title: Effect of Attention Training on Attention Bias Variability and PTSD Symptoms: Randomized Controlled Trials in Israeli and U.S. Combat Veterans.
abstract: OBJECTIVE
  Attention allocation to threat is perturbed in patients with posttraumatic stress disorder (PTSD), with some studies indicating excess attention to threat and others indicating fluctuations between threat vigilance and threat avoidance. The authors tested the efficacy of two alternative computerized protocols, attention bias modification and attention control training, for rectifying threat attendance patterns and reducing PTSD symptoms.
  
  
  METHODS
  Two randomized controlled trials compared the efficacy of attention bias modification and attention control training for PTSD: one in Israel Defense Forces veterans and one in U.S. military veterans. Both utilized variants of the dot-probe task, with attention bias modification designed to shift attention away from threat and attention control training balancing attention allocation between threat and neutral stimuli. PTSD symptoms, attention bias, and attention bias variability were measured before and after treatment.
  
  
  RESULTS
  Both studies indicated significant symptom improvement after treatment, favoring attention control training. Additionally, both studies found that attention control training, but not attention bias modification, significantly reduced attention bias variability. Finally, a combined analysis of the two samples suggested that reductions in attention bias variability partially mediated improvement in PTSD symptoms.
  
  
  CONCLUSIONS
  Attention control training may address aberrant fluctuations in attention allocation in PTSD, thereby reducing PTSD symptoms. Further study of treatment efficacy and its underlying neurocognitive mechanisms is warranted.
authors.affiliation: From the Department of Psychology, Creighton University, Omaha, Neb.; the School of Psychological Sciences and the Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; the Department of Psychology, Simon Fraser University, Burnaby, B.C., Canada; the Division of Mental Health, Medical Corps, Israel Defense Forces, Israel; and the Intramural Research Program, NIMH, Bethesda, Md.
authors.forename: Amy S
authors.initials: AS
authors.lastname: Badura-Brack
authors.affiliation: From the Department of Psychology, Creighton University, Omaha, Neb.; the School of Psychological Sciences and the Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; the Department of Psychology, Simon Fraser University, Burnaby, B.C., Canada; the Division of Mental Health, Medical Corps, Israel Defense Forces, Israel; and the Intramural Research Program, NIMH, Bethesda, Md.
authors.forename: Reut
authors.initials: R
authors.lastname: Naim
authors.affiliation: From the Department of Psychology, Creighton University, Omaha, Neb.; the School of Psychological Sciences and the Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; the Department of Psychology, Simon Fraser University, Burnaby, B.C., Canada; the Division of Mental Health, Medical Corps, Israel Defense Forces, Israel; and the Intramural Research Program, NIMH, Bethesda, Md.
authors.forename: Tara J
authors.initials: TJ
authors.lastname: Ryan
authors.affiliation: From the Department of Psychology, Creighton University, Omaha, Neb.; the School of Psychological Sciences and the Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; the Department of Psychology, Simon Fraser University, Burnaby, B.C., Canada; the Division of Mental Health, Medical Corps, Israel Defense Forces, Israel; and the Intramural Research Program, NIMH, Bethesda, Md.
authors.forename: Ofir
authors.initials: O
authors.lastname: Levy
authors.affiliation: From the Department of Psychology, Creighton University, Omaha, Neb.; the School of Psychological Sciences and the Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; the Department of Psychology, Simon Fraser University, Burnaby, B.C., Canada; the Division of Mental Health, Medical Corps, Israel Defense Forces, Israel; and the Intramural Research Program, NIMH, Bethesda, Md.
authors.forename: Rany
authors.initials: R
authors.lastname: Abend
authors.affiliation: From the Department of Psychology, Creighton University, Omaha, Neb.; the School of Psychological Sciences and the Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; the Department of Psychology, Simon Fraser University, Burnaby, B.C., Canada; the Division of Mental Health, Medical Corps, Israel Defense Forces, Israel; and the Intramural Research Program, NIMH, Bethesda, Md.
authors.forename: Maya M
authors.initials: MM
authors.lastname: Khanna
authors.affiliation: From the Department of Psychology, Creighton University, Omaha, Neb.; the School of Psychological Sciences and the Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; the Department of Psychology, Simon Fraser University, Burnaby, B.C., Canada; the Division of Mental Health, Medical Corps, Israel Defense Forces, Israel; and the Intramural Research Program, NIMH, Bethesda, Md.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: McDermott
authors.affiliation: From the Department of Psychology, Creighton University, Omaha, Neb.; the School of Psychological Sciences and the Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; the Department of Psychology, Simon Fraser University, Burnaby, B.C., Canada; the Division of Mental Health, Medical Corps, Israel Defense Forces, Israel; and the Intramural Research Program, NIMH, Bethesda, Md.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Pine
authors.affiliation: From the Department of Psychology, Creighton University, Omaha, Neb.; the School of Psychological Sciences and the Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; the Department of Psychology, Simon Fraser University, Burnaby, B.C., Canada; the Division of Mental Health, Medical Corps, Israel Defense Forces, Israel; and the Intramural Research Program, NIMH, Bethesda, Md.
authors.forename: Yair
authors.initials: Y
authors.lastname: Bar-Haim
mesh_terms: D000328:Adult; D000368:Aged; D001288:Attention / Q000502:physiology*; D001521:Behavior Therapy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome; D014728:Veterans / Q000523:psychology*; D055815:Young Adult