Past Research #3

Investigating the effects of single-session attention bias modification (ABM)
through resting-state fMRI activation differences in individuals with high social anxiety

   There have been mixed reports on the effects of attention bias modification (ABM) on socially anxious individuals. One side asserts that ABM would be effective in decreasing social anxiety (Heeren et al., 2012; Naim et al., 2018; Schmidt et al., 2009) even with a single session(Amir et al., 2008) based on studies acknowledging the role of selective attention to negative stimuli (Van Bockstaele et al., 2014). Yet, other empirical studies show that ABM may not be as effective as expected (Enock et al., 2014; Julian et al., 2012; Neophytou & Panayiotou, 2022). The current project aimed to identify whether a single-session of the aforementioned controversial method would have any neural effect on socially anxious individuals. To this end, we observed the resting-state functional connectivity differences between individuals with high social anxiety scores and healthy controls after a single-session of ABM.

   A total of 26 participants consisting of 13 individuals with high social anxiety (HSA group) and 13 healthy controls (HC group) were included in the study.

   There existed no significant difference in behavioral measurements before and after the single ABM session in both groups. While changes in attention bias were not significant as well, it was noteworthy that the number turned from positive to negative in the HSA group (p = .85).

   Significant connectivity between regions were identified using seed-based functional connectivity analysis. Functional magnetic resonance imaging (fMRI) was done before and after the ABM session. Preprocessing including slice timing, realignment, normalization and smoothing were applied through DPABI (Yan et al., 2016) and SPM12 was used for statistical analysis.

1) Seed region: right amygdala    The right amygdala showed significantly strong functional connectivity with the mid occipital gyrus and right fusiform gyrus in the HSA group after ABM. No regions were observed to show significant functional connectivity with the right amygdala in the HC group after ABM.

2) Seed region: left insula

   The left insula showed significantly strong functional connectivity with the precuneus/posterior cingulate cortex region in both groups after ABM.

3) Seed region: right precuneus/posterior cingulate cortex

   The right precuneus/posterior cingulate cortex showed significantly strong functional connectivity with the medial prefrontal cortex (mPFC) in the HSA group, and significantly strong functional connectivity with a portion of the left insula after ABM. It is notable that the precuneus/posterior cingulate cortex and mPFC are part of the default mode network, which is a distributed network of brain regions more active during rest than during performance.

   Considering the lack of significant differences after the single-session ABM in behavioral measurements and few significant observations made in the functional connectivity analysis, the current exploratory study suggests uncertainty about the effect of single-session ABM. However, results including the decrease of attention bias and increase of functional connectivity with certain regions leave room for debate and further research. Moreover, limitations due to the exploratory nature of the present project, such as small sample size and limited analysis method are acknowledged. Finally, it is also acknowledged that effects may be clearer when individuals go through repeated sessions of ABM (Abend et al., 2019; Hakamata et al., 2010).