Cognitive Bias Modification Training in Adolescents Who Have Experienced Adversity

Study Overview
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Brief Summary
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Adolescents who have experienced adversity (childhood maltreatment and other forms of broader victimisation experiences) will be randomly allocated to receive a 5-session cognitive bias modification training (with attention and interpretation bias modification modules) or a control condition. Outcome measures include measures of cognitive biases and symptoms of psychopathology; in addition, in a subset of adolescents, brain activity data will be acquired. All adolescents will complete a feedback form, upon which acceptability of the intervention will be assessed.

Detailed Description
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Up to 80 adolescents aged 12-18 years who have experienced adversity (childhood maltreatment and other forms of broader victimisation experiences) from India and Nepal will be randomly allocated to receive a 5-session cognitive bias modification training (with attention and interpretation bias modification modules) or a control condition over a 2-week period. Pre and post-assessment measures include measures of attention and interpretation biases and symptoms of internalising and externalising psychopathology. In addition, in a subset of adolescents, brain activity data acquired using EEG will be acquired either during resting or viewing emotional face stimuli. Data from these measures will be used to generate effect sizes of changes for each group as well as being used in a limited number of significance-testing analysis. All adolescents will complete a feedback form, upon which acceptability of the intervention will be assessed.

Official Title
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Cognitive Bias Modification Training in Adolescents Who Have Experienced Adversity

Conditions
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Child Abuse, Child Neglect, Victimization

Intervention / Treatment
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* Behavioral: Cognitive bias modification training
* Behavioral: Control training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adolescents aged 12-18 years Adolescents who have experienced adversity (abuse, neglect) or broader victimisation experiences (conventional crime) Exclusion Criteria: Adolescents who have difficulty reading or understanding what is being read to them Adolescents who are currently at-risk for self-harm Adolescents who are currently experiencing psychotic symptoms Adolescents who are currently experiencing high-level trauma symptoms

Ages Eligible for Study
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Minimum Age: 12 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Cognitive bias modification training<br>Participants will receive 5 training sessions, each session including attention bias modification and interpretation bias modification training modules | Behavioral: Cognitive bias modification training<br>* These training sessions aim to modify a selective attention bias towards threat and a tendency to interpret ambiguous situations in threatening ways<br>|
| Placebo Comparator: Control training<br>Participants will receive 5 sessions that involve exercises that are matched to the task demands of the attention bias modification and interpretation bias modification training modules | Behavioral: Control training<br>* These exercises are matched to the task demands of the modules of cognitive bias modification training<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Attention biases for threatening stimuli | The investigators will use an experimental measure (a visual search task) that uses reaction times (RTs) to different experimental conditions to index the degree to which attention is captured by a threatening over a non-threatening stimulus. | Immediately after the intervention (post-intervention) | 
| Interpretation biases for threatening explanations | The investigators will use an experimental measure (an ambiguous scenarios task) that uses ratings to different experimental trials to index the degree to which individuals endorse threatening over benign interpretations | Immediately after the intervention (post-intervention) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Symptoms of emotional, behavioural and social problems | 5 subscales of the Strength and Difficulties questionnaire | Immediately after the intervention (post-intervention) | 
| Acceptability of intervention | The investigators have developed a 19-item self-report feedback, comprising quantitative ratings and qualitative responses. Across eleven items, young people rate on a 4-point Likert scale whether they found the training useful, satisfying, engaging, realistic, whether it impacted anxiety, mood, coping strategies, and other difficulties , and whether they would feel motivated to complete the sessions, including without a researcher present. Higher scores reflect greater endorsement. Each of these items will be reported separately rather than used to create composite scores. There are also 8 open ended questions for young people to leave their feedback on aspects they found helpful, unhelpful, liked, disliked, improvements they would want, and other general comments. | Immediately after the intervention (post-intervention) | 
| Event related potentials to emotional face presentations during Electroencephalogram (EEG) experiment | P1, N1, P2, N2, P3 event-related potentials during face presentation | Immediately after the intervention (post-intervention) |