Social Anxiety Clinical Trial
Official title:
Attention Bias Modification Treatment in Social Anxiety: Avoidance or Exposure to Threatening Faces? The Role of Pre-existing Attentional Biases and State Anxiety
This study evaluates attention modification in social anxiety and It is comprised by 2 experiments. At experiment 1 socially anxious participants will receive either training away from threatening faces or placebo intervention and at experiment 2 they will receive either one of these 2 groups or training towards threatening faces. At experiment 2 training will be done under state anxiety levels (video-recording of a speech). Anxiety levels (self-reports, physiological and behavioral measures) as well as attentional biases changes will be examined at pre and post - intervention levels plus 6 months follow-up only for experiment 1.
Social anxiety is a highly prevalent disorder in the population. Even though there are
effective interventions that can help people who suffer from it, many of them do not seek or
receive an evidence-based, face to face treatment. According to cognitive models, attention
to social threat is one of the principles that maintain social anxiety. In fact, individuals
with social anxiety present attention bias to threat stimuli. However, there is inconsistency
in the literature with regards to attentional biases that individuals with anxiety present. A
recent model is the vigilance-avoidance hypothesis, in which socially anxious initially focus
on the threat and then they avoid it. Therefore, better understanding and then aiming to
modify these attentional biases in a computerized manner, with minimal therapist interaction
can be a novel and promising way to treat social anxiety, even among patients who avoid
presenting for therapy.
Two experiments are aiming to shed some light with regards to the effect of attention bias
modification treatment in individuals with social anxiety, taking into consideration the
previous mixed results. The first experiment compares training attention to be directed away
from threat with a placebo treatment. Approximately 60 socially anxious individuals are
randomly allocated in the 2 groups. A structured interview and self-report assessment are
done pre-treatment, post-treatment and 6 months follow-up.
The second experiment adds a third group of training towards threat (i.e. exposure),
investigating if changing attentional avoidance can also affect anxiety levels. Moreover, the
second experiment attempts to improve the typical attention modification paradigm by
targeting treatment to participants' identified pre-experimental attentional biases. In
addition, predictors of treatment effectiveness will be studied and particularly
pre-intervention attentional biases as well as state anxiety. Participants are approximately
90 adults with social phobia who are randomly allocated in treatment and placebo groups. In
experiment 2 participants will also be assessed behaviourally as well as physiologically to
better demonstrate that anxiety reactions to anxiogenic situations have been reduced between
pre and post treatment and that they are smaller than those of a placebo control group.
It is expected that participants in the intervention groups will show reduced attentional
bias and social anxiety symptoms in comparison with the placebo group in both studies. In
addition, the kind of pre-intervention bias as well as state anxiety will moderate anxiety
changes. This study will enrich existing research on attention bias modification treatment by
shedding light into potential mechanisms of change and will examine ways to improve the
efficacy of this intervention.
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