Attention retraining treatment for contamination fear: A randomized control trial

Abstract

Although an attentional bias for threat-relevant information has been connected to the etiology of contamination-based obsessive-compulsive disorder (OCD), the treatment implications of such a bias remains unclear. Accordingly, the present investigation examined the hypothesis that direct manipulation of attention for threat-relevant stimuli (disgusted faces and disgusting objects) may effectively reduce symptoms of contamination fear, commonly observed in OCD. Participants were randomly assigned to one of three probe detection conditions: (1) training away from threat (2) training toward threat, or (3) no training (control condition). Self-reported symptoms, behavioral avoidance, and physiological responding during exposure to threat-relevant images was assessed before and after two attention retraining sessions conducted one week apart. The results revealed that attention was successfully manipulated for both training groups. However, the desired attention training bias was observed for disgusting objects and not disgusted faces. Contrary to predictions, symptom levels did not improve as a result of attention training. However, there was some evidence of significant associations between change in symptoms and the magnitude of the bias observed as a function of attention training. The implications of these complex patterns of findings for the feasibility of attention retraining as a treatment for OCD and other anxiety disorders will be discussed.