2 - (SYM 109) Putting Experimental Therapeutics into Practice: Lessons, Suggestions, and Positive Participant Feedback from a Recent Clinical Trial for Attention Bias Modification Treatment for Depression

            The National Institute of Mental Health has placed an increasing emphasis on experimental therapeutic approaches to intervening with mental health challenges. This approach, which specifically considers the impact of interventions of hypothesized risk and maintenance processes and not just symptom reduction, has the potential to develop and refine new and existing interventions for psychopathology. Attention Bias Modification Treatment (ABMT) for depression is one such approach – the intervention is designed to specifically target negative attentional biases for dysphoric stimuli through experimentally manipulating attendance to non-dysphoric stimuli. Yet most studies conducted in this domain fail to screen for this hypothesized maintenance process, resulting in an intervention targeting a specific maintenance process being delivered to individuals who might or might not even express this maintenance process. Models of how such screening might be conducted in community samples and the efficacy of ABMT for depression employing such an approach is unclear.

            Consequently, we explicitly recruited individuals with at least moderate depression symptom severity [i.e. self-reported Quick Inventory of Depressive Symptomatology (QIDS-SR) ⩾13] and a negative attention bias (N = 145) were randomized to active ABMT, sham ABMT, or assessments only. ABMT training consisted of two in-clinic and three briefer at-home ABMT session per week for 4 weeks total. Intent-to-treat analyses found that the active ABMT group exhibited clear reductions in self-reported and interviewer-rated depression symptom severity  compared to assessment-only (ds = -0.49 and -0.57) and sham ABMT (ds = -0.41 and -0.42). Having a well-developed and clear data processing pipeline for screening for our targeted maintenance process, negative attentional bias, that could be enacted by research assistants required development and fine-tuning but was quite feasible in practice. Participants expressed an interest in understanding how specifically the trainings were meant to combat depression and requested a greater diversity of training stimuli. Some participants did notice specific differences in their attention in day-to-day life and shifts in focus on negative thoughts.