Efficacy and Neural Mechanisms of Approach Bias Modification Training in Patients with Internet Gaming Disorder: A Randomized Clinical Trial
Journal of Affective Disorders（2025）
Department of Psychology
Abstract
Background Internet gaming disorder (IGD) is a prevalent behavioral addiction linked to neural alterations and significant negative outcomes. Approach bias modification (ApBM) training aims to correct imbalances in reflective and impulsive systems, reducing cravings and addictions. This study examined the effectiveness of ApBM training in IGD patients and explored the brain response changes associated with the intervention. Methods Fifty-one patients with IGD were randomly assigned to an ApBM group (n = 26) or a sham-ApBM group (n = 25). Resting-state functional magnetic resonance imaging scans and behavioral assessments, including Internet Addiction Test scores, DSM-5 criteria, game craving levels, and automatic approach bias, were conducted before and after a ten-day training with five sessions. An analysis of variance (ANOVA) was employed to assess time (pre- and post-test) × group (ApBM group vs. sham-ApBM group) effects on behavioral measures. Functional connectivity (FC) analyses focused on regions of interest identified through regional homogeneity and degree centrality calculations. Additionally, we analyzed the relationship between neuroimaging variables and intervention outcomes. Results Significant group × time interactions were found for automatic approach bias, Internet Addiction Test scores, DSM-5 criteria, and game craving levels. Post-training, these measures significantly decreased in the ApBM group but showed no significant changes in the sham-ApBM group. FC analysis revealed increased connectivity within executive control regions, enhanced connectivity between executive control and reward-related regions, and decreased connectivity within reward-related regions, exclusively in the ApBM group. Conclusions ApBM training effectively reduces gaming cravings in patients with IGD, enhancing executive control and mitigating impulsive behaviors.
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Key words
Internet gaming disorder,Approach-avoidance task,Automatic approach bias,Approach bias modification,Resting-state functional connectivity
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