A Randomized Controlled Trial of Attention Bias Modification Treatment in Youth With Treatment-Resistant Anxiety Disorders.
A Randomized Controlled Trial of Attention Bias Modification Treatment in Youth With Treatment-Resistant Anxiety Disorders.
复制标题
一项针对青少年难治性焦虑症患者的注意力偏差修正治疗的随机对照试验。
DOI：
10.1016/j.jaac.2019.02.018
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发表时间：
2019
影响因子：
13.3
通讯作者：
J. Pettit;M. Bechor;Yasmin Rey;M. Vasey;R. Abend;D. Pine;Y. Bar-Haim;J. Jaccard;W. Silverman
中科院分区：
文献类型：
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作者：
J. Pettit;M. Bechor;Yasmin Rey;M. Vasey;R. Abend;D. Pine;Y. Bar-Haim;J. Jaccard;W. Silverman
目的：目前尚不存在针对青年难治性焦虑症的强化治疗策略的随机临床试验。本报告介绍了一项将注意偏倚矫正治疗（ABMT）与注意控制训练（ACT）相比较，作为该人群的增强疗法的疗效试验结果。方法64名完成认知行为治疗后继续接受焦虑诊断的青少年（34名男孩，平均年龄11.7岁）随机接受ABMT或ACT治疗。ABMT和ACT包括愤怒脸和中性脸的点探针注意训练试验；在100%的ABMT试验和50%的ACT试验中，探针出现在中性面孔的位置。独立评估者、青少年和家长完成了青少年焦虑严重程度的评分，青少年在治疗前、治疗后和2个月的随访中完成了对威胁和注意控制的注意偏倚的测量。结果两组患者焦虑程度均显著降低，两组间差异无统计学意义。具体来说，在所有被调查者中，焦虑严重程度在治疗后显著降低，并在随访中保持下降。治疗后的原发性焦虑障碍诊断恢复率为50%，随访时为58%。两组的注意控制在治疗后显著改善，但对威胁的注意偏倚没有显著改善。结论本研究首次证实了在认知行为治疗无效的青少年中，焦虑可以得到缓解，并且使用这两种注意力训练应急计划可以达到缓解焦虑的效果。这些发现和两组注意力控制的增强提出了一个有趣的问题，即通过注意力训练减少治疗抵抗青年焦虑的机制，这需要进一步的研究。儿童焦虑CBT无应答者的注意偏倚矫正训练https://clinicaltrials.gov/;NCT01819311。
ObjectiveRandomized clinical trials of augmentation strategies for youth with treatment-resistant anxiety disorders do not exist. This report presents findings from an efficacy trial of attention bias modification treatment (ABMT) as an augment for this population compared with attention control training (ACT).MethodSixty-four youths (34 boys; mean age 11.7 years) who continued to meet for anxiety diagnoses after completing cognitive-behavioral therapy were randomized to ABMT or ACT. ABMT and ACT consisted of dot-probe attention training trials presenting angry and neutral faces; probes appeared in the location of neutral faces on 100% of trials in ABMT and 50% of trials in ACT. Independent evaluators, youths, and parents completed ratings of youth anxiety severity, and youths completed measures of attention bias to threat and attention control at pretreatment, post-treatment, and 2-month follow-up.ResultsThe 2 arms showed significant decreases in anxiety severity, with no differences between arms. Specifically, across informants, anxiety severity was significantly decreased at post-treatment and decreases were maintained at follow-up. Primary anxiety disorder diagnostic recovery combined across arms was 50% at post-treatment and 58% at follow-up. Attention control, but not attention bias to threat, was significantly improved at post-treatment in the 2 arms.ConclusionThis is the first study to show anxiety can be decreased in youth who did not respond to cognitive-behaviorial therapy, and that the anxiety-decreasing effect is found using these 2 attention training contingency schedules. These findings and increases in attention control in the 2 arms raise intriguing questions about mechanisms of decreasing anxiety in treatment-resistant youth with attention training that require further research.Clinical trial registration informationAttention Bias Modification Training for Child Anxiety CBT Nonresponders; https://clinicaltrials.gov/; NCT01819311.