Evidence Relationship: Opposes
Vote on whether "A dose-response analysis of MEND found no symptom benefit even among the top decile of bias-change responders (d = 0.11, ns)" is good evidence that opposes the claim "Randomized cognitive-bias modification targeting threat appraisal reduced appraisal bias by 0.62 SD but depression symptoms by only 0.08 SD at 12 months"
Evidence Claim
A dose-response analysis of MEND found no symptom benefit even among the top decile of bias-change responders (d = 0.11, ns)
Among the 120 participants whose interpretation bias shifted by more than 1.5 SD, 12-month BDI-II change did not differ from controls. The absence of a responder subgroup argues against the interpretation that the null was driven by dilution from non-engagers.
Main Claim
Randomized cognitive-bias modification targeting threat appraisal reduced appraisal bias by 0.62 SD but depression symptoms by only 0.08 SD at 12 months
The four-site MEND trial (n=1,204 adults with childhood adversity histories, Aubrey-Nkemelu et al., 2023) delivered 16 sessions of interpretation-bias training. The mechanistic target moved substantially and durably, yet depression outcomes were near-null (BDI-II difference 1.2 points, 95% CI -0.4 to 2.8), with no dose-response relation between bias change and symptom change.
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Selecting on post-randomization response breaks randomization; this is a per-protocol-style analysis and regression to the mean in the responder group cuts both ways. Worth reporting but not decisive.
We used a principal-stratification estimator precisely for that reason; the naive comparison gave d = 0.14. Both are null.