Visual search attentional bias modification reduced social phobia in adolescents E.L. De Voogd * , R.W. Wiers, P.J.M. Prins, E. Salemink Department of Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands article info Article history: Received 11 May 2013 Received in revised form 25 November 2013 Accepted 26 November 2013 Keywords: Attentional bias Social phobia Attention bias modification Adolescents Information processing Anxiety abstract Background and objectives: An attentional bias for negative information plays an important role in the development and maintenance of (social) anxiety and depression, which are highly prevalent in adolescence. Attention Bias Modification (ABM) might be an interesting tool in the prevention of emotional disorders. The current study investigated whether visual search ABM might affect attentional bias and emotional functioning in adolescents. Methods: A visual search task was used as a training paradigm; participants (n ¼ 16 adolescents, aged 13 e16) had to repeatedly identify the only smiling face in a 4 Â 4 matrix of negative emotional faces, while participants in the control condition (n ¼ 16) were randomly allocated to one of three placebo training versions. An assessment version of the task was developed to directly test whether attentional bias changed due to the training. Self-reported anxiety and depressive symptoms and self-esteem were measured pre- and post-training. Results: After two sessions of training, the ABM group showed a significant decrease in attentional bias for negative information and self-reported social phobia, while the control group did not. There were no effects of training on depressive mood or self-esteem. Limitations: No correlation between attentional bias and social phobia was found, which raises questions about the validity of the attentional bias assessment task. Also, the small sample size precludes strong conclusions. Conclusions: Visual search ABM might be beneficial in changing attentional bias and social phobia in adolescents, but further research with larger sample sizes and longer follow-up is needed. Ó 2013 Elsevier Ltd. All rights reserved. 1. Introduction During adolescence important cognitive and social-emotional developments take place, marked by increased social pressure, more intense emotional experiences and risk-taking behaviors (Casey et al., 2010). In this vulnerable period, there is a peak prevalence of anxiety and depression, with a cumulative preva- lence of approximately 15% by 16 years of age (Costello, Mustillo, Erkanli, Keeler, & Angold, 2003). These disorders have a detri- mental influence on social and academic functioning and increase the risk of psychiatric disorders in adulthood (Woodward & Fergusson, 2001). Therefore, early prevention of emotional disor- ders is of paramount importance. Since anxiety and depression are highly comorbid, especially in adolescence (Axelson & Birmaher, 2001), it is important to look for common underlying mechanisms as a target for prevention. Cognitive models of emotional disorders propose that anxious and depressive symptoms are both caused and maintained by negatively biased attention, interpretation and memory processes (e.g., Beck & Clark, 1997; Daleiden & Vasey, 1997; Mathews & MacLeod, 2005). These information processing biases are closely linked and attentional bias, the tendency to preferentially focus attention on negative information, might be a predictor of other biases (White, Suway, Pine, Bar-Haim, & Fox, 2011). Attentional bias is considered an important target in treatment, and has been shown to diminish after cognitive behavioral therapy, with changes in bias being associated with treatment success (Legerstee et al., 2010). Cognitive models of emotional disorders have been supported by numerous studies that have shown that attentional bias is * Corresponding author. Amsterdam University, Developmental Psychology, Weesperplein 4, 1018 XA Amsterdam, The Netherlands. Tel.: þ31 20 5256909; fax: þ31 20 6390279. E-mail addresses: E.L.deVoogd@uva.nl, leonedv@gmail.com (E.L. De Voogd), R.W.H.J.Wiers@uva.nl (R.W. Wiers), P.J.M.Prins@uva.nl (P.J.M. Prins), E.Salemink@uva.nl (E. Salemink). Contents lists available at ScienceDirect Journal of Behavior Therapy and Experimental Psychiatry journal homepage: www.elsevier.com/locate/jbtep 0005-7916/$ e see front matter Ó 2013 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.jbtep.2013.11.006 J. Behav. Ther. & Exp. Psychiat. 45 (2014) 252e259