Positive Imagery Cognitive Bias Modification for Symptoms of Depression amongst University Students in Pakistan: A Pilot Study

Depression is highly prevalent amongst university students in Pakistan but treatment provision is inadequate. Computerized interventions may provide one means of overcoming treatment barriers. The present study piloted a computerized cognitive training paradigm involving repeated generation of positive mental imagery, imagery Cognitive Bias Modification (imagery CBM), as a potential brief intervention for symptoms of depression amongst university students in Pakistan. Fifty-five participants scoring above a questionnaire cut-off indicating at least mild levels of depression were randomly assigned to either imagery CBM or a sham training control condition (Peripheral Vision Task, PVT). Participants were instructed to complete one training session from home daily over the course of one week. Outcomes were measured at post-training and a subsequent two-week follow-up, and included measures of depression, anhedonia, and positive affect. Participants provided positive feedback about the imagery CBM intervention, but encountered practical problems with the study schedule, resulting in high rates of attrition, particularly at follow-up. Further, internal consistency of outcome measures was often low, and the PVT did not appear to be an adequate control condition in this study. However, overall the results suggest that with appropriate adaptations to the study methods formal investigation of efficacy is warranted.