Combined "top-down" and "bottom-up" intervention for anxiety sensitivity: Pilot randomized trial testing the additive effect of interpretation bias modification
Combined "top-down" and "bottom-up" intervention for anxiety sensitivity: Pilot randomized trial testing the additive effect of interpretation bias modification
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DOI：
10.1016/j.jpsychires.2016.11.003
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发表时间：
2017-02-01
影响因子：
4.8
通讯作者：
Schmidt, Norman B.
中科院分区：
文献类型：
--
作者：
Capron, Daniel W.;Norr, Aaron M.;Schmidt, Norman B.
目的：焦虑症在很大程度上增加了公共卫生负担。焦虑敏感性（AS）是一种对焦虑相关感觉的恐惧，是少数已知的焦虑病理学的可塑风险因素之一。以前的AS减轻治疗主要采用“自上而下”（如心理教育）干预。本研究的目的是评估在AS心理教育干预中加入“自下而上”（解释偏见修正；CBM-I）干预的效果。设计：单点随机对照试验。参与者完成了1)心理教育+主动CBM-I或2)心理教育+控制CBM-I干预。在干预后和一个月的随访中评估AS的变化。参与者：AS水平升高的个体。干预：针对AS的单次计算机干预。结果：考虑基线ASI-3评分，干预后联合组ASI-3评分显著低于心理教育+对照cbm - 1组（beta = 0.24, p < 0.05; d = 0.99）。积极的CBM-I +心理教育AS干预成功地降低了整体AS（干预后59%，p < 0.05, Cohen’s d = 0.99），并且这些降低在干预后一个月保持不变（52%,p < 0.05, Cohen’s d = 1.18）。活跃状态的参与者报告说，对生命容量二氧化碳挑战的恐慌反应率明显较低（OR = 6.34, 95% CI = 1.07 -37.66）。最后，解释偏差的改变显著调节了治疗条件与治疗后AS降低之间的关系。结论：目前的干预措施在立即和一个月的AS减少方面是有效的。鉴于其简洁性、低成本、低耻辱感和便携性，这种干预可能会减少焦虑症的负担。(C) 2016 Elsevier Ltd.版权所有。
Objective: Anxiety disorders contribute substantially to the overall public health burden. Anxiety sensitivity (AS), a fear of anxiety-related sensations, is one of the few known malleable risk factors for anxiety pathology. Previous AS reduction treatments have primarily utilized "top-down" (e.g., psycho education) interventions. The goal of the current study was to evaluate the effect of adding a "bottom up" (interpretation bias modification; CBM-I) intervention to an AS psychoeducation intervention.Design: Single-site randomized controlled trial. Participants completed either a 1) Psychoeducation + active CBM-I or 2) Psychoeducation + control CBM-I intervention. Change in AS was assessed post-intervention and at a one-month follow-up.Participants: Individuals with elevated levels of AS.Intervention: Single-session computer-delivered intervention for AS.Results: Accounting for baseline ASI-3 scores, post-intervention ASI-3 scores were significantly lower in the combined condition than in the psychoeducation + control CBM-I condition (beta = 0.24, p < 0.05; d = 0.99). The active CBM-I plus psychoeducation AS intervention was successful in reducing overall AS (59% post-intervention; p < 0.05, Cohen's d = 0.99) and these reductions were maintained through one-month post-intervention (52%; p < 0.05, Cohen's d = 1.18). Participants in the active condition reported significantly lower rates of panic responding to a vital-capacity CO2 challenge (OR = 6.34, 95% CI = 1.07 -37.66). Lastly, change in interpretation bias significantly mediated the relationship between treatment condition and post-treatment AS reductions.Conclusions: The current intervention was efficacious in terms of immediate and one-month AS reductions. Given its brevity, low-cost, low-stigma and portability, this intervention could lead to reducing the burden of anxiety disorders. (C) 2016 Elsevier Ltd. All rights reserved.