Attention Bias Modification Training in Youth with Subthreshold Impairing Anxiety

阈下损害性焦虑青少年的注意力偏差修正训练

• 批准号: 8702287
• 负责人: JEREMY W PETTIT
• 金额: $ 23.16万
• 依托单位: FLORIDA INTERNATIONAL UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-07-15 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8702287
• 关键词: Address; Adolescent; Affect; Aftercare; Age; Amygdaloid structure; Anxiety; Anxiety Disorders; Attention; Behavioral Research; Caring; Child; Clinic; Cognitive Therapy; Computer Assisted; DSM-IV; Data; Development; Diagnosis; Diagnostic; Diagnostic and Statistical Manual of Mental Disorders; Disease; Distress; Dose; E-learning; Economics; Enrollment; Evaluation; Evidence based intervention; Face; Hand; Healthcare Systems; Impairment; Intervention; Intervention Studies; Investments; Knowledge; Maintenance; Measures; Mediating; Mediator of activation protein; Mental Health Services; Modification; Neurosciences; Neurosciences Research; Online Systems; Parents; Participant; Patients; Phobic anxiety disorder; Placebo Control; Plant Roots; Positioning Attribute; Preventive Intervention; Process; Randomized; Research; Resources; Services; Severities; Stimulus; Symptoms; Syndrome; Testing; Training; Youth; base; cost; dosage; experience; follow-up; health care delivery; high risk; insight; lens; meetings; novel; primary outcome; programs; public health relevance; research study; response; secondary outcome

Project Summary This application proposes to 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 DSM 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. ABMT is a novel translational treatment for anxiety based on experimental and neuroscience research findings on attention processes. Research demonstrates that ABMT leads to reductions in anxiety and its disorders. ABMT holds promise as a potential least restrictive treatment for SubImpAnx because (a) youth with SubImpAnx display an attention bias toward threatening stimuli, (b) ABMT is brief, inexpensive, and highly portable, and (c) ABMT does not require skilled clinicians. 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.'

项目概要 该应用程序建议收集有关注意力偏差修正训练（ABMT）的初步数据 诊所转诊的表现出阈下损害性焦虑的儿童和青少年（SubImpAnx；焦虑和 不符合 DSM 焦虑症标准的相关障碍）。传统的心理方法 卫生服务提供无法满足当前需求。传统服务提供的不足之处是 当通过受损但未确诊的年轻人的镜头观察时，这一问题被放大了。这是一个尚未解决的经验问题 质疑限制最少的治疗是否可以有效减少青少年的 SubImpAnx。实证努力 解决这个问题很重要，因为患有 SubImpAnx 的青少年会经历严重的障碍， 升级为全面综合症焦虑症的风险很高，并对医疗保健系统造成负担。 ABMT 是一种基于实验和神经科学研究的新型焦虑转化疗法 关于注意力过程的发现。研究表明 ABMT 可以减少焦虑及其影响 失调。 ABMT 有望成为 SubImpAnx 的潜在限制最少的治疗方法，因为 (a) 患有以下疾病的青少年 SubImpAnx 显示出对威胁性刺激的注意力偏向，(b) ABMT 简短、廉价且高度有效 便携式，(c) ABMT 不需要熟练的临床医生。 本研究将招募 66 名临床转介的符合标准的儿童和青少年（8-16 岁） SubImpAnx。参与者将被随机分配完成 8 节 ABMT 或安慰剂课程 4 周以上的控制（PC）任务。临床医生对青少年焦虑严重程度和损害的评级将评估为 主要结果。青少年自我评价和家长对青少年焦虑症状和障碍的评价将 评估为次要结果。所有测量值将在条件分配（预处理）之前收集， 治疗后立即进行，并在 8 周随访时进行。此外，还将收集初始数据以阐明 追求（a）对威胁的注意偏差作为 ABMT 焦虑减轻的中介是否有用 (b) 在随后的更大规模研究中与 ABMT 的焦虑减轻效果相关的剂量反应问题。 具体目标是： 收集关于 ABMT 和 PC 任务对焦虑和焦虑水平影响的试点数据。 事后评估（目标 1）和事后评估 8 周后的后续 (FU) 评估中的损伤 （目标 2）；初步检验 ABMT 是否会降低对威胁性刺激的注意偏向 与术后和 8 周 FU 时的 PC 任务相比（目标 3）；描述焦虑症状的过程以及 青年人在 ABMT 条件下治疗期间的损伤（目标 4）。 该项目将通过 SubImpAnx 为青少年提供急需的 ABMT 试点数据。有了这些数据 另一方面，该领域将能够更好地确定 ABMT 是否可以用作限制最少的 对“受到损害但未经诊断”的焦虑青少年进行干预。