Active positive searching versus passive negative avoidance: A comparative investigation of large-scale offline attention bias modification training in nonclinical adolescents

Abstract

Attentional bias (AB), characterized by a disproportionate allocation of attention toward threat-related stimuli, constitutes a well-established cognitive mechanism underlying anxiety disorders. As a targeted intervention, attentional bias modification (ABM) has garnered substantial empirical support for its efficacy in attenuating AB and ameliorating anxiety symptomatology. This study evaluated and compared the effectiveness of three major ABM training paradigms in reducing attentional bias manifestations: dot-probe task-based ABM (DPT-ABM), emotional spatial cueing task-based ABM (ESCT-ABM), and visual search task-based ABM (VST-ABM). Using the attention to negative inventory (ANI) scale, we screened 202 non-clinical adolescents exhibiting elevated levels of negative attentional bias (NAB) and randomly assigned them to either an active modification group (DPT-ABM, ESCT-ABM, or VST-ABM) or a matched control group (DPT-C, ESCT-C, or VST-C). Participants underwent eight offline training sessions across a four-week period. Attentional bias scores (ABS), learning anxiety, and sense of agency (SoA) were assessed at pre-test and post-test intervals. Additionally, a three-month follow-up evaluation was conducted to examine long-term changes in ABS. The results showed that VST-ABM led to significant and sustained reductions in ABS compared to its control group, while other paradigms did not produce such effects. This study provides new evidence that active search training for positive emotional stimuli in VST-ABM is more effective than passive avoidance training of negative stimuli in reducing negative attentional bias and improving emotional well-being in non-clinical adolescents.