Development and Testing of a Cognitive Bias Protocol for Dental Fear and Anxiety

描述(由申请人提供)：由于焦虑而避免常规的牙科护理，导致许多美国人只有在疼痛时才寻求牙科治疗。这种以症状为导向的治疗加剧了人们对牙科的恐惧和回避，并导致整体口腔和一般健康状况恶化。一种令人兴奋的新心理学方法已经被开发出来，以减少恐惧，基于一项公认的观察，即焦虑的人处理关于恐惧刺激的信息的方式与非焦虑的人不同。人们开发了一种认知偏差修正(CBM)来修正焦虑个体的注意偏差，从而使他们学会将注意力从情绪上的负面/威胁上转移开 刺激，导致有意义的减少焦虑。在我们团队试点工作的基础上，该应用程序有两个具体目标，这是开发CBM治疗干预措施以减少牙科焦虑的关键下一步。具体目标1的主要目的是确定对恐吓性牙科词汇有强烈注意偏见的个体是否比没有注意偏见的个体更害怕。此外，一系列焦虑和牙科恐惧调查项目将被用来创建一个简短的筛查工具，以预测哪些人具有最大的注意力偏向。在这两项研究中，注意偏向都是使用由Project Implative(R)主持的点探针式注意偏向任务来评估。在这项任务中，“威胁性的牙齿”/“非牙齿的，非威胁性的”单词对在计算机屏幕上被简单地呈现，一个单词在另一个单词的上方。当这些单词消失时，探头立即取代牙科或非牙科单词，并要求受试者使用特定的按键快速识别探头。先前的研究表明，与不焦虑的人相比，焦虑的人在识别出现在与恐惧相关的威胁词所在位置的探测器时反应更快，而当探测器取代中性词时反应更慢。威胁偏向指数(TBI)提供了一个衡量个体注意偏向的指标，其计算方法是用代替牙科威胁相关词语的探针的中位反应时间减去代替中性对照词语的探针的中位反应时间。从这两个特定目标获得的结果将为NIH应用临床研究测试CBM治疗提供先导数据。 牙科焦虑症电池。

DESCRIPTION (provided by applicant): Avoidance of regular dental care due to anxiety causes many in the United States to seek dental treatment only when in pain. This symptom-driven treatment reinforces the fear and avoidance of dentistry and leads to a worsening of overall oral and general health. An exciting new psychological approach has been developed to reduce fear, based on the well-established observation that anxious individuals process information about feared stimuli differently from non-anxious individuals. A type of Cognitive Bias Modification (CBM) has been developed to modify the attentional bias of anxious individuals so that they learn to direct their attention away from emotionally negative/threatening stimuli, resulting in a meaningful reduction in anxiety. Building on pilot work by our group, this application has 2 specific aims that are the critical next steps in the development of a CBM therapeutic intervention to reduce dental anxiety. The primary goal of Specific Aim 1 is to determine whether individuals who have a strong attentional bias toward threatening dental words are more fearful than those without an attentional bias. In addition, a battery of anxiety and dental fear survey items will be used to create a brief screening tool to predict which individuals have the greatest attentional bias. The goal of Specific Aim 2 is to use a separate sample to validate the ability of the screening tool to predict attentional bias using a refined attentional task based on the results of Specific Aim 1. In both studies, attentional bias will be assessed using a dot-probe attentional bias task, hosted by Project Implicit(R). In this task, the "threatening dental" / "non- dental, non-threatening" word pairs are presented briefly on a computer screen, vertically with one word above the other. When the words disappear, a probe immediately replaces either the dental or non-dental word and subjects are asked to rapidly identify the probe using a specific keystroke. Prior research has shown that compared to non-anxious individuals, those with anxiety respond more quickly when identifying a probe that appears in the location of the fear-related threatening word and more slowly when the probe replaces the neutral word. The threat bias index (TBI) provides a measure of an individual's attentional bias and will be calculated by subtracting the median response times for probes presented in place of the dental threat-related words from the median response times for probes presented in place of the neutral control words. The results obtained from these 2 specific aims will provide pilot data for an NIH application for a clinical investigation to test a CBM treatment battery for dental anxiety.