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Background  Attentional bias modification (ABM) aims to reduce anxiety by attenuating bias toward threatening information. The current study incorporated virtual reality (VR) technology and three-dimensional stimuli with a dot-probe task to evaluate the effects of a VR-based ABM training on attentional bias and anxiety symptoms.    Methods  A total of 100 participants were randomized to four training groups. Attentional bias was assessed at pre- and post-training, and anxiety symptoms were assessed at pre-training, post-training, 1-week follow-up, and 3-months follow-up.    Results  Change in anxiety did not correlate with change in bias ( p  = 0.24). A repeated-measures ANOVA showed no significant difference in bias from pre- to post-ABM ( p  = 0.144), or between groups ( p  = 0.976). For anxiety symptoms, a linear mixed-effects model analysis revealed a significant effect of time. Participants showed reduction in anxiety score at each successive assessment ( p  < 0.001). However, no other significant main effect or interactions were found. A clinically significant change analysis revealed that 9% of participants were classified as ‘recovered’ at 3-months follow-up.    Conclusion  A single session of VR-based ABM did not change attentional bias. The significant reduction in anxiety was not specific to active training, and the majority of participants remained clinically unchanged.

Attentional Bias Modification in Virtual Reality – A VR-Based Dot-Probe Task With 2D and 3D Stimuli