A recent study focusing on attention bias modification (ABM) revealed a surprising result: participants with social anxiety (SAD) actually reduced their levels of fear when exposed to threatening cues. The research on SAD is saturated with information relating to attention bias. It has been established that people with SAD are biased to shift their attention to fearful and threatening cues, rather than to positive ones, when confronted with both. This shift then increases anxiety and fear, resulting in a self-perpetuating condition.
In an effort to minimize this automatic behavior, therapies have been designed that train individuals in ways to naturally shift to positive cues. Other forms of treatment include repeated exposure to positive cues in order to strengthen this bias. However, in a recent study conducted by Johanna Boettcher of the Department of Psychology at Stockholm University in Sweden, exposure to threatening cues, not positive ones, were more effective at reducing fear in people with SAD.
The study involved an Internet-based training program comprised of a threat cue bias, a positive cue bias, and a neutral cue. Boettcher enlisted 129 individuals with SAD and enrolled them in one of the three conditions. The participants completed the Internet modules every day for two weeks and were assessed before for levels of SAD and evidence of any biases, of which none were found.
After the 14-day experiment, Boettcher noticed that the participants in the positive cue and neutral cue conditions had no changes in bias. However, the participants in the threatening cue condition had significant reductions in negative bias. In other words, their natural tendency to shift their attention to negative and fear-inducing stimuli was reduced after they were exposed to the threatening cues.
These results were in direct contrast to other research showing an increase in anxiety after exposure to threat stimuli. Yet in this study, the results clearly show that prolonged and consistent exposure enabled the participants to become less sensitive to threats and more capable of shifting attention away from them when confronted with them.
Boettcher believes that although remote Internet training is still in its infancy, its success in this trial is promising. She added, “The direct comparison of remote and laboratory delivery of attention modification tasks within a randomised controlled trial would enhance our understanding of the potential of ABM in SAD.”
Boettcher, J., Leek, L., Matson, L., Holmes, E.A., Browning, M., et al. (2013). Internet-based attention bias modification for social anxiety: A randomised controlled comparison of training towards negative and training towards positive cues. PLoS ONE 8(9): e71760. doi:10.1371/journal.pone.0071760
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