Less is more: Patient-level meta-analysis reveals paradoxical dose-response effects of a computer-based social anxiety intervention targeting attentional bias.
Less is more: Patient-level meta-analysis reveals paradoxical dose-response effects of a computer-based social anxiety intervention targeting attentional bias.
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少即是多：患者层面的荟萃分析揭示了基于计算机的针对注意力偏差的社交焦虑干预措施的矛盾剂量反应效应。
DOI：
10.1002/da.22634
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发表时间：
2017
影响因子：
7.4
通讯作者：
Wallace,MeredithL
中科院分区：
文献类型：
--
作者：
Price,RebeccaB;Kuckertz,JennieM;Amir,Nader;Bar-Haim,Yair;Carlbring,Per;Wallace,MeredithL
在过去十年的研究中，人们对直接针对焦虑认知机制的计算机方法产生了浓厚的兴趣，如注意偏差修正(ABM)。方法通过汇集患者水平的ABM随机对照试验的数据，我们评估了693名社交焦虑成年人的训练剂量对相关结果的影响。结果训练试验的次数对训练后的社交焦虑症状和对威胁(ABM的目标机制)的行为注意偏差(AB)都有矛盾的影响。进行大量(1,280)次训练试验的研究表明，与对照条件相比，ABM没有好处，而那些进行较少训练试验的研究显示，ABM在减少社交焦虑方面有显著好处(P=0.02)。这些剂量的调节作用不能用其他检查变量和先前确定的调节因素更好地解释，包括患者年龄、训练环境(实验室与家庭)或焦虑评估类型(临床医生与自我报告)。结论研究结果为未来斑点探针式ABM在研究和临床环境中的应用提供了最佳剂量，并为进一步研究提供了几种新的途径。
BackgroundThe past decade of research has seen considerable interest in computer‐based approaches designed to directly target cognitive mechanisms of anxiety, such as attention bias modification (ABM).MethodsBy pooling patient‐level datasets from randomized controlled trials of ABM that utilized a dot‐probe training procedure, we assessed the impact of training "dose" on relevant outcomes among a pooled sample of 693 socially anxious adults.ResultsA paradoxical effect of the number of training trials administered was observed for both posttraining social anxiety symptoms and behavioral attentional bias (AB) toward threat (the target mechanism of ABM). Studies administering a large (>1,280) number of training trials showed no benefit of ABM over control conditions, while those administering fewer training trials showed significant benefit for ABM in reducing social anxiety (P= .02). These moderating effects of dose were not better explained by other examined variables and previously identified moderators, including patient age, training setting (laboratory vs. home), or type of anxiety assessment (clinician vs. self‐report).ConclusionsFindings inform the optimal dosing for future dot‐probe style ABM applications in both research and clinical settings, and suggest several novel avenues for further research.