DOI:10.6129/CJP.202003_62(1).0003
Chinese Journal of Psychology 2020, Vol.62, No.1, 51-72

Efficacy of Attention Bias Modification for Patients with Generalized Anxiety Disorder: Using Emotional Attention Network Test as an Evaluation of the Underlying Mechanism

Yu-Ming Hou（Department of Psychiatry, Ditmanson Medical Foundation Chia-Yi Christian Hospital）；Min-Hung Teng（Department of Psychology, National Chung-Cheng University）；Sue-Hwang Chang（Department of Psychology, National Taiwan University）

Abstract

Attention bias modification (ABM) can correct the attention bias of patients with generalized anxiety disorder (GAD) and improve their symptoms. However, the therapeutic mechanism of ABM is poorly understood (Macleod & Clarke, 2015). In this study, 28 patients (18 women and 10 men; average age = 46.04 years) with GAD were recruited. In addition, 28 healthy people (22 women and 6 men; average age = 45.43 years) were recruited as the control group. All participants were randomly assigned to either the ABM group (receiving neutral stimuli for attention training) or the placebo-training group (receiving no specific stimuli). Before and after training, both groups received two types of attention network test (ANT)-the standard ANT and the emotion ANT (e-ANT)-to assess changes in the alerting network, the orienting network, and the executive control network of the participants; e-ANT, in which threatening and neutral words serve as clues, is used to assess alertness to neutral or threatening stimuli as well as orientations, from neutral to threatening and from threatening to neutral stimuli. The results indicated that the attention allocation of the patients with GAD was inflexible. Compared with the control group, the patients’ conflict-monitoring abilities were unsatisfactory. Moreover, the patients were significantly highly alert to symbols, neutral stimuli, and threatening stimuli. Compared with the control group, shifting attention from threatening stimuli to neutral stimuli was more difficult for patients with GAD. After receiving training (of any type), the ability of patients with GAD to shift their attention from threatening stimuli to neutral stimuli improved significantly, possibly because the participants responded strategically during attention training. These results clarify the processes underlying attention bias in patients with GAD as well as the relationship between such processes and ABM, from the perspectives of the alerting, orienting, and executive control networks proposed by Posner.

Keywords: ABM, ANT, attentional bias, attention control, generalized anxiety disorder