The Attentional Bias Modification Technique: Characteristics And Uses
Although there are multiple theories, today there is still no clear and universal definition of the concept of attention. However, what is known with absolute certainty is that this basic cognitive process is of capital importance in the origin and maintenance of mental disorders and, in particular, anxiety disorders.
In the following lines we will present the impact that the Attentional Bias Modification technique is having a new attentional psychological technique designed for the treatment of social anxiety disorder or social phobia.
As pointed out by Shechner et al. (2012), attention is a basic process that encompasses different cognitive functions that allow the brain to prioritize the processing of certain information. The fact of paying attention or not to certain stimuli or information can affect the development of the person, since attention is the basis of memory and learning You can only learn and memorize experiences that you are attending to.
According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), social phobia is characterized by “intense fear or anxiety in one or more social situations in which the individual is exposed to possible examination by other people.” .
The person feels fear of behaving in a certain way that may be negatively valued by those around them. That is to say, She is afraid of being judged by others and being rejected for her actions in a situation involving several people. These situations can range from giving a talk to a large audience, to having a simple conversation with someone you know.
Najmi, Kuckertz and Amir (2011) showed that people with anxiety selectively attend to elements of the environment that they consider threatening, failing to attend to the rest of the environment, in which they could find neutral or positive elements. This attentional bias often generates mistaken value judgments that result in increased anxiety and long-term persistence of the disorder.
For example, if a person with social anxiety disorder was giving an oral presentation to an audience of 20 people, although 16 people were paying attention to the presentation and showing interest, if one person was yawning, another was playing with their cell phone, and others two talking among themselves, the speaker would only focus on these last actions, interpreting that their execution is being catastrophic and boring, leading to increased anxiety and, therefore, to an increase in the probability of making mistakes and actually worsening their performance, accompanied by a greater persistence of fear of speaking in public in the future.
On the contrary, if the person did not suffer from social anxiety, possibly the behavior of these four individuals would go unnoticed, and they would interpret it as a lack of sleep and/or interest in the topic of those particular people and not because of their own performance.
Modification of attentional bias
In this context, Amir et al. (2009) created a virtual technique in order to correct this attentional bias The patient is instructed to stand in front of a computer and determine the appearance of the letters “e” or “f” as quickly as possible and trying not to make mistakes using the mouse (“e” left button, “f” right button ) during multiple trials.
The key is that, during all attempts, Before the appearance of the letter, two images of faces are presented : a face with a neutral expression and a face with an expression of disgust or rejection. In 80% of the attempts, the letter “e” or “f” always appears where the neutral face was located moments before. In this way, even if an explicit order is not given not to pay attention to the rejection faces, the person unconsciously learns not to pay attention to the stimuli that he fears.
Despite the simplicity of the technique, these authors managed, in 8 20-minute sessions over 4 weeks, for 50% of patients with social phobia to reduce their symptoms so much that they could not be diagnosed following the DSM criteria. Other authors such as Boettcher et al. (2013) and Schmidt et al. (2009) They obtained similar results in their experiments
This technique is not without controversy.
According to Amir, Elias, Klumpp and Przeworski (2003), the true bias in anxiety disorders, and specifically social anxiety, is not being hypervigilant in the face of threatening stimuli (rejection faces) – since detecting those things that can potentially harm us is a bias that all humans share and that has helped us survive for thousands of years – but Once these threats are detected, they cannot be ignored by the person
Therefore, the bias that causes the persistence of the disorder is the impossibility of “disengaging” attention from the threat, and the modification of the attentional bias would act by eliminating this impossibility.
However, recent evidence suggests that the panorama It is much more complicated than it might seem at first Klump and Amir (2010) found that designing the task to attend to threatening faces instead of neutral ones also produced a decrease in anxiety. Yao, Yu, Qian and Li (2015) conducted the same experiment, but using geometric figures instead of emotional stimuli and also observed a decrease in the participants’ subjective distress.
Cudeiro (2016) tried to measure attentional engagement bias through an experimental paradigm of eye movements and did not obtain conclusive evidence that the bias really existed or at least could be measured empirically.
In short, still It is not clear what the mechanism(s) of action underlying this technique are Future research will have to aim to replicate the efficacy studies and determine these possible mechanisms of action.
