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Randomized Controlled Trial
. 2021 Feb;38(2):134-145.
doi: 10.1002/da.23089. Epub 2020 Aug 12.

A randomized controlled trial of gaze-contingent music reward therapy for major depressive disorder

Dana Shamai-Leshem  1   2 , Amit Lazarov  2 , Daniel S Pine  3 , Yair Bar-Haim  1   2
Affiliations
Randomized Controlled Trial

A randomized controlled trial of gaze-contingent music reward therapy for major depressive disorder

Dana Shamai-Leshem et al. Depress Anxiety. 2021 Feb.

Abstract

Background: Heightened attention allocation toward negative-valanced information and reduced attention allocation toward positive-valanced information represent viable targets for attention bias modification in major depressive disorder. Accordingly, we conducted a randomized controlled trial testing the efficacy of a novel gaze-contingent attention bias modification procedure for major depressive disorder.

Method: Sixty patients with major depressive disorder were randomly assigned to either eight training sessions of feedback-based gaze-contingent music reward therapy designed to divert patients' gaze toward positive over sad stimuli, or to a control condition which entailed eight sessions of gaze-noncontingent music. Clinician-rated and self-reported measures of depression, and proportion of dwell-time on sad faces, were assessed pretreatment, posttreatment, and at a 3-month follow-up.

Results: Gaze-contingent music reward therapy produced a greater reduction in dwell-time on sad faces compared with the control condition, but it failed to generalize to novel faces. Both groups manifested similarly significant reductions in depression symptoms from pre- to posttreatment that were maintained at follow-up. Exploratory analyses suggest that first-episode patients may benefit more from this therapy than patients with a history of multiple episodes.

Conclusions: Gaze-contingent music reward therapy can modify attention biases in depression, but clear differential clinical effects did not emerge. Theoretical and practical implications are discussed.

Keywords: attention; attention allocation; attention bias; attention bias modification; depression; eye tracking; major depressive disorder.

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Conflict of interest statement

CONFLICT OF INTERESTS

The authors declare that there are no conflict of interests.

Figures

FIGURE 1
FIGURE 1
CONSORT diagram of participants’ progress through the study. GC-MRT, gaze-contingent music reward therapy; PHQ-9, Patient Health Questionnaire
FIGURE 2
FIGURE 2
A single matrix, comprised of eight sad and eight happy faces
FIGURE 3
FIGURE 3
MADRS (a) and BDI-II (b) scores by group and time. Higher values indicate greater depression. Error bars denote the standard error of the estimated mean. BDI-II, Beck Depression Inventory-II; GC-MRT, gaze-contingent music reward therapy; MADRS, Montgomery–Asberg Depression Rating Scale
FIGURE 4
FIGURE 4
MADRS and BDI-II scores in the GC-MRT (a and b) and control (c and d) groups by time by history of depressive episodes. Higher values indicate greater depression. Error bars denote the standard error of the estimated mean. BDI-II, Beck Depression Inventory-II; GC-MRT, gaze-contingent music reward therapy; MADRS, Montgomery–Asberg Depression Rating Scale
FIGURE 5
FIGURE 5
Percent dwell-time on sad faces by group and treatment session (a; Session 1–8) and percent dwell-time on sad faces not used in training by group and assessment session (b; pretreatment, posttreatment, and follow-up). GC-MRT, gaze-contingent music reward therapy
See this image and copyright information in PMC

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