Evidence map›Paper›PMID 40850530›Full record

Trial reportJournal of the American Academy of Child and Adolescent Psychiatry2026

Gamified Attention Bias Modification Training to Augment Cognitive Behavioral Therapy for Youth Anxiety Disorders: A Randomized Controlled Trial.

Meghan E Byrne, Simone P Haller, Julia O Linke, Krystal M Lewis, Erin D Berman, Lauren M Henry, David Pagliaccio, David Quezada, Marisa Meyer, Rany Abend and 6 more

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American Academy of Child and Adolescent Psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03283930 (A Clinical Trial of a Gamified Attention Bias Modification Training in Anxious Youth), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03283930 nacompletednot on this map

A Clinical Trial of a Gamified Attention Bias Modification Training in Anxious Youth

TypeinterventionalSponsorNational Institutes of Health Clinical Center (CC)Ran2016 to 2023Enrolled121ConditionsAnxiety DisordersArmsActive Attention Bias Modification Training, Placebo Attention Bias Modification Training
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Meghan E ByrneNational Institute of Mental Health, National Institutes of Health, Bethesda, Maryland. Electronic address: meghan.byrne2@nih.gov.
Simone P HallerNational Institute of Mental Health, National Institutes of Health, Bethesda, Maryland.
Julia O LinkeUniversity of Freiburg, Freiburg im Breisgau, Germany.
Krystal M LewisNational Institute of Mental Health, National Institutes of Health, Bethesda, Maryland.
Erin D BermanNational Institute of Mental Health, National Institutes of Health, Bethesda, Maryland.
Lauren M HenryNational Institute of Mental Health, National Institutes of Health, Bethesda, Maryland.
David PagliaccioNew York State Psychiatric Institute, New York, New York.
David QuezadaUniversity of California, San Francisco School of Medicine, San Francisco, California.
Marisa MeyerTemple University, Philadelphia, Pennsylvania.
Rany AbendReichman University, Herzliya, Israel.
Katharina KircanskiNational Institute of Mental Health, National Institutes of Health, Bethesda, Maryland.
Wendy K SilvermanYale University School of Medicine, New Haven, Connecticut.
Amit LazarovTel Aviv University, Tel Aviv, Israel.
Yair Bar-HaimTel Aviv University, Tel Aviv, Israel.
Melissa A BrotmanNational Institute of Mental Health, National Institutes of Health, Bethesda, Maryland.
Daniel S PineNational Institute of Mental Health, National Institutes of Health, Bethesda, Maryland.

Funding

fMRI Studies Of Pediatric Mood And Anxiety DisordersZIAMH002781 · NIMH · NATIONAL INSTITUTE OF MENTAL HEALTH · PI PINE, DANIEL · 2009 to 2025
$41.5M
Intramural NIH HHS ZIA MH002781
6 · The paper itself

Abstract

objectiveAugmenting cognitive behavioral therapy (CBT) with attention bias modification training (ABMT) may maximize therapeutic benefit for anxiety through targeting different underlying processes. Yet, corresponding neural mechanisms are unclear. This preregistered double-blind, randomized controlled trial assigned youth with anxiety disorders receiving CBT to active or sham gamified ABMT. Group differences in clinical efficacy, and associations between amygdala connectivity and treatment outcomes, were examined.

methodPediatric patients (N = 121; 8-17 years of age) with anxiety disorders were randomized to active or sham gamified ABMT alongside 12 weeks of manualized CBT. Primary outcomes were clinician-rated Pediatric Anxiety Rating Scale (PARS) and Clinical Global Impression-Improvement (CGI-I) Scale scores. Amygdala seed-based connectivity during a functional magnetic resonance imaging (fMRI) dot-probe attention bias task was measured before and after treatment in patients, and across the same time interval in healthy controls.

resultsOver treatment, PARS decreased significantly in both groups (F

conclusionHypotheses that youth receiving active gamified ABMT+CBT would show greater improvement were not supported. Findings highlight the need to explore alternative attention bias modification strategies for augmenting the clinical response to CBT for anxiety. Future research should continue to examine reliability of attention bias tasks adapted for fMRI. PLAIN LANGUAGE SUMMARY: Attention bias modification training (ABMT) may target different aspects of anxiety (ie, attentional bias to threat) than cognitive behavioral therapy (CBT), serving as a potential augmenting treatment for individuals with anxiety disorders. This double-blind randomized controlled trial examined treatment efficacy data from 121 youth (ages 8-17 years) with anxiety disorders assigned to either active or sham ABMT alongside manualized CBT. Results showed that while symptoms improved in both groups, ABMT did not enhance symptom reduction. These unexpected findings highlight the need to explore alternate strategies to help improve therapy outcomes for kids with anxiety. CLINICAL TRIAL REGISTRATION INFORMATION: A Clinical Trial of a Gamified Attention Bias Modification Training in Anxious Youth; https://clinicaltrials.gov/study/NCT03283930. STUDY REGISTRATION INFORMATION: The Nature of the Effect; https://osf.io/fxc54github.

Indexed as

AmygdalaAnxiety DisordersAttentional BiasCognitive Behavioral TherapyAdolescentChildCombined Modality TherapyDouble-Blind MethodFemaleHumansMagnetic Resonance ImagingMaleTreatment Outcomeanxiety disordersattention bias modificationcognitive behavioral therapyfMRIRCT

Identifiers

PMID40850530
PMCPMC12464829

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.