Anxiety Disorder Clinical Trial
Official title:
Augmenting Effects of Attention Bias Modification Treatment on Cognitive Behavioral Therapy in Anxious Children: A Randomized Clinical Trial
The development of easily disseminated and efficacious treatment of psychiatric disorder is
an important goal for translational neuroscience research. To that end, Attention Bias
Modification Treatment (ABMT), a novel intervention targeting threat-related attention
biases, has been shown to reduce anxiety in adults. To date, only one RCT study examined
whether ABMT reduces clinical anxiety in children {Eldar, 2012 #32}, and no study has
examined whether ABMT augments the efficacy of Cognitive Behavioral Treatment (CBT), the
treatment of choice for anxiety disorders. Studying this question in youth is particularly
important given that the onset of most anxiety disorders is during childhood, and early
interventions may reduce long-term affliction. The current study is the first randomized
control trial designed to examine the augmenting effects of ABMT on CBT among clinically
anxious youth.
The purpose of Attention Bias Modification Therapy (ABMT) is to implicitly shape
anxiety-related biases in attention orienting. ABMT uses the dot-probe task as a therapeutic
tool. During training, the target location is systematically manipulated to increase the
proportion of targets appearing at the location opposite the patient's bias. For example, in
a training protocol intended to reduce threat bias, targets would appear more frequently at
locations of neutral than threat stimuli.
Although CBT is an effective treatment for anxiety disorders, combining it with other
treatment such as ABMT could result in additional treatment effects. CBT and ABMT are two
interventions targeting different aspects of anxiety and therefore could potentially
complement one another. While CBT modifies explicit and voluntary attention through verbal
intervention, ABMT alters implicit and involuntary attentional biases. If ABMT augments CBT,
the integration of the two treatments can have few significant benefits: First, it will
combine the explicit learning of CBT with the implicit learning of ABMT and by that reduce
the number of patients who respond poorly to CBT or do not respond at all. Second,
computer-based training of attention may be more acceptable than traditional in-person
therapy formats for some children and adolescents and can raise the cooperation in therapy.
Finally, the CBT setting and the therapist presence can help to insure that ABMT is
delivered consistently
The current study was designed to examine the ABMT augmentation effects on CBT for children
with anxiety disorders. This study is the first randomized control trial in clinically
anxious youth. Participants were randomly assigned to one of three conditions: 1. Training
condition (CBT+ABMT), 2. Placebo condition (CBT+ ABMT-Placebo) 3. Control condition (CBT
alone). We hypothesize that participants in the training condition will show the greatest
improvement in anxiety symptoms.
n/a
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Outcomes Assessor), Primary Purpose: Treatment
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