Neural changes with attention bias modification for anxiety: A randomized trial

Jennifer C. Britton, Jenna G. Suway, Michelle A. Clementi, Nathan A. Fox, Daniel S. Pine, Yair Bar-Haim

Research output: Contribution to journalArticlepeer-review

51 Scopus citations


Attention bias modification (ABM) procedures typically reduce anxiety symptoms, yet little is known about the neural changes associated with this behavioral treatment. Healthy adults with high social anxiety symptoms (n1/453) were randomized to receive either active or placebo ABM. Unlike placebo ABM, active ABM aimed to train individuals' attention away from threat. Using the dot-probe task, threat-related attention bias was measured during magnetic resonance imaging before and after acute and extended training over 4 weeks. A subset of participants completed all procedures (n1/430, 15 per group). Group differences in neural activation were identified using standard analyses. Linear regression tested predictive factors of symptom reduction (i.e., training group, baseline indices of threat bias). The active and placebo groups exhibited different patterns of right and left amygdala activation with training. Across all participants irrespective of group, individuals with greater left amygdala activation in the threat-bias contrast prior to training exhibited greater symptom reduction. After accounting for baseline amygdala activation, greater symptom reduction was associated with assignment to the active training group. Greater left amygdala activation at baseline predicted reductions in social anxiety symptoms following ABM. Further research is needed to clarify brain-behavior mechanisms associated with ABM training.

Original languageEnglish (US)
Article numbernsu141
Pages (from-to)913-920
Number of pages8
JournalSocial cognitive and affective neuroscience
Issue number7
StatePublished - Jul 21 2014


  • Amygdala
  • Anxiety
  • Attention training
  • Dot-probe
  • Treatment
  • fMRI

ASJC Scopus subject areas

  • Experimental and Cognitive Psychology
  • Cognitive Neuroscience


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