Attention bias modification for depression: A systematic review and meta-analysis

Area of Science:

• Psychiatry
• Clinical Psychology
• Cognitive Science

Background:

• Depression is a complex mental health disorder with varied symptoms.
• Attention bias modification (ABM) is a therapeutic approach used for depression.
• Existing research on ABM for depression yields inconsistent results.

Purpose of the Study:

• To systematically review and meta-analyze the efficacy of ABM for depression.
• To explore optimal protocols for ABM interventions in depression treatment.

Main Methods:

• A systematic search of seven databases was conducted up to October 2022 for randomized controlled trials (RCTs) of ABM for depression.
• Two reviewers independently selected studies, extracted data, and assessed risk of bias using the Cochrane ROB 2.0 tool.
• Meta-analysis was performed using RevMan and Stata, with subgroup analyses and meta-regressions to address heterogeneity. Certainty of evidence was assessed using GRADE.

Main Results:

• Nineteen trials with 1,262 participants were included. ABM demonstrated significant improvements in depression (SMD = -0.48) and rumination (MD = -3.46) compared to attention control training (ACT).
• No significant differences were found in attentional control between ABM and ACT.
• Subgroup analyses indicated greater benefits for adults than adolescents, and specific ABM protocols (dot-probe task, face stimuli, left-right training) showed better antidepressant effects. Laboratory-based training was more effective than home-based.

Conclusions:

• Current evidence is limited by high heterogeneity and few studies, suggesting ABM may not be definitively effective for depressive symptoms.
• More rigorous RCTs are necessary to validate ABM's benefits and determine optimal protocols for depression.
• Publication bias may exist, and the overall certainty of evidence is low to very low.