Changing attention to emotion: A biobehavioral study of attention bias modification using event-related potentials

Anxiety is characterized by an attentional bias toward threat; that is, anxious individuals will preferentially attend to threatening versus non-threatening information. Recent research has demonstrated that reducing this bias, through attention bias modification (ABMT), leads to reductions in anxious symptoms and stress reactivity. Although these effects are promising for the development of an alternative intervention for anxiety, little is known about the attentional processes underlying ABMT effects. The present research used event-related potentials (ERPs) to investigate the neurocognitive attentional processes altered by ABMT over the course of three studies. In Study 1, non-anxious participants were trained towards and away from threat; findings suggest that training towards threat affects relatively early attentional processing of threat. In Studies 2 and 3, anxious participants were trained away from threat; in addition to collecting neurocognitive measures of the threat bias and threat processing these studies also included an assessment of stress reactivity. Training led to increases in controlled attention to threat and decreases in elaborated threat processing. Additionally, these studies demonstrated the utility of ERPs in tracking both how and for whom ABMT works. Findings suggest that behavioral measures of the threat bias as an outcome measure may be missing important changes in attention following ABMT. Additionally, the present studies raise important questions regarding the role of flexibility of the threat bias and administering ABMT to individuals who are avoidant of threat. Taken together, findings from this research have the potential to inform identification of individuals with anxiety and to contribute to future studies assessing the efficacy of ABMT as a viable treatment alternative