25805405
BACKGROUND	Accruing evidence suggests that positive imagery-based cognitive bias modification ( CBM ) could have potential as a standalone targeted intervention for depressive symptoms or as an adjunct to existing treatments .
BACKGROUND	We sought to establish the benefit of this form of CBM when delivered prior to Internet cognitive behavioral therapy ( iCBT ) for depression
METHODS	A randomized controlled trial ( RCT ) of a 1-week Internet-delivered positive CBM vs. an active control condition for participants ( N = 75 , 69 % female , mean age = 42 ) meeting diagnostic criteria for major depression ; followed by a 10-week iCBT program for both groups .
RESULTS	Modified intent-to-treat marginal and mixed effect models demonstrated no significant difference between conditions following the CBM intervention or the iCBT program .
RESULTS	In both conditions there were significant reductions ( Cohens d .57 -1.58 , 95 % CI = .12 -2.07 ) in primary measures of depression and interpretation bias ( PHQ9 , BDI-II , AST-D ) .
RESULTS	Large effect size reductions ( Cohens d .81 -1.32 , 95 % CI = .31 -1.79 ) were observed for secondary measures of distress , disability , anxiety and repetitive negative thinking ( K10 , WHODAS , STAI , RTQ ) .
RESULTS	Per protocol analyses conducted in the sample of participants who completed all seven sessions of CBM indicated between-group superiority of the positive over control group on depression symptoms ( PHQ9 , BDI-II ) and psychological distress ( K10 ) following CBM ( Hedges g .55 -.88 , 95 % CI = -.03 -1.46 ) and following iCBT ( PHQ9 , K10 ) .
RESULTS	The majority ( > 70 % ) no longer met diagnostic criteria for depression at 3-month follow-up .
CONCLUSIONS	The control condition contained many active components and therefore may have represented a smaller ` dose ' of the positive condition .
CONCLUSIONS	Results provide preliminary support for the successful integration of imagery-based CBM into an existing Internet-based treatment for depression .

