JMIR Publications

ABSTRACT

Background:

Smartphone-delivered Attention Bias Modification Training (ABMT) intervention has gained popularity as a remote solution for alleviating symptoms of mental health problems. However, the existing literature presents conflicting results and inconclusive evidence regarding the effectiveness of this intervention.

Objective:

In this systematic review and meta-analysis, we sought to assess the impact of smartphone-delivered ABMT on attention bias and symptoms of mental health problems, with a specific focus on examining different design approaches and methods of administration.

Methods:

Our search spanned the years 2014 to 2023 and encompassed four major databases: MEDLINE, PsycINFO, PubMed, and Scopus. We conducted study selection, data extraction, and critical appraisal using the PRISMA guideline independently by 3 authors. When necessary, we pooled the standardized mean difference (SMD) with a 95% confidence interval (CI). Additionally, we conducted sensitivity, subgroup analyses, and meta-regression analyses to explore moderator variables of active and placebo AMBT on reducing symptoms of mental health problems and attention bias.

Results:

Our review included 12 papers, involving a total of 24,503 participants, and we were able to conduct a meta-analysis on 20 different study samples from 11 papers. The active ABMT exhibited an effect size of -0.18 (p = 0.0284) in reducing symptoms of mental health problems while the overall effect remained significant. Similarly, placebo ABMT showed an effect size of -0.38 (p = 0.0077) in reducing symptoms of mental health problems. Additionally, active ABMT (effect size -0.1676, p = 0.0041) had significant effects in reducing attention bias, while the placebo ABMT did not significantly alter attention bias (effect size -0.0369, p = 0.6582).

Conclusions:

Our understanding of smartphone-delivered ABMT's potential highlights the value of both active and placebo interventions in mental health care. The insights from the moderator analysis also showed that tailoring smartphone-delivered ABMT to specific threat stimuli and considering exposure duration is crucial for optimizing their efficacy. This research underscores the need for personalized approaches in ABMT to effectively reduce attention bias and symptoms of mental health problems.