Effect of attention training on attention bias variability and PTSD symptoms: Randomized controlled trials in Israeli and U.S. Combat Veterans

Amy S. Badura Brack, Reut Naim, Tara J. Ryan, Ofir Levy, Rany Abend, Maya M. Khanna, Timothy J. McDermott, Daniel S. Pine, Yair Bar-Haim

Research output: Contribution to journalArticle

71 Scopus citations


Objective: Attention allocation to threat is perturbed in patients with posttraumatic stress disorder (PTSD), with some studies indicatingexcessattentiontothreatandothersindicatingfluctuations between threat vigilance and threat avoidance. The authors tested the efficacy of two alternative computerized protocols, attention biasmodification and attention control training, for rectifying threat attendance patterns and reducing PTSD symptoms. Method:Tworandomizedcontrolled trialscomparedtheefficacy of attention bias modification and attention control training for PTSD:onein IsraelDefenseForcesveteransandoneinU.S.military veterans.Bothutilizedvariantsof thedot-probetask,withattention bias modification designed to shift attention away fromthreat and attention control training balancing attention allocation between threat and neutral stimuli. PTSD symptoms, attention bias, and attentionbiasvariabilityweremeasuredbeforeandaftertreatment. Results: Both studies indicated significant symptom improvement after treatment, favoring attention control training. Additionally, both studies found that attention control training, but not attention bias modification, significantly reduced attention bias variability. Finally, a combined analysis of the two samples suggested that reductions in attention bias variability partially mediated improvement in PTSD symptoms. Conclusions: Attention control training may address aberrant fluctuations in attention allocation in PTSD, thereby reducing PTSD symptoms. Further study of treatment efficacy and its underlying neurocognitive mechanisms is warranted.

Original languageEnglish
Pages (from-to)1233-1241
Number of pages9
JournalAmerican Journal of Psychiatry
Issue number12
Publication statusPublished - Dec 1 2015


All Science Journal Classification (ASJC) codes

  • Psychiatry and Mental health
  • Medicine(all)

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