Pooled patient-level meta-analysis of children and adults completing a computer-based anxiety intervention targeting attentional bias.
Pooled patient-level meta-analysis of children and adults completing a computer-based anxiety intervention targeting attentional bias.
复制标题
对完成针对注意力偏差的基于计算机的焦虑干预的儿童和成人进行汇总患者水平荟萃分析。
DOI：
10.1016/j.cpr.2016.09.009
复制
发表时间：
2016-12
影响因子：
12.8
通讯作者：
Bar-Haim, Yair
中科院分区：
文献类型：
--
作者：
Price, Rebecca B.;Wallace, Meredith;Kuckertz, Jennie M.;Amir, Nader;Graur, Simona;Cummings, Logan;Popa, Paul;Carlbring, Per;Bar-Haim, Yair
关键词：
基于计算机的方法，如注意力偏差修正（ABM），可以帮助改善对焦虑的护理。ABM的研究水平荟萃分析产生了相互矛盾的结果，并留下了关于ABM的作用机制和临床潜力的关键问题尚未解决。我们汇总了来自儿童和成人高焦虑随机对照试验的患者水平数据集。对威胁的注意偏向（AB），ABM的目标机制，被测试作为一个结果和机制的中介和调节焦虑减少。诊断缓解和Liebowitz社交焦虑量表（LSAS）是足够多的研究中可用的临床结局，可进行汇总。从13/16项合格研究[86%的合格受试者; n=778]中获得了至少一项结局的每例患者数据。观察到ABM对诊断缓解（ABM-22.6%，对照-10.8%; OR=2.57; p= 0.006）和AB（β*（95%CI）=-0.63（-0.83，-0.42）; p<0.00005）的显著主效应。ABM对LSAS无主效应。然而，主持人分析表明，ABM对年轻（≤ 37岁）、在实验室接受过培训和/或由临床医生评估的患者有效。在同样的条件下，ABM是有效的，AB和焦虑减少之间的机械联系的支持。在这些特定情况下，ABM通过其靶向机制减少焦虑并发挥作用，支持ABM的理论基础，同时提出临床适应症和改进措施，以改善其目前有限的临床潜力。
Computer-based approaches, such as Attention Bias Modification (ABM), could help improve access to care for anxiety. Study-level meta-analyses of ABM have produced conflicting findings and leave critical questions unresolved regarding ABM’s mechanisms of action and clinical potential. We pooled patient-level datasets from randomized controlled trials of children and adults with high-anxiety. Attentional bias (AB) towards threat, the target mechanism of ABM, was tested as an outcome and a mechanistic mediator and moderator of anxiety reduction. Diagnostic remission and Liebowitz Social Anxiety Scale (LSAS) were clinical outcomes available in enough studies to enable pooling. Per-patient data were obtained on at least one outcome from 13/16 eligible studies [86% of eligible participants; n=778]. Significant main effects of ABM on diagnostic remission (ABM—22.6%, control—10.8%; OR=2.57; p=.006) and AB (β*(95%CI)=−.63(−.83, −.42); p<.00005) were observed. There was no main effect of ABM on LSAS. However, moderator analyses suggested ABM was effective for patients who were younger (≤37y), trained in the lab, and/or assessed by clinicians. Under the same conditions where ABM was effective, mechanistic links between AB and anxiety reduction were supported. Under these specific circumstances, ABM reduces anxiety and acts through its target mechanism, supporting ABM’s theoretical basis while simultaneously suggesting clinical indications and refinements to improve its currently limited clinical potential.
登录
查看更多内容
影响因子：
6.9
作者：
Fresco, DM;Coles, ME;Goetz, D
通讯作者：
Goetz, D
影响因子：
10.6
作者：
Hakamata, Yuko;Lissek, Shmuel;Bar-Haim, Yair;Britton, Jennifer C.;Fox, Nathan A.;Leibenluft, Ellen;Ernst, Monique;Pine, Daniel S.
通讯作者：
Pine, Daniel S.
影响因子：
3.7
作者：
Boettcher J;Leek L;Matson L;Holmes EA;Browning M;MacLeod C;Andersson G;Carlbring P
通讯作者：
Carlbring P
影响因子：
3.7
作者：
Beard C;Sawyer AT;Hofmann SG
通讯作者：
Hofmann SG
影响因子：
5.3
作者：
Greenberg, PE;Sisitsky, T;Fyer, AJ
通讯作者：
Fyer, AJ