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Attention control training reduces attention bias variability, improves PTSD symptoms

Attention control training balancing attention allocation between threat and neutral stimuli improved PTSD symptoms among two different study cohorts of veterans from Israel Defense Forces and the U.S. military.

“Given the attentional bias toward threat in anxiety disorder patients, attention bias modification for anxiety disorders such as social phobia and generalized anxiety disorder typically trains attention away from threat. However, patterns of threat-related attention in patients with [PTSD] are more variable than in anxiety disorders; some studies show a bias toward threat, whereas others show threat avoidance,” Amy S. Badura-Brack, PhD, of Creighton University in Omaha, Nebraska, and colleagues wrote.

Amy S. Badura-Brack

Researchers conducted two randomized controlled trials to compare efficacy of attention bias modification and attention control training for PTSD. One trial included Israel Defense Forces veterans and the other included U.S. military veterans. Both trials used the dot-probe task with attention bias modification designed to shift attention away from threat and attention control training focused on balancing attention allocation between threat and neutral stimuli. PTSD symptoms, attention bias and attention bias variability were assessed before and after treatment.

Results from both trials indicated significant improvement in PTSD symptoms after treatment, particularly after attention control training.

Both trials found that attention control training, but not attention bias modification, significantly reduced attention bias variability.

Combined analysis of the two study cohorts indicated reductions in attention bias variability partially mediated improvement in PTSD symptoms.

“The current results support the importance of attention bias variability as a marker of PTSD, and they demonstrate that a reduction in attention bias variability is associated with reduced PTSD severity following attention control training,” Badura-Brack and colleagues wrote. “These findings resonate with recent reports that higher attention bias variability correlates with more severe PTSD, and they extend this work by indicating that change in attention bias variability induced through attention control training appears to mediate clinical improvement in PTSD.” – by Amanda Oldt

Disclosure: The researchers report no relevant financial disclosures.