Attentional retraining

Attentional retraining is the retraining of automatic attentional processes. The method of retraining varies but has typically employed computerized training programs. The term originally indicated retraining of attention to rehabilitate individuals after a brain injury who suffered from neurological disorders of attention including hemineglect, perseveration, limited attention span, and even ADHD. However, in more recent research and clinical applications attentional retraining has also been applied as a type of cognitive bias modification. In this application, attentional retraining refers to the retraining of automatic attentional biases that have been observed in high levels of anxiety.

Computerized approaches to cognitive rehabilitation rose out of the recreational use of video games in the 1970s and the rise of the personal computer in the 1980s. The increased availability of personal computers and accessible programming languages allowed for researchers and clinicians to begin experimenting with computerized cognitive training. Most tasks consisted of simple and repetitive training tasks that would increase in difficulty over time. In one such task participants must sit and observe on screen randomly presented numbers and push a buzzer when they see a specific digit – say, 3. Similar tasks were developed and administered to individuals demonstrating neuropsychological impairment in areas of attentional processing. The theorized mechanism of action in this approach to cognitive retraining rests on the ability of the generally trained task (recognizing and responding to numbers presented on screen) can generalize to attentional processes employed in everyday life.

In a 2001 meta-analysis of outcomes in attention rehabilitation after brain injury found the authors surveyed 30 studies with 359 patients. In this most recent meta-analysis of outcomes the authors found that there were significant and large effect sizes (d statistic) from pre-training to post-training. However, this large effect size was only found for studies without a control group. When the authors analyzed those pre/post studies with a control group the authors found much smaller effect sizes. This finding may reflect the natural improvement seen over time after brain injury.

Attention training for anxiety is a form of applied cognitive processing therapy (ACPT) and is also referred to in the scientific literature as cognitive bias modification therapy for attention. CBM therapies (CBMT) also include applied cognitive processing therapies for attention bias, interpretation bias and imagery.

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