Attention Bias Modification Treatment Reduces Depression Symptoms in Youth.

ajor depression is a commonly occurring, serious, and recurrent disorder that often starts at a M young age. According to the World Health Organization, depression is ranked among the leading causes of disability worldwide. In 2013, an estimated 2.6 million adolescents 12 to 17 years old in the United States had at least 1 major depressive episode in the past year, representing 10.7% of the population in this age range. Efficacious treatments for major depression, including cognitive-behavioral therapies and pharmacotherapy, have been available for decades. However, the prevalence rates of major depression remain notably consistent, with fewer than 15% of potential patients receiving minimally adequate treatment. This observation has led to a call for interventions that take advantage of technology to increase patient access and lower cost through the use of computerbased procedures. One such intervention, attention bias modification treatment (ABMT), was originally designed to directly target a posited cognitive mechanism of anxiety, namely selective attention to threat stimuli. Recently, ABMT has been tested for depression. Cognitive theories of depression implicate attention biases in the processing of emotional information as a key factor in the etiology and maintenance of the disorder. Two types of attentional biases have been reported in major depression: increased attention allocation to negatively valenced stimuli compared with positive or neutral stimuli and a lack of attentional bias toward positive stimuli that typically characterizes healthy individuals. Therefore, computerized ABMT protocols have started to emerge that target these specific biases in adult patients with depression. ABMT protocols are typically designed to implicitly modify biased attentional patterns. For instance, in a dotprobe task, 2 stimuli, 1 related to threat and 1 neutral (e.g., threat and neutral words), are shown briefly at each trial, and their removal is followed by a small target probe in the location just occupied by one of the stimuli. Patients are required to discriminate as quickly as possible between 2 variants of the probe (e.g., 1 or 2 dots) without compromising accuracy. In the classic format of this task, designed to measure attention biases, targets appear with equal probability at the location of threat and neutral stimuli. Thus, attention bias toward threat is shown when participants are faster to respond to probes that replace threat-related stimuli rather than neutral stimuli. In attention training variants of the dot-probe task, target location is systematically manipulated to increase the proportion of targets appearing at the location of the intended training bias. It is assumed that because attending to such contingencies can assist in task