Attention Bias Modification Treatment for Pediatric Anxiety Disorders: A Randomized Controlled Trial

Abstract

Objective While attention bias modification (ABM) is a promising novel treatment for anxiety disorders, clinical trial data remain restricted to adults. The authors examined whether ABM induces greater reductions in pediatric anxiety symptoms and symptom severity than multiple control training interventions. Method From a target sample of 186 treatment-seeking children at a hospital-based child anxiety clinic, 40 patients with an ongoing anxiety disorder who met all inclusion criteria were enrolled in the study. Children were randomly assigned to one of three conditions: ABM designed to shift attention away from threat; placebo attention training using stimuli identical to those in the ABM condition; and placebo attention training using only neutral stimuli. All participants completed four weekly 480-trial sessions (1,920 total trials). Before and after the attention training sessions, children’s clinical status was determined via semistructured interviews and questionnaires. Reduction in the number of anxiety symptoms and their severity was compared across the three groups. Results Change in the number of anxiety symptoms and their severity differed across the three conditions. This reflected significant reductions in the number of anxiety symptoms and symptom severity in the ABM condition but not in the placebo attention training or placebo-neutral condition. Conclusions ABM, compared with two control conditions, reduces pediatric anxiety symptoms and severity. Further study of efficacy and underlying mechanisms is warranted.

Biased attentional processing of food cues and modification in obese individuals.

“…Future research will need to determine whether effects of attentional re-training to food cues can also be obtained outside the laboratory. For example, home-based delivery of attentional bias modification via the internet has already been trialled in the field of anxiety (Eldar et al, 2012;See, MacLeod & Bridle, 2009). Second, the effects of attentional re-training on biased processing and word stem completions were assessed immediately after training.…”

Affect-biased attention as emotion regulation

“…Moreover, recent research has extended ABM training to anxiety reduction in children, as well. In a recent randomized control trial, clinically anxious children who demonstrated attention biases for threat were either assigned to an ABM condition or one of two control conditions [64]. After four training sessions over four weeks, only the children in the ABM condition showed reduced attentional biases and anxiety symptoms as measured in both clinician interviews and on a DSM-IV anxiety severity scale measured in a post-treatment session.…”

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

“…Some of these interventions have been configured to modify processing biases that favour negative emotional information (cf., MacLeod & Clarke, 2015;Lowther & Newman, 2014), for example by training children and young people to shift attention away from environmental threat (e.g. Bar-Haim, Morag, & Glickman, 2011), or to move attention towards positive stimuli (e.g., Eldar et al, 2012). 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).…”