Development of Attention Bias Modification for Depression
Condition: Depression
MeSH terms: Depression; Depressive Disorder
Study type: Interventional

Summary: 
      Although negatively biased attention has a central theoretical and empirical role in the
      maintenance of depression, there are few behavioral treatments that successfully target and
      improve this deficit. The current proposal builds upon prior work and aims to further develop
      an attention bias modification intervention. The investigators propose to develop a highly
      specific intervention that directly targets negative attention bias and the neurobiology that
      supports it, using cutting-edge cognitive neuroscience to inform treatment development and
      improve quality of life of patients whose psychopathology is maintained by negative attention
      bias.
    

Detailed description: 
      The overall goal of this project is to continue development of an attention bias modification
      (ABM) intervention that targets and reduces negative attention bias among adults with
      elevated symptoms of depression. The investigators' prior work indicates that attention bias
      for negative information is associated with the maintenance of depression and that neural
      circuitry within frontal-parietal brain networks supports biased attention for negative
      information, thus allowing us to develop specific and targeted interventions that directly
      alter the neurobiology of negative attention bias. The proposed R33 study builds upon the
      investigators' prior National Institute of Mental Health (NIMH) funded work (R21MH092430),
      which examined whether ABM reduces negative attention bias and improves symptoms of
      depression. Findings indicate that compared to placebo ABM, active ABM reduced negative
      attention bias and increased resting state connectivity within a neural circuit (i.e., middle
      frontal gyrus and dorsal anterior cingulate cortex) that supports control over emotional
      information. Further, change in negative attention bias from pre- to post-ABM was
      significantly correlated with depression symptom change but only in the active training
      condition. Importantly, a 40% decrease in symptoms was observed in the active training
      condition; however, similar symptom reduction was also observed in the "placebo ABM"
      condition. Exploratory analyses indicated that placebo training may have promoted depression
      improvement by enhancing sustained attention. Although these preliminary findings are
      encouraging and demonstrate that ABM successfully alters the treatment target (i.e., negative
      attention bias), the investigators' prior work is among the first to document efficacy of ABM
      among adults with clinically significant depression. It is now prudent and necessary to
      obtain additional efficacy evidence for ABM before moving forward with large-scale clinical
      trials of ABM for depression. Aim 1 is to conduct a randomized clinical trial among adults
      with elevated symptoms of depression and a negative attention bias that compares the efficacy
      of active ABM to cognitive control training and an assessment-only control condition that
      does not involve any ABM procedures. Aim 2 is to examine whether ABM alters negative
      attention bias and functional connectivity within frontal-parietal neural circuitry that
      support negative attention bias. Aim 3 is to identify mechanisms responsible for the putative
      efficacy of active ABM and cognitive control training. Study Impact: The current project
      proposes to target and reduce negative attention bias with a novel intervention grounded in
      basic psychopathology research. The investigators believe this experimental medicine approach
      will lead to the development of a highly specific and targeted intervention, using
      cutting-edge cognitive neuroscience to inform treatment development, and improve the quality
      of life of people whose psychopathology is maintained by negative attention bias.
    

Intervention name(s): Attention Bias Modification; Cognitive Control Training
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Behavioral intervention designed to decrease negative attention bias.; Behavioral intervention designed to improve sustained attention.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment