Attention Bias Modification Treatment for children with anxiety disorders who do not respond to cognitive behavioral therapy: a case series

Bechor, Michele; Pettit, Jeremy W.; Silverman, Wendy K.; Bar‐Haim, Yair; Abend, Rany; Pine, Daniel S.; Vasey, Michael W.; Jaccard, James

doi:10.1016/j.janxdis.2013.09.001

Cited by 46 publications

(29 citation statements)

References 41 publications

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“…This limitation compromises confident conclusions concerning attentional change in two case study series. Bechor et al (2014) carried out one of these using only 6 clinically anxious children, aged 10 to 13 years. Children were given the avoid-threat ABM procedure used by Amir, Beard, Taylor, et al (2009), and across the 4-week period mean reduction on all the self-report measures of anxiety was significant.…”

Section: Impact Of Extended Abm On Anxiety When Its Impact On Attentimentioning

confidence: 99%

The Attentional Bias Modification Approach to Anxiety Intervention

MacLeod

Clarke

2015

Clinical Psychological Science

283

207

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Anxiety vulnerability and dysfunction are characterized by an attentional bias to threat. Cognitive training procedures designed to modify selective attentional responding to threat originally were developed to test the hypothesis that this attentional bias causally contributes to anxious disposition. The capacity of attentional bias modification (ABM) training to alleviate dysfunctional anxiety has since attracted growing interest, and the present article reviews studies that have evaluated this therapeutic potential. When intended ABM training has successfully reduced attention to threat, it also has reduced anxiety vulnerability and symptomatology with a high degree of reliability. When the delivery of intended ABM training has not resulted in such anxiety reduction, this typically has reflected the failure to successfully modify attentional selectivity as required. We discuss ways in which ABM training procedures may be refined to optimize their capacity to reduce attentional bias to threat, to improve delivery of the resulting anxiolytic benefits.

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Section: Impact Of Extended Abm On Anxiety When Its Impact On Attentimentioning

confidence: 99%

The Attentional Bias Modification Approach to Anxiety Intervention

MacLeod

Clarke

2015

Clinical Psychological Science

283

207

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“…Other interventions instead have been configured to enhance attentional control (e.g., Roughan & Hadwin, 2011;Hadwin & Richards, 2016; see also Owens, Koster & Derakshan, 2013;Sari, Koster, Pourtois & Derakshan, 2015 for similar work with adult populations). Researchers have demonstrated that interventions designed to directly alter attentional functioning can serve as a positive adjunct to more traditional CBT interventions for anxiety reduction in individuals who experience elevated anxious affect and who demonstrate associated attentional difficulties (Schechner et al, 2014), and may be useful for children and young people who do not show positive outcomes following conventional CBT (e.g., Bechor et al, 2014).…”

Section: Translational Implicationsmentioning

confidence: 99%

Introduction to the Special Issue: Understanding the Role of Attentional Control in the Development of Anxiety in Childhood, Adolescence and across the Lifespan

Hadwin

Visu‐Petra

Muris³

et al. 2016

Journal of Experimental Psychopathology

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Anxiety is characterised by a distinctive emotional, cognitive and behavioural symptomatology. The central emotional symptoms are fear and apprehension, often evoked by the occurrence or anticipation of specific types of situations; the primary cognitive symptoms are negative thoughts and worries concerning the uncertainties and potential threats associated with such situations; and the main behavioural symptom is avoidance or attempted avoidance of these situations (Grills, Seligman & Ollendick, 2014). People differ in terms of the degree to which they are inclined to experience anxiety, which reflects a temperamental dimension known as trait anxiety. Trait anxiety is defined as a general and stable predisposition to experience worries and concerns across different contexts, and its presence increases current and transient feelings of state anxiety in the context of or expectation of threat (Gidron, 2013). Higher levels of trait anxiety are associated with intolerance of uncertainty, which reflects a preference for certainty and increased engagement in behaviours linked to the management and avoidance of situations that are unpredictable or ambiguous (Birrell, Meares, Wilkinson & Freeston, 2011; Chen & Lovibond, 2016). Individual differences in the disposition to experience anxiety are evident from early childhood, when elevated anxiety vulnerability typically manifests as behavioural inhibition (BI). Children with high levels of BI display negative reactions to novelty, heightened sensitivity to stimulus variations and withdrawal from social situations, which can result in peer rejection and reduced assertiveness (Fox & Pine, 2012). Early manifestations of heightened dispositional anxiety predict an increased tendency to experience problematic levels of anxiety in adolescence (Fox, Henderson, Marshall, Nichols & Ghera, 2005). In addition, longitudinal evidence supports multifactorial models in which anxious rearing and parental trait anxiety play a major role in the development

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“…First, it is brief, with the modal treatment course spanning four weeks with two 15-minute sessions per week. Second, it is portable and can be administered in clinics or using combinations of clinic based and home based administrations (Bechor et al, 2014; Eldar et al, 2012; Pergamin-Hight, Pine, Fox, & Bar-Haim, 2016; Rozenman, Weersing, & Amir, 2011). Third, it allows for efficient use of provider time and resources because the computer-based program does not require skilled clinicians.…”

Section: Introductionmentioning

confidence: 99%

“…Finally, it shows promising anxiety reduction effects in youth with anxiety disorders. In open trials (Bechor et al, 2014; Cowart & Ollendick, 2011; Rozenman et al, 2011) and randomized controlled trials (Eldar et al, 2012; Pergamin-Hight et al, 2016) using samples of youth with anxiety disorders, ABM has resulted in statistically significant reductions in anxiety symptoms (for reviews, see Lowther & Newman, 2014; Price et al, 2016). …”

Section: Introductionmentioning

confidence: 99%

Can less be more? Open trial of a stepped care approach for child and adolescent anxiety disorders

Pettit

Rey

Bechor

et al. 2017

Journal of Anxiety Disorders

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This open trial presents a stepped care treatment approach for youths with anxiety disorders. In Step 1, 124 youths (65 girls; M age=9.7 years) participated in a low intensity computer administered attention bias modification (ABM) protocol. Statistically significant reductions in youth anxiety severity were found following Step 1. Youths and parents were then given the option to not continue with further treatment or step up to a higher intensity cognitive behavioral therapy (CBT) protocol (Step 2). Of 112 youths who completed Step 1, 67 (59.8%) discontinued treatment and 45 (40.2%) stepped up. Co-occurring ADHD and higher anxiety severity at baseline were significantly associated with the decision to step up. Of those youths who completed Step 2, additional statistically significant reductions in youth anxiety severity were found. Across the entire protocol, 68.6% of youths were rated as either very much improved or much improved on the Clinical Global Impressions-Improvement scale. In a hypothetical comparison in which all youths received CBT alone, the stepped care protocol resulted in approximately 50% less time in treatment sessions. These findings support the promise of initiating youth anxiety disorder treatment with low intensity treatment and then stepping up to higher intensity treatment as needed.

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Attention Bias Modification Treatment for children with anxiety disorders who do not respond to cognitive behavioral therapy: a case series

Cited by 46 publications

References 41 publications

The Attentional Bias Modification Approach to Anxiety Intervention

The Attentional Bias Modification Approach to Anxiety Intervention

Introduction to the Special Issue: Understanding the Role of Attentional Control in the Development of Anxiety in Childhood, Adolescence and across the Lifespan

Can less be more? Open trial of a stepped care approach for child and adolescent anxiety disorders

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