Augmenting Effects of ABMT on CBT in Anxious Children: A Randomized Clinical Trial
Condition: Anxiety Disorder
MeSH terms: Anxiety Disorders
Study type: Interventional

Summary: 
      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.
    


Intervention name(s): Cognitive behavioral therapy for anxiety; Attention Bias Modification Treatment
Intervention type(s): Behavioral; Behavioral
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Attention bias modification treatment (ABMT); Attention biases; Anxious children; Cognitive Behavioral Therapy (CBT)