Many smartphone applications (apps) for mental health (MHapps) are available to the public. However, few have been the subject of a randomized controlled trial (RCT), and the change processes that are hypothesized to mediate claimed effects have not been previously studied. This RCT compared the efficacy of three publicly available MHapps to a waitlist control condition in a community sample, in which no MHapp was provided. The three MHapps included cognitive behavioural therapy (CBT) toolkit app MoodKit, mood tracking app MoodPrism, and CBT strategy app MoodMission. Participants were randomly allocated to each condition, completed a baseline assessment, downloaded their allocated MHapp, and completed a second assessment 30 days later, with n = 226 included in final analyses (81% female; M age = 34 years). Compared to the control condition, all MHapp groups experienced increases in mental wellbeing, MoodKit and MoodMission groups experienced decreases in depression, and no groups experienced effects on anxiety. Mediated regressions revealed that increasing coping self-efficacy, rather than emotional self-awareness or mental health literacy, was the underlying process contributing to effects on mental health for all three MHapps. MHapps appear to be an effective solution for improving public mental health, notably by improving users' confidence in their ability to cope.

Behaviour research and therapy

Anxiety vulnerability and dysfunction are characterized by an attentional bias to threat. Cognitive training procedures designed to modify selective attentional responding to threat originally were developed to test the hypothesis that this attentional bias causally contributes to anxious disposition. The capacity of attentional bias modification (ABM) training to alleviate dysfunctional anxiety has since attracted growing interest, and the present article reviews studies that have evaluated this therapeutic potential. When intended ABM training has successfully reduced attention to threat, it also has reduced anxiety vulnerability and symptomatology with a high degree of reliability. When the delivery of intended ABM training has not resulted in such anxiety reduction, this typically has reflected the failure to successfully modify attentional selectivity as required. We discuss ways in which ABM training procedures may be refined to optimize their capacity to reduce attentional bias to threat, to improv...

The attentional bias modification approach to anxiety intervention

Attention bias modification for social anxiety: A systematic review and meta-analysis.

People with emotional disorders, such as social anxiety disorder (SAD), generalized anxiety disorder (GAD), and depression, demonstrate a consistent tendency, or bias, to generate negative interpretations of ambiguous material. This is different from people without emotional disorders who tend, in general, to make positive interpretations of ambiguity. If central components of an emotional disorder have high levels of inherent ambiguity (e.g., concern about the negative perceptions of others in SAD, or worry in GAD), then interpretive bias may have a causal maintaining role, and this has been demonstrated in studies using cognitive bias modification techniques. This research has also shown that interpretation biases combine with other cognitive processes, such as imagery and memory, which could exacerbate distress. Psychological interventions will benefit from effectively targeting negative interpretations, and future experimental research can inform ways to improve facilitation of more benign inferential processing to maximize amelioration of key components of emotional disorders.

Resolving Ambiguity in Emotional Disorders: The Nature and Role of Interpretation Biases.

Background

Attention bias modification treatment (ABMT) is a novel treatment for anxiety disorders. Although a number of other meta-analytic reviews exist, the purpose of the present meta-analysis is to examine issues unaddressed in prior reviews. Specifically, the review estimates the efficacy of ABMT in clinically anxious patients and examines the effect of delivery context (clinic vs. home) on symptom reduction.



Methods

A literature search using PsychInfo and Web of Science databases was performed. Only randomized controlled trials (RCTs) examining dot-probe-based ABMT in clinically diagnosed anxious patients were included. From 714 articles located through the search, 36 ABMT studies were identified and 11 studies met inclusion criteria (N = 589 patients).



Results

ABMT was associated with greater clinician-rated reductions in anxiety symptoms relative to control training: between-groups effect (d = 0.42, P = .001, confidence interval (CI) = 0.18–0.66), contrast of within-group effects (Q = 7.25, P < .01). More patients in the treatment group no longer met formal diagnostic criteria for their anxiety disorder posttreatment relative to patients in the control condition (P < .05). Analyses of patients’ self-reported anxiety were nonsignificant for the between-groups contrast (P = .35), and were at a trend level of significance for the contrast between the within-group effects (P = .06). Moderation analysis of the between-groups effect revealed a significant effect for ABMT delivered in the clinic (d = 0.34, P = 0.01, CI = 0.07–0.62), and a nonsignificant effect for ABMT delivered at home (d = −0.10, P = 0.40, CI = −0.33–0.13).



Conclusions

The current meta-analysis provides support for ABMT as a novel evidenced-based treatment for anxiety disorders. Overall, ABMT effects are mainly evident when it is delivered in the clinic and when clinical outcome is evaluated by a clinician. More RCTs of ABMT in specific anxiety disorders are warranted.

/pdf/quantitative-evaluation-of-the-clinical-efficacy-of-1ccoknzh39.pdf

Quantitative evaluation of the clinical efficacy of attention bias modification treatment for anxiety disorders.

http://liu.diva-portal.org/smash/get/diva2:698013/FULLTEXT01.pdf

Moderation and mediation of the effect of attention training in social anxiety disorder

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Moderation and mediation of the effect of attention training in social anxiety disorder