Attentional Cognitive Bias Modification, ACBM

Attentional Cognitive Bias Modification Study
72% of participants in one CBM study were cured of Social Anxiety Disorder

attentional bias modification evidence
CBM has been shown to cause physical changes in the brain associated with positive, happier thinking

Attentional Cognitive Bias Modification for Depression
Just 7 days of bias modification improved the mood of depressed patients in Oxford study

Cognitive Bias Modification can help Boost Your Mood, Reduce Stress and Break Addiction

Cognitive Bias Modification (CBM), also known as Attentional Bias Training (ABT), is a computer-based therapy that works by gradually changing your attentional bias. An attentional bias is the tendency for our perceptions to be affected by our recurring thoughts. To put it another way: what we pay attention to in the world around us has a lot to do with what we’re thinking about. For example, a person who thinks a lot about clothes and fashion will be quick to notice what other people are wearing. Similarly, a depressed person whose thoughts are mostly negative will tend to only pay attention to negative events going on around them. In other words, they have a negative attentional bias. A negative bias can be very useful in dangerous situations, because it can quickly draw your attention to any potential threats and help you to avoid the danger, but in normal, everyday situations, having a tendency to automatically zoom in and focus on negative information can cause stress, anxiety and depression

The trouble with a negative bias

Every time you focus your attention on negative or threatening information, your amygdala (an almond shape nucleus found in the brain’s temporal lobe) instantaneously triggers the release of stress hormones and neurotransmitters, like adrenalin and cortisol. These stress chemicals can help boost our strength and speed, but their effect on our mental functioning can be quite detrimental – disrupting our ability to think logically, communicate and process language, while at the same time causing feelings of anxiety, irritability and depression.

The amygdala can be incredibly sensitive and it doesn’t take much to sound the alarm. A bad smell, loud noises, a hostile facial expression, or even a negative word can trigger a stress response. While most people don’t even notice most of these ‘little threats’ that they encounter on a daily basis, if you have a strong, negative bias, even the smallest threats can be difficult to ignore, because a negative bias functions on a subconscious level.

It takes around 500 milliseconds for an experience to register in the conscious mind, but the amygdala reacts to a threat in less then 50 milliseconds. So a person suffering from a negative bias might consciously decide to turn their attention away from a perceived threat, but by then it’s already too late – the amygdala has already been triggered.

Along with physical changes, such as in increase in heart rate and blood pressure, the stress response also induces a state of hyper vigilance – senses are heightened and tuned to detect any further ‘threats’, in effect, causing a stronger, negative attentional bias. In other words, the more stressed you are, the more likely you are to focus on negative information, and the more you focus on negative information, the more stressed you become. Psychologists call this a positive feedback loop.

The birth of Cognitive Bias Modification

One method of testing for a negative bias, known as the dot probe task, pairs negative stimuli (usually a word or a picture) with positive stimuli, and then tests how quickly the user responds to negative stimuli. Researchers discovered that people who suffer from anxiety and depression tend to react quicker to the negative words or images. In other words, they have a strong negative attentional bias.

Based on these findings, psychologists then went on to develop a computer program that helps to alleviate anxiety and depression by altering this negative bias. They called it Cognitive Bias Modification (CBM).

The majority of bias modification programs are based on the design of the dot-probe task. Positive and negative images or words are displayed together and the user is prompted to select the positive word or image. For instance, a CBM program for anxiety or depression usually pairs pictures of smiling or neutral faces with pictures of angry or hostile faces. The aim of the game is to tap the happy face as quickly as possible. This simple process of consciously and repeatedly selecting positive information over negative information, helps the user to gradually develop a positive bias – a tendency to focus more on positive information in their everyday life.

Does Cognitive Bias Modification work?

Just as focusing your attention on negative or threatening information can trigger the release of ‘stress’ hormones like cortisol and adrenaline, focusing your attention on positive information triggers the release of the ‘happy’ chemicals, like endorphin, serotonin and oxytocin. It is therefore perhaps not surprising that bias modification applications have been showing such positive results in the treatment of stress, anxiety and mood disorders.

The majority of studies on CBM have been in relation to its efficacy in reducing and controlling anxiety. In 2009, the Journal of Abnormal Psychology reported on a study in which 72% of the volunteers were cured of Social Anxiety Disorder after just 2 hours CBM therapy, and in 2010 there were 12 studies which all concluded that Cognitive Bias Modification can be an effective treatment for anxiety.

A number of studies have shown that CBM can also help to alleviate depression. One Oxford University study showed that just 7 days of CBM training improved the mood of depressed volunteers, and in another study, after several weeks of CBM, participants showed increased activity in the lateral prefrontal cortex – the area of the brain associated with more positive, happier thinking.


The future of Cognitive Bias Modification

Although studies on bias modification have so far been promising, more randomised clinical trials will need to be conducted before it becomes a widely accepted treatment method. With further research, and the wider availability of CBM therapy with iPhone and Android apps, CBM will almost certainly become a key player in psychotherapy, and everyday maintenance of good mental health.



Attentional Cognitive Bias Modification can reduce anxiety associated with public speaking
Amir, N., Weber, G., Beard, C., Bomyea, J., & Taylor, C. T. (2008). “The effects of a single-session attention modification program on response to a public-speaking challenge in socially anxious individuals.” Journal of Abnormal Psychology, 117, 860-868.

CBM causes changes in the lateral prefrontal cortex – the area of the brain associated with positive, happier thinking.
Michael Browning, Emily A. Holmes, Susannah E. Murphy, Guy M. Goodwin, and Catherine J. Harmer (May 15, 2010) “Lateral Prefrontal Cortex Mediates the Cognitive Modification of Attentional Bias” Biol Psychiatry. 67(10): 919–925.

Cognitive Bias Modification can be effective in the treatment of Generalised Anxiety Disorder
Amir, N., Beard, C., Burns, M., and Bomyea, J. “Attention modification program in individuals with generalized anxiety disorder”. J Abnorm Psychol. 2009; 118: 28–33

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