Gaze-Contingent Music Reward Therapy for Social Anxiety Disorder

Patients with social anxiety disorder exhibit increased attentional dwelling on social threats, providing a viable target for therapeutics. We purpose a novel gaze-contingent music reward therapy for social anxiety disorder designed to reduce attention dwelling on threats

Attention bias modification refers to a novel group of treatments grounded in cognitive neuroscience targeting aberrant threat-related attention patterns in anxiety disorders. However, efficacy remains inconsistent across studies, possibly from a failure of some reaction-time-based protocols to effectively engage aberrant attentional processes.

Eye-tracking measures provide better therapeutic targets. Socially anxious individuals tend to observe threats for more extended periods than nonanxious individuals, a pattern that manifests stably over time and thus can provide a viable target for treatment. 
• Gaze-contingent music reward therapy yielded more significant reductions of symptoms of social anxiety disorder than the control condition on both clinician-rated and self-reported measures. 
• Therapeutic effects were maintained at follow-up. 
• Gaze-contingent music reward therapy also reduced dwell time on threat, which partially mediated clinical effects. 
• Gaze-contingent music reward therapy also altered dwell time on socially threatening faces not used in training, reflecting near-transfer training generalization.

Results indicate that gaze-contingent music reward therapy was significantly more effective than a control condition in reducing both clinician-rated and self-reported social anxiety disorder symptoms posttreatment. Moreover, overall symptom reduction reflected reductions in experienced social fear and avoidance behaviors. The effects of gaze-contingent music reward therapy were maintained at a 3-month follow-up.

US Patent.
Lazarov, A., Pine, D. S., & Bar-Haim, Y. (2017). Gaze-contingent music reward therapy for social anxiety disorder: A randomized controlled trial. American Journal of Psychiatry, 174(7), 649–656. https://doi.org/10.1176/appi.a…

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