Attention Bias Modification Treatment for Adolescents With Major Depression: A Randomized Controlled Trial

Abstract

Objective: Attention bias modification (ABM) is a promising treatment for depression, but trial data remain restricted to adults. The present trial examined effects of ABM on adolescent depression.

Method: A total of 45 adolescents with major depressive disorder (MDD), selected from a school population (n = 2,731) using a 2-stage case-finding procedure, were randomized to an active ABM intervention (n = 23) or placebo ABM training (n = 22). In the active condition, participants completed a neutral ABM over 2 weeks for 8 sessions (320 trials each) to shift attention away from sad words to neutral words. At a 9-week follow-up, they received a positive ABM for 2 weeks with 4 more sessions (480 trials each), shifting attention to positive words. The placebo training used the same tasks but shifted attention toward neutral and sad words equally often. Attentional biases and clinical status determined by semi-structured interviews and questionnaires were obtained before and after each training. Depressive symptoms were reassessed at 8- and 12-month follow-ups.

Results: Greater reductions in attentional bias score and clinician-rated depressive symptoms were found for active ABM compared with placebo after initial neutral ABM. More participants no longer met diagnostic criteria for MDD in active ABM than in placebo. Greater reductions in self-reported depressive and anxious symptoms at the 12-month follow-up were also found in active ABM compared with placebo.

Conclusion: ABM may be a potential treatment tool for mild to moderate adolescent major depression.

Clinical trial registration information: Attention Bias Modification Treatment for Major Depressive Disorder in Adolescents: A Randomized Controlled Trial; http://clinicaltrials.gov/; NCT02078258.

Keywords: adolescent; attention bias modification (ABM); major depression; treatment.