How does attention training work in social phobia: disengagement from threat or re-engagement to non-threat?

Social phobics exhibit an attentional bias for threat in probe detection paradigms. Attention training, whereby probes always replace non-threat in a display presenting both threat and non-threat, reduces attentional bias for threat and social anxiety. However, it remains unclear whether therapeutic benefits result from learning to disengage attention from threat or learning to orient attention towards non-threat. In this experiment, social phobics were randomly assigned to one of four training conditions: (1) disengagement from threat, (2) engagement towards non-threat, (3) disengagement from threat and re-engagement towards non-threat, and (4) a control condition. Effects were examined on subjective and behavioral responses to a subsequent stressor. Data revealed that training to disengage from threat reduces behavioral indices of anxiety. Engagement towards non-threat faces did not have effects in itself. These results support that the difficulty in disengaging attention from threat is a critical process in maintenance of the disorder.

RCT Entities:   Population Interventions Outcomes