title: Practitioner Review: Cognitive bias modification for mental health problems in children and adolescents: a meta-analysis.
abstract: BACKGROUND
  Despite accumulating research and bold claims about the efficacy of cognitive bias modification (CBM) for young populations, no meta-analysis has attempted to synthesize the research literature so far. We examined whether there was empirical evidence for the clinical efficacy of CBM interventions in youths, while also considering the methodological quality of this evidence.
  
  
  METHODS
  Studies were identified through systematic searches in bibliographical databases (PubMed, PsychInfo, Cochrane Library and EMBASE to June 2014). We included randomized controlled trials of CBM interventions, and considered both clinical outcomes and targeted biases. We examined the quality of the trials, as well as potential publication bias and possible moderators.
  
  
  RESULTS
  We identified 23 trials that reported on four types of outcomes: mental health, anxiety, depression and bias. Effect sizes were small and nonsignificant for all symptom outcomes considered. We found a moderate significant effect size for bias outcomes (Hedges' g of 0.53), with significant heterogeneity. There were no differences between types of CBM interventions, or between one versus multiple-session applications. A small but significant effect size for mental health problems arose when the intervention was delivered in schools. The quality of almost all of the included studies was suboptimal and the vast majority did not include information needed for allowing quality assessment.
  
  
  CONCLUSIONS
  We conducted the first meta-analysis of CBM interventions for children and adolescents and found no effects for mental health outcomes, but we did find moderate and significant effects on the targeted biases. Our results cast serious doubts on CBM interventions having any clinical utility for nonadult populations. Demand characteristics might play an important part in CBM research.
authors: Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania.|Clinical Psychology Branch, Department of Surgical, Medical, Molecular and Critical Pathology, University of Pisa, Pisa, Italy.
authors: Ioana A
authors: IA
authors: Cristea
authors: Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania.
authors: Cristina
authors: C
authors: Mogoașe
authors: Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania.|Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors: Daniel
authors: D
authors: David
authors: Department of Clinical Psychology, VU University, Amsterdam, The Netherlands.|EMGO Institute for Health and Care Research, VU University and VU University Medical Centre, Amsterdam, The Netherlands.
authors: Pim
authors: P
authors: Cuijpers
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D001288:Attention; D001521:Behavior Therapy; D002648:Child; D003072:Cognition Disorders / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D007600:Judgment; D010043:Outcome and Process Assessment, Health Care; D016032:Randomized Controlled Trials as Topic; D057545:Social Stigma
keywords: Cognitive bias modification; RCT interventions; adolescents; children; clinical efficacy; mental health; meta-analysis
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