The effect of ABM on attentional networks and stress-induced emotional reactivity in a mixed clinical sample with depression: A randomized sham-controlled trial

Research on the efficacy of Attention Bias Modification for depressive symptoms has predominantly yielded unfavorable outcomes. Despite adhering to rigorous conventions in randomized controlled trials, findings from these studies have indicated minimal effect sizes, thereby raising concerns about their limited clinical significance. This may be attributed to the overlapping mechanisms in ABM and the sham comparator, both affecting attentional processes. Participants with a diagnosis of major depressive disorder, with and without comorbid anxiety (N = 101) were randomized to a two-week preregistered randomized trial of ABM compared to sham. Attentional networks were assessed prior to and after the intervention by the Attention Network Task (ANT), and emotional reactivity was assessed in response to a lab-stressor. Irrespective of condition, participants improved their performance on the alerting and executive attentional networks, but not orienting, and stress-induced emotional reactivity was marginally decreased. Changes in attentional networks predicted post-intervention depression scores. It is imperative to reconsider the employment of a sham comparator in the exploration of the clinical efficacy of ABM.