Emotional bias training as a treatment for anxiety and depression: Evidence from experimental medicine studies in healthy and medicated samples

Anxiety and depression are leading causes of disability worldwide, yet individuals are often unable to access appropriate treatment. There is a need to develop effective interventions that can be delivered remotely. Previous research has suggested that emotional processing biases are a potential target for intervention, and these may be altered through brief training programs. We report two experimental medicine studies of emotional bias training in two samples: individuals from the general population (n = 522) and individuals currently taking antidepressants to treat anxiety or depression (n = 212). Participants, recruited online, completed 4 sessions of EBT from their own home. Mental health and cognitive functioning outcomes were assessed at baseline, immediately post-training, and at two-week follow-up. In both studies, our intervention successfully trained participants to perceive ambiguous social information more positively. This persisted at two-week follow-up. There was inconsistent evidence that this change in emotional processing transferred to improvements in symptoms and functional outcomes. In both studies there was weak evidence for an improvement in quality of life following EBT amongst individuals with more depressive symptoms at baseline. No clear evidence of transfer effects was observed for self-reported daily stress, anhedonia or depressive symptoms. However, exploratory analyses suggested that younger participants reported greater treatment gains. These studies demonstrate the effectiveness of delivering a multi-session online training program to promote lasting cognitive changes. Given the inconsistent evidence for transfer effects, EBT requires further development before it can be recommended as a treatment for anxiety and depression.