Measuring and Modifying Threat-Related Attention Bias in Posttraumatic Stress Disorder: An Attention Bias Modification Study.

Background: Dominant models of posttraumatic stress disorder (PTSD) implicate threat-related attention biases in both the development and maintenance of posttraumatic stress symptoms. However, the ability to better understand and modify threat-related attention biases in PTSD has been hampered by the low reliability of attention bias measures more generally. Methods: The current study adopts a new approach to calculate attention bias from a dot-probe task, response-based attention bias (RB-AB) computation, in a sample of 689 individuals reporting significantly elevated PTSD symptoms who participated in a clinical trial of threat-related attention bias modification training. Results: RB-AB is a reliable strategy for deriving threat-related attention bias scores that correlate with both PTSD severity and anxiety. On the other hand, scores from the traditional approach were unreliable and not associated with clinical symptoms. Attention training led to reductions in RB-AB indices of attention bias, but not the traditional index, although attention bias training conditions did not appear to moderate these effects. Conclusions: Taken together, these findings support evidence that threat-related attention biases may be a feature of PTSD and that RB-AB computation is a more reliable and valid approach for studying reaction-time-based attentional processes. Using the RB-AB approach to assess attention bias could allow us to better understand threat-related attention biases in PTSD and to ultimately develop more precise interventions to reduce threat-related attentional biases in PTSD and other disorders.