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Smartphone-delivered intervention improves attention, executive control in GAD

Tristan Manalac
09 Jan 2019
Uses of smartphone and interaction on social media could be analysed to predict when a patient is likely to suffer from mental illnesses.

Home-delivered attentional bias modification (HD-ADM) training, delivered via a smartphone, effectively improves attention control, executive control and attention bias index (ABI) in individuals with generalized anxiety disorder (GAD), according to a recent study.

Researchers enrolled 82 individuals with GAD, who were randomly assigned to HD-ABM training (n=30; mean age 21.46±2.18 years), placebo training (n=30; mean age 21.50±1.57 years) or waiting list (n=22; mean age 21.50±1.59 years). Participants were assessed at baseline and once weekly for 4 weeks thereafter. At each assessment, self-report scales were completed, as well as cognitive tests like the dot-probe task and the attentional network test (ANT).

Two-way analysis of variance revealed that both the HD-ABM (F, 11.98; p<0.01) and placebo (F, 11.11; p<0.01) groups showed significant changes over time in self-reported attention control, measured using the attentional control scale (ACS) scores. No such effect was observed for the waitlist group (F, 4.02; p<0.01). [J Affect Disord 2018;27:444-451]

Significant between-group differences across the four follow-up assessments were also detected (week 2: p<0.05; weeks 3 and 4: p<0.01). Week 2 scores in the placebo group were significantly higher than that in the waitlist group, while ACS scores in both the HD-ABM and placebo groups were better than the waitlist participants in weeks 3 and 4.

Moreover, ABI scores changed significantly between the different assessment points in both the HD-ABM (F, 79.35; p<0.01) and placebo (F, 16.2.0; p<0.01) groups.

Between-group differences at the various assessments likewise achieved significance (p<0.01 for all). Posthoc comparisons showed that at weeks 3 and 4, waitlist participants had significantly higher ABI scores than HD-ABM and placebo participants, and that those who received the HD-ABM intervention scored significantly lower than those who received placebo.

In terms of ANT, researchers found that only participants in the HD-ABM (F, 23.08; p<0.01) and placebo (F, 8.21; p<0.01) groups showed significant changes in executive control scores.

Relative to waitlist controls, “individuals in the HD-ABM and placebo groups demonstrated significant increases in their self-reported attention control scores, decreases in their ABI scores and progress in their executive control abilities,” said researchers.

“Regarding the self-reported anxiety, depression and worry symptoms, all participants revealed significant improvement in the later stages of the training, but no intragroup difference was observed despite the differences among the trainings that the participants received,” they added.

In the study, researchers made use of a smartphone application to deliver attention training. The programme includes a fixation cross displayed for 500 ms at the centre of the screen followed by a pair of stimulus words, flashed on either side. One of the words would then be replaced by a target probe, which the participants were instructed to tap with their thumbs.

“The experimental results demonstrated that use of the developed ABM app improved the executive functions and attentional control of participants. Further research should be conducted to identify the mechanisms of this therapeutic effect,” said researchers. The development of new cognitive tasks that will allow for simultaneous measurement of orienting, alert and executive networks will contribute to this end.

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