Training-associated changes and stability of attention bias in youth: Implications for Attention Bias Modification Treatment for pediatric anxiety

Abstract

Attention Bias Modification Treatment (ABMT), an emerging treatment for anxiety disorders, is thought to modify underlying, stable patterns of attention. Therefore, ABMT research should take into account the impact of attention bias stability on attention training response, especially in pediatric populations. ABMT research typically relies on the dot-probe task, where individuals detect a probe following an emotional-neutral stimulus pair. The current research presents two dot-probe experiments relevant to ABMT and attention-bias stability. In Experiment 1, anxious youth receiving 8-weeks of cognitive-behavioral therapy (CBT) were randomly assigned to ABMT that trains attention towards happy faces (n=18) or placebo (n=18). Two additional comparison groups, anxious youth receiving only CBT (n=17) and healthy comparison youth (n=16), were studied. Active attention training towards happy faces did not augment clinician-rated response to CBT; however, individuals receiving training exhibited reductions on self-report measures of anxiety earlier than individuals receiving CBT only. In Experiment 2, healthy youth (n=12) completed a dot-probe task twice while undergoing functional magnetic resonance imaging. Intra class-correlation demonstrated stability of neural activation in response to attention bias in the ventrolateral prefrontal cortex and amygdala. Together, these two studies investigate the ways in which attention-bias stability may impact future work on ABMT.

Emotional reactivity and executive control: A pathway of risk for the development of childhood worry

“…Efforts to retrain attentional bias have been successful both in laboratory and naturalistic environments (Bar-Haim, 2010;Britton et al, 2013;Kuckertz et al, 2014), and our results lend support for further efforts to decrease worry symptoms in children through the use of attentional training therapies.…”

The effectiveness of an attention bias modification program as an adjunctive treatment for Post-Traumatic Stress Disorder

“…We did not exclude participants on the basis of prior treatment stability, psychiatric comorbidity (e.g., substance dependence), etc. While two recent studies have not yielded incremental effects resulting from ABM administered in combination with ABT, both studies administered highly standardized and specific forms of CBT in the context of an outpatient research setting utilizing specific inclusion and exclusion criteria (Britton et al, 2013; Rapee et al, 2013). Thus, individuals in these studies with relatively uncomplicated diagnostic and treatment profiles may have benefited from ceiling effects of CBT.…”

“…Several research studies have examined whether ABM results in anxiety reductions over and above the effects of CBT alone (Britton et al, 2013; Rapee et al, 2013; Riemann, Kuckertz, Rozenman, Weersing, & Amir, 2013). One of these studies (Riemann et al, 2013) supported the use of ABM as an adjunctive treatment, while two did not (Britton et al, 2013; Rapee et al, 2013). Both studies that did not find an augmentation effect of ABM were conducted in the context of a research based laboratory setting using highly structured, standardized, and well-monitored provision of CBT.…”

Empirical Examination of the Potential Adverse Psychological Effects Associated with Pediatric fMRI Scanning

“…Then, all subjects performed an fMRI task used in one of our research protocols, which are generally designed to elicit some level of fear response. A range of techniques was employed, from fear conditioning and extinction tasks (Britton et al 2012) to exposure tasks using threatening faces and contexts ( Jarcho et al 2013), with some tasks involving negative and positive feedback (Guyer et al 2006). Immediately after scanning, subjects were asked to rate their emotional response to the fMRI experience, and their level of anxiety.…”