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. 2010 Feb;51(2):162-72.
doi: 10.1111/j.1469-7610.2009.02143.x. Epub 2009 Sep 10.

CBT for childhood anxiety disorders: differential changes in selective attention between treatment responders and non-responders

Jeroen S Legerstee  1 , Joke H M Tulen, Bram Dierckx, Philip D A Treffers, Frank C Verhulst, Elisabeth M W J Utens
Affiliations

CBT for childhood anxiety disorders: differential changes in selective attention between treatment responders and non-responders

Jeroen S Legerstee et al. J Child Psychol Psychiatry. 2010 Feb.

Abstract

Background: This study examined whether treatment response to stepped-care cognitive-behavioural treatment (CBT) is associated with changes in threat-related selective attention and its specific components in a large clinical sample of anxiety-disordered children.

Methods: Ninety-one children with an anxiety disorder were included in the present study. Children received a standardized stepped-care CBT. Three treatment response groups were distinguished: initial responders (anxiety disorder free after phase one: child-focused CBT), secondary responders (anxiety disorder free after phase two: child-parent-focused CBT), and treatment non-responders. Treatment response was determined using a semi-structured clinical interview. Children performed a pictorial dot-probe task before and after stepped-care CBT (i.e., before phase one and after phase two CBT).

Results: Changes in selective attention to severely threatening pictures, but not to mildly threatening pictures, were significantly associated with treatment success. At pre-treatment assessment, initial responders selectively attended away from severely threatening pictures, whereas secondary responders selectively attended toward severely threatening pictures. After stepped-care CBT, initial and secondary responders did not show any selectivity in the attentional processing of severely threatening pictures. Treatment non-responders did not show any changes in selective attention due to CBT.

Conclusions: Initial and secondary treatment responders showed a reduction of their predisposition to selectively attend away or toward severely threatening pictures, respectively. Treatment non-responders did not show any changes in selective attention. The pictorial dot-probe task can be considered a potentially valuable tool in assigning children to appropriate treatment formats as well as for monitoring changes in selective attention during the course of CBT.

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