:Face; D005149:Facial Expression; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D011597:Psychomotor Performance; D012931:Social Environment; D055815:Young Adult
keywords: amygdala; anxiety; attention training; dot-probe; fMRI; treatment