JMIR Publications

ABSTRACT

Introduction Cognitive biases refer to automatic attentional or interpretational tendencies. To date several studies have examined the efficacy of cognitive bias modification, and meta-analytical studies have synthesised the evidence for overall efficacy. The clinical utility of cognitive bias modification interventions has previously been limited to the confines of a laboratory, but recent advances in web technologies can change this. The aim of this systematic review is to determine the scope of web-based cognitive bias interventions and to synthesise the evidence for their effectiveness. Methods Databases (PubMed, MEDLINE, EMBASE, PsycINFO, Science Direct and Cochrane Central) were searched from inception through to 5th December 2017. The following search terminologies were used: “attention bias” OR “cognitive bias” or “approach bias” or “avoidance bias” or “interpretative bias” AND “Internet” OR “Web” OR “Online”. The selection and evaluation of the articles were in accordance to the PRIMSA-P guidelines. For the synthesis of the evidence, a narrative synthesis was undertaken, as a meta-analysis was not appropriate given the lack of reported effect sizes and the heterogeneity in the outcomes reported. Results 22 papers were identified to be relevant for inclusion. Most of the published studies have examined the utility of web-based cognitive bias modification for social anxiety disorders (9 studies) and addictive disorders (4 studies). Web-based interventions helped to reduce biases in adolescents with heightened symptoms of anxiety and depression and for individuals with obsessive-compulsive disorder. However, the evidence was inconclusive for depressive disorders, addiction disorders and social anxiety disorders. Conclusions This is the first systematic review to map out the evidence for web-based cognitive bias modification for psychiatric disorders. The synthesized evidence highlights there being a need for future studies to investigate factors that could account for the negative findings in studies.