Much research testing positive psychological interventions (PPIs) has focused on the outcome of emotion regulation (e.g., increased positive or decreased negative emotions and affect). On the other hand, most research testing the effects of attention bias modification (ABM) has focused on the process of emotion regulation (e.g., reducing biased attention towards threatening faces in those with social anxiety disorder). Evidence is sparse and inconsistent on the process of emotion regulation in PPIs and the outcome of emotion regulation in ABM programs. Furthermore, few studies have examined the combined effects of a positive ABM (PABM) with PPIs, which is the focus of the current investigation. The aim of the study is to examine two relationships: 1) the effects of the gratitude letter PPI on the process of emotion regulation and 2) the combined effects of the PABM program and the gratitude letter PPI on the process and outcome of emotion regulation. The researchers used a dot-probe task to bias attention. The dot-probe task presented positive-neutral stimuli pairs (e.g., babies; geometric pattern). In the train-positive group, the probe appeared behind the positive images 90% of the time, compared to 50% in the control group. The researchers used a gratitude letter PPI, where participants wrote a letter for 15 minutes to someone they have never thanked, compared to the control condition who wrote a letter about their morning routine. The results suggest that the gratitude letter PPI does not affect the process of emotion regulation via attentional biases but does increase positive affect in the short term. Further, the PABM program may not affect the outcome of emotion regulation but did demonstrate a biasing of reaction time to positive pictures. This biasing of reaction times in the dot-probe was not consistent with eye-gaze patterns to positive images, suggesting that the dot-probe task does not measure or manipulate attentional biases. Finally, combining the dot-probe task and gratitude letter PPI did not produce a stronger effect on the process and outcome of emotion regulation than the gratitude letter alone. The findings of the current study suggest that the gratitude letter may be an effective and quick intervention to increase positive affect, but that the intervention is not suitable for long-term changes after a single administration. Further, individuals should not expect the dot-probe task to bias attention and should not except the task to influence the outcome of emotion regulation. Instead, researchers could use the task to measure and manipulate one’s decision-making processing speed.

Objective: Attention Bias Modification Training (ABMT) for anxiety aims to train attention away from threatening stimuli and toward neutral stimuli. Although ABMT shows promising anxiety reduction effects in children and adolescents, no study has examined its influence on neural indicators of attention measured using event-related potentials (ERPs) in children or adolescents (i.e., youths). The present study examined the influence of ABMT on the P1, N170, P2 and P3 ERP components during completion of the emotional faces dot probe task in youths with anxiety disorders who failed to respond to cognitive behavioral therapy. Method: Thirty youths (M age = 11.97, SD = 2.89) with primary DSM-IV-TR anxiety disorders completed the dot probe task while undergoing electroencephalogram (EEG) to obtain ERPs before, immediately after, and eight weeks after eight sessions of either ABMT (n = 14) or a control task regimen (CT), (n = 16). Results: At post-treatment, statistically significant effects were found for P1 and P3 mean amplitudes: P1 was significantly higher during trials showing neutral-neutral (NN) face pairs in the ABMT arm than in the CT arm; P3 was significantly higher during trials showing NN face pairs than during trials showing neutral-threat (NT) face pairs in the ABMT arm, but not the CT arm. At eight-week follow-up, participants in both arms showed significantly higher (more negative) N170 responses for NN trials than for NT trials. Conclusions: Attention Bias Modification Treatment led to increases in neural processing of neutral stimuli in early and late stage attentional processing, as measured by the P1 and P3 components, respectively. These components during the dot probe task are promising neural markers of ABMT’s effects on attentional processing in youth with anxiety disorders.