SPOILER ALERT! ~ High-anxious individuals tend to pay attention to negative stimuli in their environment. It is called attention bias towards negative stimuli ~ Attention bias towards negative stimuli worsens anxiety ~ Attention bias modification (ABM) training helps reduce anxiety by training individuals to shift their attention towards positive stimuli or away from negative stimuli. ~ Research shows that attention training alone is as effective at reducing anxiety as ABM training in threat avoidance. ~ ABM-positive-search training, which involves training to turn attention towards positive stimuli is consistently effective at reducing anxiety in both children and adults. ~ Training attention towards positive things is effective at reducing anxiety for the long-term
From a cognitive perspective (i.e., the study of how we think), there are two internal processes at work that contribute to anxiety. The first one, referred to as bottom-up processes, produces automatic reactions to a stimulus (i.e., a stimulus is anything that is catching attention), while the other one, called top-down processes, involves appraisal and estimation of the attributes of that stimulus (i.e., positive or negative) before producing an appropriate behavior.
A good balance between these two systems is required for effective emotion regulation, as top-down processes typically oppose the reactivity of the bottom-up processes. Conversely, imbalance between these two systems gives rise to increased anxiety through excessive attention to negative stimuli.
Increased Anxiety caused by Attention Bias towards Negative Stimuli
As a result, the theory that anxiety is caused by attention bias towards threatening stimuli has gained popularity. Indeed, the theory asserts that highly anxious individuals tend to automatically pay attention to threatening stimuli (i.e, a threatening stimulus in social anxiety would be angry faces, while in post-traumatic stress disorder it could be a particular noise) in their environment, which in turn causes and/or worsens their anxiety.
In support of this theory, Attention Bias Modification (ABM) training is a technique aimed at reducing anxiety by reducing attention bias towards threatening stimuli. More specifically, it is a computer task for which the participant is encouraged to respond to a probe (e.g., clicking on a dot or letter) wherever it appears on the screen.
Typically, the probe appears in the same location as that of a previous threatening stimulus (e.g., an angry face) or across the screen from it (i.e, neutral spot). Attention bias to threat is indicated by the participant’s reaction time when clicking on the probe, which is expected to be faster when it is located at the same place as that of the threatening stimulus. Faster reaction times typically occur when the probe is located where the threatening stimulus was previously shown, which suggests that the participant’s attention was focused on that area of the screen.
To reduce attention bias, ABM training is performed with different techniques, including ABM-threat-avoidance training, which involves leading the participant to avoid looking at a threatening stimulus, and ABM-positive search training, which encourages the individual to pay attention to positive stimuli (e.g., paying attention to happy faces for example instead of angry faces).
Training Attention is Effective at Reducing Anxiety
A review of the research findings about the efficacy of ABM training on anxiety highlights the anxiolytic effects (i.e., reduce anxiety) of training attention. Indeed, the role of attention control is indicated by reports showing that anxiety reduction is accompanied by improved control of attention during different ABM training methods.
Specifically, unlike previously thought, results demonstrate that not every anxious individuals’ attention is oriented towards threat, and therefore ABM-training designed to avoid threat does not show more efficacy than simple attention training.
By contrast, ABM-positive-search training yields promising results for anxiety reduction. The anxiolytic effects of this type of ABM training are obtained consistently in adults and children whether they trained in a laboratory, at home or in school. For example, about half of the children who used ABM-positive-search training at home were not only free of their anxiety disorder but they remained anxiety free or improved further at 6 months follow-up.
Mogg K, Waters AM, Bradley BP. Attention Bias Modification (ABM): Review of Effects of Multisession ABM Training on Anxiety and Threat-Related Attention in High-Anxious Individuals. Clin Psychol Sci. 2017 Jul;5(4):698-717. doi: 10.1177/2167702617696359. Epub 2017 Apr 26. PMID: 28752017; PMCID: PMC5513441.