Journal of Abnormal Child Psychology

, Volume 47, Issue 5, pp 881–894 | Cite as

Age Moderates Link Between Training Effects and Treatment Response to Attention Bias Modification Treatment for Social Anxiety Disorder

  • Rany AbendEmail author
  • Reut Naim
  • Lee Pergamin-Hight
  • Nathan A. Fox
  • Daniel S. Pine
  • Yair Bar-Haim


Attention bias modification treatment (ABMT) aims to reduce anxiety symptoms via practice on computerized attention training tasks. Despite evidence of efficacy, clinical effects appear heterogeneous. More research on ABMT mechanisms and moderators of treatment response is needed. Age is one potentially important moderator, as developmental differences in training effects may impact response. We examined developmental links between ABMT training effects and response in social anxiety disorder (SAD). We pooled data from two randomized controlled trials in treatment-seeking youths and adults with SAD (N = 99) that used identical ABMT methods. We first characterized learning effects associated with the eight-session ABMT training protocol. We then tested whether learning magnitude predicted the clinical (change in SAD symptoms) and cognitive (change in attention bias) responses to treatment. Finally, we tested whether age moderated the association between ABMT learning and treatment response. Results indicate that ABMT was associated with an incremental learning curve during the protocol, and that learning improved with age. Age further moderated the association between learning gains during the ABMT protocol and subsequent reduction in self-reported SAD symptoms, such that this association was stronger with age. These effects were not evident in bias scores or clinician ratings. Finally, pre-treatment SAD symptoms and bias scores predicted ABMT learning gains. This study highlights the links among age, learning processes, and clinical response to ABMT. These insights may inform attempts to increase the clinical efficacy of ABMT for anxiety.


Anxiety Development Attention bias Treatment Learning Children Age 



This research was supported in part by the Intramural Research Program of the National Institute of Mental Health (ZIAMH002781-15, NCT00018057).

Compliance with Ethical Standards

Conflict of Interest

All authors declare no conflicts of interests.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

10802_2018_494_MOESM1_ESM.docx (64 kb)
ESM 1 (DOCX 64 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Rany Abend
    • 1
    Email author
  • Reut Naim
    • 2
  • Lee Pergamin-Hight
    • 2
  • Nathan A. Fox
    • 3
  • Daniel S. Pine
    • 1
  • Yair Bar-Haim
    • 2
  1. 1.Section on Development and Affective NeuroscienceNational Institute of Mental HealthBethesdaUSA
  2. 2.School of Psychological SciencesTel Aviv UniversityTel AvivIsrael
  3. 3.Department of Human Development and Quantitative MethodologyUniversity of MarylandCollege ParkUSA

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