Attention Bias Modification Training in Youth With Subthreshold Impairing Anxiety
Condition: Anxiety
MeSH terms: Anxiety Disorders
Study type: Interventional

Summary: 
      This study is a pilot test of Attention Bias Modification Training (ABMT) among clinic
      referred children and adolescents with subthreshold impairing anxiety (i.e., anxiety and
      related impairment that fails to meet criteria for an anxiety disorder diagnosis). Half of
      participants will receive 8 sessions of computer administered ABMT and the other half of
      participants will receive a 8 sessions of a computer administered control task.
    

Detailed description: 
      This study will collect preliminary data on Attention Bias Modification Training (ABMT) among
      clinic referred children and adolescents who display subthreshold impairing anxiety
      (SubImpAnx; anxiety & related impairment that fails to meet diagnostic criteria for an
      anxiety disorder). Traditional approaches to mental health service delivery cannot meet
      current demand. The inadequacies of traditional service delivery are magnified when viewed
      through the lens of impaired but undiagnosed youth. It is an unaddressed empirical question
      whether a least restrictive treatment can effectively reduce SubImpAnx in youth. Empirical
      efforts to address this issue are important because youths with SubImpAnx experience
      substantial impairment, are at high risk of escalation to full syndrome anxiety disorder, and
      pose a burden on the health care system.

      This study will enroll 66 clinic referred children and adolescents (ages 8-16 years) who meet
      criteria for SubImpAnx. Participants will be randomly assigned to complete 8 sessions of
      either ABMT or a placebo control (PC) task over 4 weeks. Clinician ratings on youth anxiety
      severity and impairment will be evaluated as the primary outcome. Youth self ratings and
      parent ratings on youth anxiety symptoms and impairment will be evaluated as secondary
      outcomes. All measures will be collected before condition assignment (pretreatment), at
      immediate posttreatment, and at an 8 week follow up. In addition, initial data will be
      collected to shed light on whether it would be useful to pursue (a) attention bias to threat
      as a mediator of ABMT's anxiety reduction effects and (b) dose-response issues related to
      ABMT's anxiety reduction effects in a subsequent, larger study.

      The specific aims are: Collect pilot data on the effects of ABMT and a PC task on levels of
      anxiety and impairment at a post evaluation (Aim 1) and at a follow up (FU) evaluation 8
      weeks after the post evaluation (Aim 2); Preliminarily examine whether ABMT leads to lower
      levels of attention bias toward threatening stimuli as compared to a PC Task at post and 8
      week FU (Aim 3); Describe the course of anxiety symptoms and impairment during treatment
      among youth in the ABMT condition (Aim 4).

      This project will provide critically needed pilot data on ABMT for youth with SubImpAnx. With
      these data in hand, the field will be in a better position to determine whether ABMT may be
      used as a least restrictive intervention among anxious youth who are 'impaired but
      undiagnosed.'
    

Intervention name(s): Attention Bias Modification; Placebo Attention Task
Intervention type(s): Behavioral; Behavioral
Intervention description(s): At each of eight sessions, participants complete 160 computer administered trials wherein a pair of threatening stimuli and neutral stimuli is presented simultaneously and then followed immediately by a probe. The probe always replaces the neutral stimulus and never replaces the threatening stimulus. The intervention is based on the idea that attention can be shaped via repetitive computer based training methods, and training attention toward neutral stimuli will lead to a reduction in anxiety and its disorders.; At each of eight sessions, participants complete 160 computer administered trials wherein a pair of threatening stimuli and neutral stimuli is presented simultaneously and then followed immediately by a probe. The probe replaces the neutral stimulus and the threatening stimulus with equal probability.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Outcomes Assessor)
Primary purpose: Treatment