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.'

项目摘要 本申请旨在收集关于注意偏差修正训练（ABMT）的初步数据， 临床转诊的表现出阈下损害性焦虑（SubImpAnx;焦虑& 不符合焦虑症的DSM标准的相关损害）。传统的心理治疗方法 保健服务的提供无法满足目前的需求。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透镜来观察时，它被放大了。这是一个未解决的经验 问题是，限制性最小的治疗是否能有效减少青年SubImpAnx。经验性努力， 解决这个问题很重要，因为SubImpAnx的青少年经历了严重的损伤， 升级为全面综合征焦虑症的风险很高，并对卫生保健系统造成负担。 ABMT是一种基于实验和神经科学研究的新型焦虑转化治疗方法 注意力过程的发现。研究表明，ABMT导致减少焦虑， 紊乱ABMT有望成为SubImpAnx潜在的限制性最小的治疗方法，因为（a） SubImpAnx显示对威胁性刺激的注意偏向。（B）ABMT是短暂的，廉价的，高度 便携式，和（c）ABMT不需要熟练的临床医生。 本研究将入组66名符合以下标准的门诊转诊儿童和青少年（8 - 16岁）： SubImpAnx。受试者将被随机分配完成8次ABMT或安慰剂治疗 对照组（PC组）4周。临床医生对青少年焦虑严重程度和损伤的评级将被评估为 主要成果。青少年自我评分和家长评分的青少年焦虑症状和损害将 作为次要结局进行评价。将在条件分配（预处理）前收集所有测量值， 在治疗后即刻和8周随访时。此外，还将收集初步数据， 是否有必要探讨（a）对威胁的注意偏向作为ABMT焦虑减少的中介因素 效应和（B）在随后的更大的研究中与ABMT的焦虑减少效应相关的剂量反应问题。 具体目标是：收集ABMT和PC任务对焦虑水平影响的试验数据， 评估后（目标1）和评估后8周随访（FU）评估时的损伤 (Aim 2）;初步检验ABMT是否导致对威胁性刺激的较低水平的注意偏向 与术后和8周随访时的PC任务（目标3）相比;描述焦虑症状的病程， 在ABMT条件下青年治疗期间的损害（目标4）。 该项目将为SubImpAnx的青年提供急需的ABMT试验数据。有了这些数据 另一方面，该领域将处于更有利的地位，以确定ABMT是否可以用作限制性最小的一种方法。 对"受损但未确诊"的焦虑青年进行干预。'